Homelessness and Mental Health: Moving Past Stereotypes

written by Lisa Stand
May 6, 2013

Many people automatically associate homelessness with mental illness, based on stereotypes of men and women on city streets, disheveled and talking to themselves. In fact, certain groups of people experiencing homelessness do live with severe mental health conditions, though this is not true of all homeless people. With May being Mental Health Awareness Month, this is a good time to take a look at the connection between homelessness and mental illness.

Of the 633,800 people who were homeless on any given night in 2012, about 99,900 people (or 18 percent) could be described as severely mentally ill. Many are chronically homeless, meaning they have been without homes for a long time or have experienced multiple episodes of homelessness. Their mental conditions make it impossible for them to remain stably housed for long without intensive help. The consensus in the homeless assistance field is that best way to help them is by providing permanent supportive housing.

That’s not the entire story, however. Anyone experiencing homelessness, for any reason, may confront challenging conditions like depression, anxiety, or addiction. They also may experience trauma. An episode of trauma might have caused their homelessness, or might actually have resulted from a homeless episode. Often, the most effective way to help these people is a limited but realistic amount of aid, including housing and voluntary short-term services to support their continued stability. This is known as rapid re-housing.

For many of the most vulnerable people, access to proper mental health care services, including preventive care, can help them avoid or escape homelessness for good. A recent study of health reform in Oregon, the Oregon Health Insurance Study, showed that people who obtained Medicaid coverage were better able to access health care services and, as a result, suffered less from depression and had fewer financial worries.

One promising new source of funding is the Affordable Care Act (ACA) of 2010, which offers increased Medicaid coverage for mental health and substance abuse services. If all states implement the Medicaid expansion, the lives of millions of low-income adults with mental illness and substance-related conditions could be improved. If you’re interested in learning more about the impact of the ACA on homelessness, visit the Health Care page of the Alliance website.

Providing housing and services tailored to meet the needs of individuals who suffer from mental health conditions takes commitment and cooperation at all levels. And while mental health treatments and trauma-informed support are crucial, the most important service for all people experiencing homelessness is the one that offers a permanent place to live. This is the basic principle of Housing First, which recognizes that, for people to recover and reach independence, they must be stably housed first.

That’s what we at the Alliance, and advocates, service providers and officials around the country are working so hard to accomplish.

Image “Homeless and Cold” courtesy of Ed Yourdon’s photostream.