Mental Illness in Homeless PeopleMental Illness in Homeless PeopleMental Illness Among the HomelessA man living on the streets of Philadelphia called himself Joe No Name. A researcher observed him regularly and tried to persuade him to get help. On one visit Joe “reached out and asked to touch his finger to see if he was real or part of the electric current in the wires above their heads” (Torrey 10). Next time you are walking down the streets of a large city, take a moment to notice all the people living on the streets. They make shelter out of cardboard boxes, keep warm on heating grates, and eat food out of dumpsters. Mental illness had a strong association with the homeless. Severe illnesses such as schizophrenia, depression, and manic-depressive illness affect many homeless people. Mental illness is the cause of the majority of men, women, and even children becoming homeless due to weak support systems, deinstitutionalization, employment barriers, complicated daily living, substance abuse, and the continuous fight with the police.
Homelessness can be characterized into two categories, benign and malignant. Benign homelessness is a relatively little hardship to the person being affected. This type of homelessness only lasts for a short period of time and does not recur often. It is reasonably easy to gain back a home and retain stability. Malignant homelessness, however, is a significant hardship. It lasts an extensive period of time or recurs in short intervals. Immense effort is needed to gain back a home but many attempts are often unsuccessful (Bingham, Green, and White 100). “According to the Federal Task Force on Homelessness and Mental Illness, up to 600,000 Americans can be classified as homeless on any given night” (Brown 2). Approximately 30-40 percent are considered mentally ill. The percent between men and women is fairly distributed, men being 42 percent of the population and women being 48 percent (Isaac, and Armat 4-5). The amount of people considered mentally ill in the United States has drastically increased over time.
The number of public mental health hospitals in the United States has risen significantly over time. In 1830, only four mental health hospitals were in practice in the U.S., holding just under two hundred people. Rapid growth continued to occur and, in 1880 there were seventy-five public hospitals, treating 36,780 people. The number continued to climb and reached 150,157 people in 1904. Small towns and cities became overpopulated with mentally ill homeless. Almshouses or “poor houses” were built to shelter them and keep them from begging for food from others in their communities (Torrey 37- 39). Today there are twice as many homeless mentally ill people on streets and in shelters than in health institutions (Isaac and Armat 7). The main factor in the mentally ill becoming homeless is that they have weak social support systems.
Frequently found in homeless persons are many forms of government-sanctioned mental health service, such as the Social Security Administration.
Permanent Depleted and/or Impaired Aging (CDR) in Public Facilities
The following table shows a comparison of CDR for homeless persons, homeless adults under age 25 in the United States and general population ages 50 to 79. In 1976, homeless persons in the United States received $1,085,000 of government money or federal benefits, or almost four times what the average was for all adults (Figures 4, 5 and 8).
Table: Homeless Persons, Homeless Adults, and Unborn Persons in the United States, 1976 by Year, Population, and Age of Homeless Persons, Homeless Adults, and Unborn Persons, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, and Homeless Adults, or
(Note: Estimates assume that there are no homeless persons with permanent disability or who no longer qualify for state Medicaid. Estimates for homeless person status will differ by state or metropolitan area. Estimates also vary by age group and the availability of federal disability and financial assistance. These estimates relate to individuals who have recently served their sentence or served parole or other sentence imposed for mental health or substance abuse; persons who have been issued a mental health or substance abuse treatment program. In order to estimate homeless persons and their populations, numbers of homeless persons and their populations are multiplied by the number of persons living with the person, as determined by the Housing and Urban Development Review.
Source: MDEA, 2011. (Note: Estimates assume that people who are homeless are overrepresented in the population. Estimates do not assume that all homeless persons also have permanent disabilities or who no longer qualify for state Medicaid.)
All the numbers for homeless persons in the U.S. depend on the data collected on the U.S. Census Bureau’s Homeless Persons and Underage Persons Monitoring Network (HPUN) or the Homeless Persons and Adolescents Prevention Survey (HPDVS). An increase in homeless persons in the U.S., with an aging population, would create a projected shortfall of $5 billion in FY2014.
Frequently found in homeless persons are several forms of government-sanctioned mental health service, such as the Social Security Administration (SSA) and Medicare. In 1973, SSSA and Medicare required each state to issue a Mental Health and Substance Abuse Treatment and Development Assistance (MATCH) policy. These programs established the State Mental Health Center for the Homeless (SLCH), a mental health center for homeless persons in rural areas and the Centers for Disease Control and Prevention (CDC) Mental Health Center for the Homeless (MHC).
According to the SLCH, homeless persons received $6 million—about two quarter the amount as provided under Medicare. The poverty rate
Men and women who are considered mentally ill and homeless are generally single or are divorced. They have an increased likelihood of having a childhood history containing foster care, group home placement, or running away from home (Brown 2). This specific type of homelessness leaves them with no family support or structure and often face challenges alone. Without stability and people to back them up, these mentally ill people are often left on the streets. Deinstitutionalization was another major cause of the mentally ill becoming homeless.
The U.S. Department of Health and Human Services states that, “In 1955 almost 559,000 individuals were hospitalized in State mental health facilities; today there are fewer than 114,000” (3). The idea of deinstitutionalization was to release patients from the public mental health system and to get them living independently (Ibid). In many cases, however, lacking vital support can result in homelessness. The mentally ill homeless face additional burdens to those of regular homeless people.
Homeless people who are mentally ill usually cannot maintain steady employment. They have a difficult time upholding a position, and without a job they cannot keep a residence and are left on the streets or in a shelter. Their daily living is complicated with their finding a place to stay or something to eat. They may be so far into their illness that they do not know what they need to sustain good health. Many homeless people with a mental illness also associate with drugs