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Why do so many homeless people suffer from mental illness?

Homelessness and mental illness, unfortunately, often go together. But why is that? We explore the cyclical nature of these two conditions.

There are many factors that can lead to homelessness — financial strain, substance abuse, and mental illness. Financial hardship and drug dependence are external factors, and it is easier to draw a clear line between these issues and how they might lead to someone sleeping on the street.

Mental illness, on the other hand, is an internal factor. We can’t look at a person and see exactly what they’re suffering from. It’s impossible to tell what exact problems they may be having or how they are affected by them in their everyday lives.

This causes many, myself included, to ask the question: does mental illness cause someone to become homeless? Or, do people develop mental illness because they are homeless?

Mental illness is rampant in the homeless population

In 2015, the U.S. Department of Housing and Urban Development conducted a study on the homeless community. They counted 564,708 homeless people in a single night in the United States. Of those, roughly 45% had some kind of mental illness. Even worse, 25% of the entire homeless population were seriously mentally ill, which is approximately 5x worse than the general U.S. population.

With mental illness being so prevalent in the homeless population, it is critical that we try and understand the link between the two. Getting someone out of homelessness means addressing all of the things that are pushing them toward destructive behavior: their physical, emotional, and mental trauma must all be worked through.

Mental illness can lead to homelessness

There are many forms of mental illness and even people with the same mental illness can experience different symptoms and have varying degrees of severity. Broadly speaking, though, having a moderate-to-severe mental illness can make it difficult to find and maintain a job. 

Some mental illnesses may make it difficult for people to perform certain tasks or reliably come to work. It also may prevent them from driving, which would severely limit their transportation options. Then there is the stigma of mental illness itself.

While we as a society have made great strides in destigmatizing mental illness, there are still many who see those suffering from it as unemployable. Research has shown that those suffering from common mental illnesses are 3 times as likely to be unemployed, while those suffering from severe mental illness are 7 times as likely to be unemployed. This is attributed, at least in part, to employers being unwilling to hire someone who has a mental illness, regardless of if they are treating it or not.

In America especially, getting the right medication can be expensive. Low-income individuals are the most likely to fall into homelessness, and they are also the most likely to be unable to afford the proper medication. With no employer, health insurance can be very expensive. Like any sickness, mental illnesses will get worse over time if they are left untreated.

Combine worsening mental health with difficulty maintaining a steady stream of income and lack of access to proper medication, and it becomes clearer why so many homeless people suffer from mental illness.

Homelessness can lead to mental illness

Unfortunately, mental illness leading to homelessness is only one-half of the problem. The experience of being homeless is a traumatic one. Every day, homeless people must focus on simply surviving. They are constantly hungry, thirsty, and are frequently put in dangerous situations, both with law enforcement and other homeless people in the area. There is a constant compounding of stress that leads to both physical and mental exhaustion. It should come as no surprise that when stress is severe and prolonged, it increases the risk of both mental health issues and physical problems.

Homelessness is also extremely isolating. I have been personally told by some of our guests here at Nashville Rescue Mission that being homeless makes them feel invisible. No one asks their name, no one even looks at them. That isolation is every bit as damaging to one’s mental health as being forced to sleep on the street night after night. This is why so many homeless people form their own communities, such as tent neighborhoods, so that they might be able to connect with other people. 

Connection is one of the most valuable aspects of a place like Nashville Rescue Mission. Yes, we give people food and shelter, but we also give them a human connection. The simple act of acknowledging someone restores their dignity and does wonders for their mental and emotional wellbeing. It’s also something anyone can do.

There is help available

The good news is, there are programs specifically designed and funded to help homeless people address their mental health issues. My guest on the latest episode of Real Hope was the Commissioner of the Tennessee Department of Mental Health and Substance Abuse Services, Marie Williams. We spoke about many of these services, including ones to help homeless individuals better transition from homelessness into a more independent life. 
For those of us who’ve never experienced homelessness, it can be difficult to imagine what it would be like. However, I believe we can all be more empathetic toward our neighbors, especially ones who are struggling so mightily against huge obstacles like mental illness. Perhaps next time you get the opportunity, say hello to a homeless person and ask their name. It may help ease a burden you’d never know about.

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