According to the Homeless Hub, 30-35% experiencing homelessness have a mental illness. Among women, that figure jumps to 70%. How does society allow this to happen to some of our most vulnerable people? Housing is a basic fundamental need that all people should be able to access. Why are people with mental illness disproportionately represented in the homeless population?
The Homeless Hub identifies poverty, disaffiliation, and personal vulnerability as key reasons for the link. Mental illness can chip away at the network of family and friends that provide the social support system that otherwise might be there as a backup.
Maintaining employment can be difficult due to the illness itself, but also due to systemic discrimination against those of us with mental illness in the world of work. Disability benefits may be difficult to get, and the amounts may not always be adequate to support the cost of living. The costs associated with obtaining appropriate health care can also be considerable.
Illness can impair judgment, leading to bad decision-making that may come with significant consequences, financial or otherwise. Landlords are not always prepared to tolerate behaviours associated with uncontrolled mental illness, especially if there is a co-occurring substance use disorder as well. Poorly controlled psychosis can make it hard for people to tolerate remaining in housing if they’re feeling persecuted by neighbours.
When I worked at a community mental health team, we got a lot of new client referrals from the local shelter. Because hospitals can’t hold people for the amount of time it takes to find housing, discharge to a shelter wasn’t all that unusual. That may sound cruel, but at the same time, it can take months or even years for someone to find subsidized housing, especially supported housing. Hospitals simply couldn’t hold people for that long. In the city where I live, the average monthly rent for a one-bedroom apartment is $1438. The monthly shelter portion for provincial disability assistance is only $375.
A study conducted by the Mental Health Commission of Canada found that when homeless people were provided with housing as part of a “Housing first” model, the cost savings in terms of health and social services required was greater than the cost of providing and subsidizing the housing.
The Homeless Hub cites a 2013 figure that homelessness cost the Canadian economy over $7 billion that year to cover the cost of shelters, social services, increased use of emergency first responders, increased health care costs, and increases criminal justice system contacts. Clearly, it makes so much more sense to house people.
It’s frightening to think of ending up homeless, but it’s something that is a possibility for anyone. If those of us living with mental illness are more vulnerable, that’s all the more reason for governments to step up and improve access to mental health services in order to prevent these kinds of extreme outcomes. Because we really all do deserve a roof over our heads.
There’s more on social issues on the Social Justice Issues page.
My book Making Sense of Psychiatric Diagnosis breaks down the different categories of DSM-5 diagnoses, explaining the diagnostic criteria and providing first-hand stories of the various illnesses. It’s available on the MH@H Store, as well as Amazon and other online retailers.