Homelessness Mental Health

Depression, social isolation, loneliness, mental health and discrimination concept. Sad, lonely, depressed and unhappy man. Hooded person sitting in dark alley.

Knowing the state of mental health among unhoused individuals is the first step to advocating for change. Consider how mental health plays a role in issues surrounding homelessness, and how your organization can begin to work towards eradicating adverse mental health in your communities.

This blog is part of a series addressing mental health issues in a variety of communities. Click here to read another article in this series on minority mental health.

Mental Health Among Those Experiencing Homelessness

In 2015, a US study found that on any given night, over 500,000 individuals–or half a million–experience homelessness. This shocking number has continued to grow, and COVID-19 has only exacerbated the disparity.

These individuals face homelessness for a large variety of reasons–growing income inequalities, housing shortages, or other social determinants of health, just to name a few–but one common issue is more prevalent than others: adverse mental health.

In fact, about 25% (or one in four) people experiencing homelessness also report severe mental illness. This number expands greatly when considering less-severe (but still adverse) mental health concerns.

The most typical concerns include affective disorders such as depression, bipolar disorder, schizophrenia, anxiety disorders and substance abuse disorders. Unfortunately, while this is a common experience for people without housing, it is not common for them to receive treatment. Experts estimate that more mentally ill people are living on the streets in the US than are currently in facilities receiving care.

Why Is Adverse Mental Health Prevalent?

Although communities have made large strides in the last decade regarding mental health, stigma surrounding the issue still persists. Negative connotations surrounding those experiencing homelessness often acts as a barrier for receiving mental health care. 

Additionally, health and human services can look at the current organization of healthcare for answers. “Care silos” exist in almost every avenue of health and social care, meaning that mental health is often separated from more traditional health care. Community resource centers that address one issue–such as LGBTQ services, homeless shelters, or domestic abuse facilities–may not always offer additional care (like mental health services) or effectively coordinate with services that do provide such care.

It is also difficult for social services to remain in contact with people experiencing homelessness. Due to the prevalence of transience, many unhoused individuals have to repeat intake assessments time and time again, or are not contacted again following a visit to the hospital or ER. Case management systems that are networked with community organizations can help remedy this issue, allowing data on those experiencing homelessness to be stored and kept track of no matter how long inactivity may be.

Homelessness and Whole Person Care

Helping people experiencing homelessness must include addressing mental health. Combining health and human service approaches by coordinating with other organizations is one of the most effective ways to do so. Known as whole person care, it involves using a multi-disciplinary approach to care for the individual.

In practice, this looks like coordinating individuals in homeless shelters with food banks, mental health services, and other social programs. Although it sounds straightforward, it can often be complicated. There is often a start-up cost to coordination (such as an increase in time and resources and the need for social worker coordinators), but the payoff is significantly greater. In the long term, research shows that whole person care saves exponentially more money and resources than siloed care.

How does a health and human service organization go about instituting this kind of care, however? Below we unpack what social services can do today to better address mental health and whole person care for those experiencing homelessness.

Instituting Better Mental Health Care

Luckily, there are actions health and human service organizations can make today to work towards improving the state of mental health for unhoused individuals. Actions include education and awareness, care coordination, policy changes, case management, advocacy and outreach.

  1. Education and Awareness

    Knowledge is the first step in making change, and mental health care is no exception. Talking about internalized discrimination, social determinants of health, and racial and ethnic disparities in social services for unhoused individuals is a great place to start.

  2. Care Coordination

    To strengthen your community, you need to strengthen your coordination. Getting to know the services in your area is important to improving care coordination for those experiencing homelessness. As you work with other social services in your community, you can work together to bridge the gaps so common for unhoused people.

  3. Policy Changes

    Policy is another important way to help improve homelessness mental health. This can come in many forms, whether it is advocating for better public transportation or increased funding for mental health clinics in underserved neighborhoods or areas with large amounts of unhoused people.

  4. Case Management

    Another critical tool for improving minority mental health services is effective case management. Platforms like industry-leading ClientTrack™ help organizations keep track of those they serve, while coordinating with other programs to offer the best whole person care available.

  5. Advocacy and Outreach

    The fifth tool we recommend is working towards better advocacy and outreach. Advocacy goes hand-in-hand with education, awareness, and policy change. Consider participating in community events addressing homelessness issues and incorporating outreach for unhoused people, even if your organization focuses on other issues (such as refugee resettlement or domestic abuse). These issues are often inter-connected.

It is important to recognize the strength that comes from community. As we work towards better mental health care for those experiencing homelessness, we will likewise be able to lift our communities as a whole.


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Sources Used: 

  1. https://mentalillnesspolicy.org/consequences/homeless-mentally-ill.html
  2. https://www.bbrfoundation.org/blog/homelessness-and-mental-illness-challenge-our-society 
  3. https://www.psychiatrictimes.com/view/never-ending-loop-homelessness-psychiatric-disorder-and-mortality 
  4. https://www.homelesshub.ca/about-homelessness/topics/mental-health 

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