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Alannah Chatfield 5/1/23 English 5B Mental Health in the Homelessness community Fujinami Homelessness is a very complex 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 are 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 in. 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.

Although solving homelessness sounds like an impossible task, as there’s not one solution due to the multiple problems that factor into homelessness. From mental health to addiction, how do we find a solution that factors in all branches of the problem? Through my research the solutions which have been put in place to protect and prevent mental health and addiction in the homeless community, are donations to help awareness, facilities and preventive foundations to help make easier access and more availability to doctors, also housing programs for short term living. Although these solutions are embedded in our community, are they really effective? Are they really making a difference? Addressing access to appropriate health care and treatment for mental illness and substance abuse, 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 are numerous factors contributing to homelessness, mental illness and substance addiction are the most prevalent causes in developed societies and significant investment and support in treating and educating people at risk is crucial to reducing homeless rates and assisting current homeless individuals and families in finding stable housing. Housing prices play a huge part in the cause of homelessness, with many organizations assisting to use “housing first philosophy” (Fowler and Hovmand). Housing first is an organizing philosophy that “coordinates resource allocation” to people in need of somewhere to leave. With this serving as an answer to quick housing support. The program makes it easier to obtain and

maintain housing with a “shift in philosophies” (Fowler and Hovmand) moving towards “a person centered and recovery oriented approach” (Fowler and Hovmand) rather than just another organization trying to help the mass population which is ineffective and unreliable. This organization is one that provides the homeless with access to housing and support ranging from mental health awareness to addiction interventions. The organization wanted to test their approach and see if by giving homeless individuals long term housing, it will help them in the long run. This experiment first took place in the 1980s and 1990s, to see how the homeless community reacted to the “housing first philosophy” (Fowler and Hovmand). They split a range of homeless individuals into two groups, with one group put into the housing first philosophy and the other one also put into that philosophy but put through treatment and doctor support first. It was recognised and discovered rather quickly within the results that the homeless community are strongly impacted by severe mental illness which is more consistently shown to the housing first instead of treatment first services. This helped the organization realize that giving homeless people a roof over their heads isn’t enough to help them move forward into the future and support them to take a positive step forward in their life. It was strongly emphasized that putting a treatment plan in place to help achieve healthy and happy people before getting put in a house, will make for more opportunities for these homeless individuals to find employment. 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 are numerous factors contributing to homelessness, mental illness and substance addiction are the most prevalent causes in developed societies and significant investment and support in treating and educating people at risk is crucial to reducing homeless rates and assisting current homeless individuals and families in finding stable housing. 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. Homelessness is an issue that can be provided with solutions to prevent and protect individuals. By understanding the behavioral health needs of the homeless population we can start to develop ways in which to end homelessness. “A growing body of psychological research has already contributed to knowledge in this area with reviews of risk factors for the homeless revealing that adverse childhood experiences, mental illness and substance abuse are strongly associated with homelessness.” (Susser, Moore, & Link, 1993; Tsai & Rosenheck, 2015). This means that if we protect the next generations and

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