People with poor mental health are more susceptible to the three main factors that can lead to homelessness: poverty, disaffiliation, and personal vulnerability. Because they often lack the capacity to sustain employment, they have little income. Delusional thinking may lead them to withdraw from friends, family, and other people. This loss of support leaves them fewer resources to cope with times of trouble. Mental illness can also impair a person’s ability to be resilient and resourceful; it can cloud thinking and impair judgment. For all these reasons, people with mental illness are at greater risk of experiencing homelessness.
Homelessness, in turn, amplifies poor mental health. The stress of experiencing homelessness may exacerbate previous mental illness and encourage anxiety, fear, depression, sleeplessness, and substance use. The needs of people with mental illness who experience homelessness are similar to those without mental illnesses: physical safety, education, transportation, affordable housing, and affordable medical and dental treatment. When providing care to those experiencing homelessness, it is essential to create a non-threatening and supportive atmosphere, address basic needs (e.g., food and shelter), and provide accessible care.
People with mental illness experience homelessness for longer periods of time and have less contact with family and friends. In general, 30-40% of those experiencing homelessness have a mental illness (this figure climbs to 76% in one international study of wealthy countries that also included substance use disorders). Based on Canadian data from 2009, 20-25% of people experiencing homelessness suffer from concurrent disorders (severe mental illness and addictions). People who have experienced homelessness at some point in their lives are two to three times more likely to report their mental health as being poor. People who have severe mental illnesses are over represented among those experiencing homelessness as they are often released from hospitals and jails without proper community supports in place.
Community-based mental health services play an important role. Homelessness could be drastically reduced if people with severe mental illness were able to access supportive housing as well as other necessary community supports. They encounter more barriers to employment and tend to be in poorer health than other people experiencing homelessness. Housing outreach services that provide a safe place to live are a vital component of stabilizing the illness and helping individuals on their journey to recovery.