Not all homeless people suffer mental illnesses, but they are more likely to develop mental and physical illnesses. Sometimes, people that suffer from mental illnesses will also end up in the homeless population.
Homelessness is a growing problem and effects all of us. Homeless people can come from all walks of life. Some have good families that worry about them. Others may not. We find mentally ill people walking the streets, runaways, and children. We find homeless people living in the streets, in bathrooms, on downtown benches, in tents close to busy traffic lights, in temporary shelters or sleeping on their friend’s couch.
Homelessness is a growing problem both in the United States and globally. Socially, people may be afraid of the homeless population. There are many people that believe that there is something severely psychologically wrong with homeless people. Some cities even criminalize homelessness (CDC, 2020).
Both the homeless population and people with mental illnesses face stigmas and biases that may prevent them from asking for help. It is hard sometimes for someone with a mental illness to get up and go to a doctor. The same is true for a homeless person. People may talk about going to the dentist, but not many people talk about going to see a therapist. Homeless people have a hard time finding their next meal. A trip to the doctor may be hard for them to think about. Mental conditions are something that is not often talked about in public either.
Serious mental illness costs the United States an estimated $193.2 billion in lost earnings annually and only about 41% of persons with a disorder receive any treatment (Shi & Singh, 2019). Homeless people do not have access to medical care and experience higher rates of adverse physical and mental health conditions, suicides, substance abuse, and respiratory diseases. One in two homeless people are without shelter making them susceptible to extreme weather conditions. Many homeless people face depression because of the stigmas that people have about them.
Homeless people will have difficulty qualifying for and receiving public assistance because they have no address or access to communicate with service providers. There is much debate about whether or not treatment first or housing first is the best approach to ending homelessness (State of Homelessness, 2020). Nursing.net posted a study concluding that the treatment first approach gets people with substance abuse problems in treatment first but that the housing first approach costs less (All Answers Ltd., 2018). Personally, I think the housing first approach is not only more cost effective but also a better approach to ending homelessness and the underlying issues that cause it. I feel like the housing first approach is a longer lasting approach that enables homeless people and people with mental illnesses to access medical and mental health services. Someone that is experiencing homelessness or a mental health episode may not be ready to ask for help or accept help right now, but next week or next month they may want help. I just can’t imagine trying to keep a doctor’s appointment if I didn’t know where I was going to sleep or where my next meal was going to come from, so I like the housing first approach.
Most homeless people are men and a large number of them are under the age of 25 (State of Homelessness, 2020). In January 2020, there were 580,466 people experiencing homelessness in America. Most were individuals (70%), and the rest were families with children. They lived in every state and territory, and they reflected the diversity of our country (State of Homelessness, 2020). Specific subpopulations policy makers are concerned with include people in families with children (30%), unaccompanied youth (under age 25, 6%), people experiencing “chronic homelessness” belong to another group that is often singled out for attention (19%), and veterans (6%). (State of Homelessness, 2020).
Risk of becoming homeless is significantly tied to gender, race, and ethnicity. Males are far more likely (70%) to experience homelessness than their female counterparts.
Race is another significant predictor. Marginalized groups are more likely to be disadvantaged within housing and homelessness spheres. Higher unemployment rates, lower incomes, less access to healthcare, and higher incarceration rates are some of the factors likely contributing to higher rates of homelessness among people of color (State of Homelessness, 2020).
Numerically, white people are the largest racial group within homelessness, however, racial groups are far more likely to experience homelessness as a result of segregation and discrimination in employment and housing. Native Hawaiians and other Pacific Islanders have the highest rate of homelessness (109 out of every 10,000 people). Native Americans (45 out of every 10,000) and Black or African Americans (52 out of every 10,000). These rates are much higher than the nation’s overall rate of homelessness (18 out of every 10,000). (State of Homelessness, 2020)
Children are often a priority for homeless services systems. As a result, families with children are least likely to be unsheltered. Runaways and young people not living with their families do not receive the same access to services. It is estimated that unaccompanied youth make up 50% of the homeless youth population and they are unsheltered. 66% of all homeless people live with no shelter at all and often in places that are not meant for human habitation.
Poverty is the highest risks factor that leads to homelessness.
SAMSHA’s national mental health statistics show that yearly, about 42.5 million (18.2%) American adults suffer from some mental illness (Health.am, 2021). Approximately 9.3 million adults (4%) experience severe mental illness that interferes with their daily lives. Nearly half (45%) of those with any mental disorder meet criteria for two or more disorders, with severity strongly related to comorbidity (Health.am, 2021). Mood disorders affect about 20.9 million American adults (9.5%) with the median age being around 30 years old. Suicide rates in Wyoming are the highest in the U.S. while New Jersey has the rates for suicide. Depression, unshakeable feelings of dread, despair, loneliness, and hopelessness seem to be leading signs and causes of suicide. Schizophrenia affects about 2.4 million American adults (1.1%) in any given year (Health.am, 2021). The Pacific Northwest and the Midwest seem to suffer more from mental illness than other regions.
Racial profiling can traumatize people of color making their daily life experience different from Caucasians. Racial and ethnic minorities have less access to mental health services and may not receive the same level of care. Statista shows that as of April 2021, around 25.5% of U.S. black, non-Hispanic public health workers reported having depression in the past 2 weeks, while 32.4% of white, non-Hispanic health workers reported the same. The numbers may not be accurate because other populations are not included in the study and because some people such as homeless people, do not have access to care.
All Answers Ltd. (2018). Comparison of the Housing First and Treatment First Methods of Reducing Homelessness. Retrieved from https://nursinganswers.net/case-studies/comparison-of-the-housing-first-and-treatment-first-methods-of-reducing-homelessness.php?vref=1
CDC, (2020), Homelessness as a Public Health Law Issue, Center for Disease Control, Retrieved From, https://www.cdc.gov/phlp/publications/topic/resources/resources-homelessness.html
Community Solutions, (2021), The Challenge, Homelessness is a problem that’s more costly to ignore than to solve. Homelessness is a complex, life-threatening problem. It can be solved — but only if systems are built to get to zero. Retrieved From, https://community.solutions/the-challenge/
Health.am, (2015), Mental Health Disorder Statistics, http://www.health.am/psy/more/mental-health-disorder-statistics/
Shi, L., & Singh, D. A. (2019). Essentials of the U.S. health care system with access (5th ed.). Burlington, MA: Jones & Bartlett Learning. ISBN: 9781284156720.
State of Homelessness: 2020 Edition, National Alliance to End Homelessness, Retrieved From, https://endhomelessness.org/homelessness-in-america/homelessness-statistics/state-of-homelessness-2020/
Statista, (2021), Prevalence of depression, anxiety, PTSD, and suicidal ideation in the past 2 weeks among public health workers in the United States as of April 2021, by race/ethnicity, https://www.statista.com/statistics/1255157/prevalence-select-mental-health-conditions-by-race-in-us/