Mental Illness and Homelessness

by Mieke Dale-Harris, Institute for Advanced Studies

Last week Giving to beggars is bad and exploitative labor is goodwas posted. This article cited people’s rationalizations for not giving to beggars. Two of the major public perceptions of beggars that the author received were that the adults were on the streets by their own fault and that direct charity would discourage them from doing something pro-active to relieve themselves of homelessness. However, data from developing countries and in particular the United States (U.S) indicates that many homeless people are not to blame for there homeless state, but suffer from mental disabilities and often severe mental illness (SMI). Persons with SMI are identified as

“individuals with serious and long-term mental disorders that impair their capacity for self-care, interpersonal relationships, work and schooling.”

Being poor with SMI, is a combination that results in high vulnerability to further poverty and homelessness. Some 200 thousand homeless in the United States have been identified as having a SMI. And according to the National Resource and Training Centre on Homeless and Mental Illness between 20 and 25 percent of America’s homeless suffered from severe or persistent mental illnesses in 2003.

“These individuals tend to be relatively young, unmarried, poor and with low prospects of long-term gainful employment.”

Their plight as a homeless person is therefore not due to laziness or an aptitude for scrounging but rather a mental inability to look after themselves and find consistent work.

Unfortunately, instead of decreasing, the number of mentally ill homeless in the U.S significantly increased during the last half of the 20th century (see graph). This increase can be directly attributed to America’s psychiatric service policy changes away from mental hospitals toward community service. Although the theory behind this policy was well intended, disorganised and inefficient community services meant that many mentally ill were left without consistent care and as a result ended up as homeless or in prison.

Allowing the mentally ill or those vulnerable to mental illnesses to become homeless is placing them in a vicious cycle of poverty and mental illness. As, not only does mental illness lead to poverty, but poverty can also create mental illness. Australia based research found that 15% of homeless had mental illnesses prior to becoming homeless and 16% developed mental health issues after becoming homeless. Both mental health issues developed prior and following homelessness decrease the individuals chances of finding employment or support that will provide them with security, food and housing.

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2 replies on “Mental Illness and Homelessness”

  1. The US is the 12th worst country of the world for disability adjusted years of life lost to mental illness.
    (Based on data at: ^ “Death and DALY estimates for 2004 by cause for WHO Member States: Persons, all ages” (xls). World Health Organization. 2002. Retrieved 2009-11-12. cited in Wikipedia page cited below.)
    Based on Age-standardized DALYs per 100,000 by cause, and Member State,  2004 (a,m,p) the US ranks 12 based on a ranking of the percentage of the total for each countryfor 192 countries by the WHO
    The reporting and measurement rates in many of the poorer countries and those ravaged by civil war and rebellion might be considered suspect. There may also be a skewing in countries with benefits for those who qualify on this ground, so countries with higher benefits may have a higher proportion than countries with no benefits for this category of disability.
    I am sure that statisticians could provide many correlations (many highly unlikely to be causations) which would prove interesting.
    Many would say that the test of the degree of civilisation of a country is how it treats those who through no fault of their own are unable to be productive, self supporting members of society. On this measure, the changing rates of homelessness and incarceration suggest that the US is becoming a less civilised society. This could also be applied to Australia where the closure of psychiatric hospitals, partly on the basis of abuse suffered by inmates proceded apace about 20 to 30 years ago. Now the abuse takes place on the streets and in jails where so many of the mentally ill live.
    The 20 countries with the biggest losses per 100,000 are listed below.
    Disability-Adjusted Life Years is a better measure of the burden of illness than life expectancy:
    Sweden 36%
    Switzerland 35%
    Norway 35%
    Canada 34%
    Finland 33%
    Iceland 33%
    Israel 32%
    France 32%
    Austria 32%
    United Kingdom 31%
    Germany 31%
    United States of America 31%
    Netherlands 31%
    Monaco 31%
    San Marino 31%
    Luxembourg 30%
    Chile 30%
    Andorra 30%
    Ireland 30%
    Australia 29%

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