Bedlam on the Streets

Caroline Knowles with photography by Ludovic Dabert.

Routledge

£16.99

ISBN 0 415 23299 6

This account of homelessness as lived by people discharged from
mental hospitals in Montreal is a document of our time. It arose
from a study of the interaction of race and ethnicity in the lives
of people receiving community psychiatry in an urban area. The
conditions the researchers found caused them to expand their work
to encompass all aspects of the lives of people who might formerly
have lived in large asylums. Knowles suggests that these people are
paying part of the cost of economic progress.

Her team interviewed 60 people living on the streets, in
shelters and soup kitchens, and in the adult foster homes that are
the controlling equivalent of our small residential care homes.
They also interviewed 43 workers in these settings, mostly people
such as soup servers and foster home providers rather than mental
health workers.

One of the interesting aspects of this study is the presence of
an elite of people who are well served by community psychiatry, who
are used by city and government to illustrate that all is well in
community mental health services. One strength of this book is this
conjunction of government rhetoric, policy and administrative
arrangements with the details of the conditions experienced by
people who are invisible in official accounts.

It is impossible to know how similar North American conditions
are to the situation in UK cities. The background of burger bars
and shopping malls is familiar, and readers of The Big
Issue will recognise some of the circumstances people
encounter.

Unusually, this account is illustrated by respectful photographs
which add an extra dimension. It is an academic study so not a
quick read, but nonetheless a page-turner for anyone concerned
about social exclusion as it is experienced.

Vivien Lindow is a mental health researcher and consultant,
working from the perspective of a former long-term mental health
service user