Mental health is among the most researched issues that affect homeless people. Although homeless people are not all mentally ill, most of them experience mental health problems that negatively impact their well-being. Some develop multiple and severe behavioral and psychological disorders. In the United States, over 550,000 people lack regular or fixed residence on any particular night. The mean prevalence of any form of psychological disorder among homeless people is about 76%. The most diagnosed mental health challenge in the population is alcohol use disorders, followed by drug use disorders, schizophrenia spectrum issues, and major depression. While the government, through various social and community organizations, has developed initiatives to address the problem of homelessness and mental health, there still exist individuals with mental health disorders living on the streets. Research shows that the development and implementation of interventions that are supported by robust policies can reduce the prevalence of psychological and behavioral challenges in the homeless population. The current paper builds on evidence to examine the prevalence of mental health disorders among homeless individuals in the US and the impact of policy-guided programs to address the problem.
The Prevalence of Mental Health Disorders among Homeless Individuals in the US and the Call for Policy Making
Prevalence of Mental Health Disorders among Homeless Individuals in the United States
According to several research works, there is a bi-directional nexus between homelessness and mental health. Research performed by Singh et al. (2019) demonstrates that prior exposure to a housing disadvantage greatly influences adverse mental health in later years. The study classified housing disadvantages as housing mobility, overcrowding, housing tenure, and mortgage delinquency. It also categorized mental health issues as depression, anxiety, mental strain, psychological impairment, and allostatic load. The findings established a strong association between the two sets of variables. Similar findings are also recorded by Gutwinski et al. (2021), who established a high prevalence of mental health disorders among homeless people. The highest percentage of homeless individuals suffer from alcohol and drug abuse. A meta-analysis was performed by the authors to establish the rates of each mental health disorder. Findings show that about 36% of homeless people with mental health disorders suffer from alcohol use disorders, while 21% have other drug use disorders. The other common psychological illnesses include depression and schizophrenia. Bullock-Johnson et al. (2020) further confirm that housing instability is a risk factor for mental health disorders. Therefore, evidence confirms the high prevalence of psychological health issues in the homeless population.
The significance of Policies in addressing the challenge of Mental Health in the Homeless Population
Policies that relate to social and community services are effective in addressing most of the social issues that impact populations. Similarly, initiatives backed up with policies can help to address the issue of mental health among homeless people. Padgett, D. K. (2020) explains that the ultimate causes of homelessness are embedded in systemic and governance structures or frameworks. For instance, the lack of affordable housing is a result of neo-liberal government austerity policies. The policies limit public funding, displace poor families and broaden the disparities between classes in US society. In modern US society, households must contribute over 50% of their earnings towards paying rent (Padgett, 2020). Other governance issues that increase the prevalence of mental health challenges among homeless people include the high cost of healthcare services, lack of health insurance coverage, and disparities in education acquisition. The challenges increase the number of people on the streets, subject them to the burden of mental health and make it hard to access healthcare services. Consequently, the most effective interventions to address the problem of mental health in homeless individuals are those that are linked with policies that address the various systemic and governance challenges. Shin and Cohen (2019) further highlight a series of policies that can be adopted to end homelessness, such as increasing the supportive services meant to help people maintain stable housing. Additionally, the article suggests the need to have policies that foster legal representation, mediation services, and financial assistance for families facing eviction. Bullock-Johnson (2020) also emphasizes the significance of policy in addressing mental health linked to homelessness.
The Call for Policy Making
In the United States, there is limited evidence of the issue of housing receiving much attention from the government. The Obama-era ACA provided opportunities for Medicaid expansion to cover millions of individuals from low-income households. However, federal law does not allow states to use Medicaid funds to pay for housing. Unfortunately, funds aimed at developing new housing units are inadequate across the country (Padgett, 2020). Similarly, healthcare costs remain significantly high despite efforts to increase healthcare insurance. Hence, initiatives that aim to create social change must push for the establishment of policies that address these systemic and political challenges.
Evidence demonstrates the bi-directional association between homelessness and mental health. Not all homeless people have mental health disorders, and vice versa. However, a greater percentage of the homeless population is subjected to the burden of mental health challenges. Some of the common mental health disorders are substance use disorders, major depression, anxiety, and schizophrenia. Although there exist multiple initiatives to address the problem of mental health in homeless people, evidence suggests that focusing on policy development could improve their outcomes.
Bullock-Johnson, R., & Bullock, K. (2020). Exploring Mental Health Treatment and Prevention among Homeless Older Adults. In Healthcare Access-Regional Overviews. IntechOpen. https://doi.org/10.5772/intechopen.89731
Gutwinski, S., Schreiter, S., Deutscher, K., & Fazel, S. (2021). The prevalence of mental disorders among homeless people in high-income countries: An updated systematic review and meta-regression analysis. PLoS medicine, 18(8), e1003750.
Padgett, D. K. (2020). Homelessness, housing instability and mental health: making the connections. BJPsych bulletin, 44(5), 197-201. https://doi.org/10.1192/bjb.2020.49
Shinn, M., & Cohen, R. (2019). Homelessness prevention: A review of the literature. Center for Evidence-Based Solutions to Homelessness. https://fr.bfzcanada.ca/wp-content/uploads/Microsoft-Word-evidence-page-prevention-10.29.18rev-opt2.pdf
Singh, A., Daniel, L., Baker, E., & Bentley, R. (2019). Housing disadvantage and poor mental health: a systematic review. American journal of preventive medicine, 57(2), 262-272. https://doi.org/10.1016/j.amepre.2019.03.018