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Dec 6, 2023
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Uploaded by UltraMagpie2807
Alannah Chatfield
2/10/23
English 5B
Mental Health links to Homelessness
Fujinami
Homelessness is a very complex major issue throughout society and requires much
recognition, support and intervention from federal, state and local governments, along with
community and charitable foundations and organizations. This support and intervention measures
must aid to reduce the number of homeless by providing avenues for individuals and families to
attain consistent, sustainable housing and utilities. There is many causes of homelessness
throughout first world countries and much assistance is required to address these issues.
Throughout developed nations, housing affordability has continued to decrease and there have
been significant costs of living increases, making groceries, utilities such as electricity and gas,
along with health care far more expensive. With housing and cost of living expenses increasing,
having stable well paid employment is critical to be able to meet these costs. Maintaining stable
employment, having the ability to make sound financial decisions and having access to health
care and support are central to having sustainable housing to live.
Much research into the cause
and prevalence of homelessness has shown a significant number of individuals who are suffering
from homelessness are also suffering from mental health conditions and substance addiction
disorders, showing us the importance of addressing these issues.
A survey was conducted in 2008 by the “United States Conference of Mayors reviews 25
US cities to report on the top three causes of homelessness”. The survey found that substance
abuse was the single largest cause of homelessness for single adults. According to the study of
Homelessness by Didenko and Pankratz in 2007, two thirds of homeless people report that drug
and or alcohol were a major reason for having to live on the streets. They found “additionally,
some people may view the use of drugs and alcohol as necessary thing to be accepted among the
homeless community.” Individuals who are homeless often abuse drugs and alcohol to cope with
their situation and circumstance to receive temporary relief from their problems they are facing.
The use of drugs and alcohol then further exacerbates their problems as they are unable to
maintain or gain employment and seek money for drugs rather than housing or utility costs.
For many homeless people, substance abuse comes about as a result of mental illness.
Mental illness can lead to homelessness when individuals don’t receive appropriate treatment or
support, increasing the chances of losing their jobs and even just making it difficult to gain
employment or welfare support. Often people with untreated mental illnesses use street drugs as
a form of self medication, causing further issues. Mental illness is a diagnosable health disorder
that affects an individual's cognitive, emotional or social abilities (DoHA 2009). Without
appropriate management and or treatment mental health issues can be extremely damaging on
individuals, families and have an impact on all of society. There is a strong link between mental
illness and homelessness, with mounting evidence that there is a significantly higher prevalence
of mental issues in people who are homeless compared to that of the general population.
Homeless people may not receive adequate health care to treat mental health illness due
to financial barriers, lack of transportation to treatment facilities, lack of health care or private
health insurance, also with no permanent address contact details making it nearly impossible for
follow ups and further may have a lack of insight or understanding into their illness. There may
also be a reluctance to seek any treatment due to past negative experiences or refusal to get
treatment. If treatment is used, the transient lifestyle of a homeless individual may increase the
likelihood that they do not continue treatment or take appropriate medicines regularly.
Individuals suffering mental illness may have symptoms or behaviors that prevent or
threaten housing stability. These include, disruption to neighbors, missing rent or utility
payments, keeping housing in an unsanitary state or causing damage to housing and furthermore
causing a threat to themselves or others.
Having insecure housing and low housing stick and affordability can have further impact
on mental health disorders and subsequently lead to homelessness. A 2010 review by Greenberg
and Rosenheck, “estimated that between 20 and 50% of people” who are homeless have serious
mental illness. The study also notes that people who experience a week of homelessness since
age 18 were “significantly more likely” to develop mental illness than those who had not.
A Canadian study by M Hwang Et Al looked at the prevalence of mental illness in
homeless individuals and found that it was extremely high, with over one third of individuals
reporting diagnosis of a mental health disorder. The study found that homelessness can increase
the risk of mental health disorders through the trauma, social isolation and poverty associated
with homelessness, along with the inability to access health services.
The Australian Institute of Health and Welfare in a 2017 study found “There were
234,033 people aged 10 years and older assisted by specialist homelessness agencies nationally
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in 2020-21. Of these almost 2 in 5 were clients with a current mental health issue.” The rate of
individuals being assisted by homelessness agencies, conducted by the same Australian
Institution in 2011, which found “20% of homeless individuals suffered a mental disorder”.
“The Canadian Institute of Substance Abuse in a 2021” also report that people with poor
mental health or who have a mental illness are more vulnerable to homelessness. They found that
people living with mental illness experience increased stress that can impact their ability to exit
from homelessness due to their economic, health and social struggles. As noted in the article that
“people who do not experience mental health issues while housed can experience poor health if
they become homeless. This is due to the risks and stresses inherent in the homeless situation.”
A 2021 systematic review analysis conducted of previous studies into the prevalence of
mental disorders among homeless people across 11 high income countries found that of 39
publications with a total of 8049 participants, the prevalence of mental disorder was estimated at
76.2%, with the most common being alcohol and drug addictions. The study found the burden of
mental health disorders on the homeless was substantia and needed to be addressed as a major
public health challenge. The study also found that there was a high prevalence of mental health
disorders among homeless people significantly higher compared to the average societal.
Substance abuse can either be the initial cause of homelessness or also can occur as a result of
homelessness and individuals seek out substances due to their situations they are facing.
It is clear from all the study and research into the cause and reduction of homelessness,
that mental illness and substance abuse has a strong correlation and connection with an
individual’s ability to access stable housing and maintain employment, with either being the
cause of the homelessness or the outcome from it. Addressing access to appropriate health care
and treatment for mental illness and substance abuse, not just for the existing homeless but also
for at risk individuals and families, is extremely important, to prevent the loss of stable housing
and employment and assist people already on the streets who are suffering these conditions to
find housing and long-term solutions to maintain stable homes. While there is numerous factors
contributing to homelessness, mental illness and substance addiction are the most prevalent
causes in developed societies and significant investment and support in to treating and educating
people at risk is crucial to reducing homeless rates and assisting current homeless individuals and
families on finding stable housing.
References:
1.
RA;, G. G. A. R. (2023, February 8).
Mental health correlates of past homelessness in the
National Comorbidity Study Replication
. Journal of health care for the poor and
underserved. Retrieved February 8, 2023, from
https://pubmed.ncbi.nlm.nih.gov/21099075/
2.
National Coalition for the Homeless. (2018, February 21). Substance abuse and
homelessness. Retrieved February 9, 2023, from
http://www.nationalhomeless.org/factsheets/addiction.pdf
3.
Gazzar, B. (2022, April 25).
Substance use disorder
. National Health Care for the
Homeless Council. Retrieved February 10, 2023, from
https://nhchc.org/clinical-
practice/diseases-and-conditions/substance-use-disorder/
4.
Norman, T., & Reist , D. (2021).
HOMELESSNESS, MENTAL HEALTH AND
SUBSTANCE USE
. HOMELESSNESS, MENTAL HEALTH AND SUBSTANCE USE
understanding the connections. Retrieved February 10, 2023, from
https://www.heretohelp.bc.ca/sites/default/files/homelessness-mental-health-and-
substance-use.pdf
5.
Gutwinski, S., Schreiter, S., Deutscher, K., & Fazel, S. (2021, August 23).
The
prevalence of mental disorders among homeless people in high-income countries: An
updated systematic review and meta-regression analysis
. PLoS medicine. Retrieved
February 10, 2023, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8423293/
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