As a general hospital psychiatric consultant, I’m rarely asked to see those patients who are admitted after some kind of accident that seems to result from what may be an alternate way of life…the life of a hobo. Sometimes the reason for hospitalization are injuries sustained from falling off a railroad car because riding the rails is a convenient if dangerous mode of travel. My colleagues who request consultation are often enough driven by a humanitarian motive to help people who ride the rails all over the country in an apparent wanderlust that looks aimless and odd to those who live in the mainstream. When I try to run a literature search on PubMed on the term “hobo”, I come up with nothing. However, homelessness, a necessary but maybe not a sufficient condition for being a hobo, is associated with psychiatric illness, including but not limited to depression.
When I talk with someone who identifies himself as a hobo (they are often males), they talk about their way of life as a choice. They may criticize the conventional culture of the 9 to 5 desk job and a stable residence. They’re usually politely accepting of my visit, even though they don’t think they’re “crazy”. Once when I happened to mention the Hobo Convention held annually in Britt, Iowa (for which the city budgets as much as $20,000), to one of them, he didn’t have much of anything complimentary to say about it. As one of them put it, a hobo rides the rails to find work in which to earn money to support a family–which may be a telling comment on our economy as well as a description of a way of life.
Those who identify themselves as hobos are probably not a cohesive group with a consistent set of demographic characteristics. Some of them struggle with mental illness. Or maybe “struggle” is the wrong word. It may be more correct to say we in mainstream society view them as mentally ill because of the inherent unpredictability and danger in the way some of them choose to live. Their situation may be a kind of both/and rather than an either/or. They may have a diagnosable mental illness and may also be making a choice about how they want to pursue happiness in this country.
Some, (maybe even most) hobos may not want anything from conventional psychiatric providers. That doesn’t mean we can’t offer them whatever help we can without judging them, and trying to understand them without stigmatizing them.