How to Help

Another heart-rending request came in today. Because I am on so many referral sites on-line, I get phone calls or e-mails all the time, and sometimes I can help. Aaaand sometimes not. (There ain't that many therapists providing out-patient mental health for low- or no-income clients, folks!) Since I am not eligible for Medicare or Medicaid, I offer a sliding-scale fee, but even there many can't afford the minimum on that scale.
So, occasionally, I do therapy pro bono, which means I don't charge at all. Uh, very occasionally! But there are those I wish I could help, and just can't afford to.
I went into this line of work so I could be there for people at their point of greatest need. And I learned very quickly that, besides those whom I am just not capable of helping, there are those whose need is so great, or those who don't really want to be helped, as well as those who very problem prevents them from accepting the help they need (like a question preventing its own answer)!
So when this woman writes for help for someone who has been refused disability, has no income, can't drive, my human response is I want to help! Then I take a step back, calm my breathing, and know that (1)this person has more needs  than I could handle, (2) the cost would be too much, (3) it was the friend who contacted me, and that disabled person needs to be the one to show enough commitment to call me himself.
Okay, okay, I come across as callous, even to me. And the money should not be that big a deal. Although, in our society today, we tend to measure worth by cost: anything that's free is worth every penny!
But then the bigger picture hits me: why is the need for mental health coverage so lousy for those who have only Medicare or Medicaid, or even nothing at all? Those much-maligned street people wandering downtown, carrying on conversations with themselves, are there because they are given vestigial care consisting of fifteen minutes every couple of months to renew their prescription for meds they may or may not be taking.
No, I have no answers to that question, either. I do my little best, but sometimes I feel as though I were trying to bail out the ocean with a teaspoon.
Maybe we are looking at a tectonic shift in perception of people in need. Excuse me while I give a cynical scoff.