Homelessness and Mental Health (Part 4)

The relationship between homelessness and mental illness is a complicated one. To begin with, we know that the rate of mental illness is much higher in the homeless population, as about 1/4 t o1/3 of homeless individuals have a serious mental illness, such as Schizophrenia, Bipolar Disorder, or Major Depressive Disorder. In comparison only 6% of the American population has a serious mental illness. Next there is the chicken or the egg question: does homelessness lead to mental illness or does mental illness lead to homelessness? And the answer, as you might guess, is yes. It is definitely not a one-way relationship in either direction, and is instead a very complex interaction. While interning at a psychiatric hospital, I worked with many individuals who became homeless due to a debilitating mental illness, which would seem to suggest that mental illness causes homelessness. However, as I learned more about their stories, I saw how being homeless created increased emotional distress and exacerbated their symptoms and mental illness. Also, being homeless left them with little or no consistent mental health services, including barriers to receiving the medications they desperately needed. For example, I regularly heard from patients in the hospital suffering from Schizophrenia that when they ran out their medication they began using drugs or alcohol to help "quiet the voices" in their head. The pain and agony of hearing voices can become almost unbearable, and left without necessary treatment they sought any solution they could. This, or course, would often lead to an additional issue of substance abuse, adding to the list of their hardships and difficulties. My experience at the psychiatric hospital and interactions with the homeless have made it clear to me that the relationship between mental illness and homelessness is dynamic and complex one. Being that homelessness and mental illness have this interwoven relationship, it follows that many of the solutions that address either issue will help the other, as well. The most significant and straightforward of these solutions is to increase the mental health services available to all individuals, in particular those who are or are at risk for being homeless. The current system is not sufficient: the services available are not adequate and additionally there are barriers to accessing mental health services and medications, especially for those struggling with homelessness. It is imperative that we increase and improve the mental health services available in our country to help advance the lives of all who have mental illnesses and in the process reduce the number of individuals suffering from homelessness.