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|Stable housing and supportive services are critical to help people experiencing homelessness move toward recovery.|
Homelessness and health concerns often go hand in hand. An acute behavioral health issue, such as an episode of psychosis, may lead to homelessness, and homelessness itself can exacerbate chronic medical conditions or lead to debilitating substance abuse problems. At the most extreme, a person can become chronically homeless when his or her health condition becomes disabling and stable housing is too difficult to maintain without help.
People living in shelters are more than twice as likely to have a disability, according to the Department of Housing and Urban Development. On a given night in 2012, nearly 40 percent of the homeless population had serious mental illness or conditions related to chronic substance abuse. Thousands of people with HIV/AIDS experience homelessness on a given night. Half of veterans in shelters are disabled.
Medical conditions such as diabetes and heart disease are also found at high rates among the homeless population, in addition to injury and physical ailments from living outdoors. Many people experiencing homelessness have also experienced trauma, either resulting from homelessness or in some way leading to it. Behavioral health issues and trauma are found disproportionately among unaccompanied youth who are homeless.
Treatment and preventive care can be difficult for homeless people to access, because they often lack insurance coverage, or are unable to engage health care providers in the community. This lack of access can lead a homeless individual to seek medical care only once his or her condition has worsened to the point that a trip to the emergency room is unavoidable.
The extent of health conditions and disability should be considered when designing effective, efficient strategies to end homelessness. For chronically homeless people, permanent supportive housing provides stable housing coupled with supportive services as needed – a cost-effective solution to homelessness for those with the most severe health, mental health, and substance abuse challenges.