Mental Illness: How to help the Homeless

 Mental Illness: How to help the Homeless

By Matthew Quevedo

Why do we look away?

    For most of us we see the appearance of those less fortunate than ourselves and more often than not we turn our heads and look away. Why? When we were little were we not taught to be kind and generous to those less fortunate than ourselves? How are these people any different? The simple answer is we fear that a member of this community may have a mental illness and could harm us. The fact that the number of homeless individuals with a mental illness is high enough that it is easier to just neglect the problem than fix it.

How bad is it?

    The situation of the homeless population in Los Angeles has reached 15,000. Of this number the Los Angeles Homeless Services Authority, the Los Angeles Times, and UCLA have conducted research into the population of mentally ill in the community. From the graph bellow we can see that the percentage of those with mental illness is not to be ignored. With the recent pandemic the homeless population is expected to grow by 86% over the course of the next 4 years. This means that we can expect the population of homeless individuals to double in a relatively short amount of time. 

What can we do?

    We can implement a Housing First Model. The most well-known Housing First model is Pathways to Housing in New York City. Established in 1992, Pathways to Housing offers, people who are homeless and have psychiatric or substance-related disorders, direct access to lasting, independent apartments without needing participation in psychiatric treatment or sobriety as a requirement for entering. Housing and treatment services are separated. Clients rent apartments—with the lease held by Pathways to Housing—from landlords who do not have a direct relationship with the treatment agency. The program uses a low demand approach that does not forbid substance use as a condition for obtaining or retaining housing. The program requires that clients pay 30% of their income for rent and take part in two home visits by their case manager each month. Following housing placement, interdisciplinary Assertive Community Treatment (ACT) teams are available 24 hours a day, 7 days a week to provide treatment, care, and other needed services to the client in a neighborhood office or in the client’s home.

How do we know it will work?

    The Housing First Model has been used in a number of states and even other countries have started to develop and implement it to solve their homeless problem. For example, research has been done in the city of Toronto to determine if this solution is viable or a number of different mental disorders. Homeless individuals with either high needs or moderate needs for mental health support were recruited through service providers in the city. Below is the breakdown of the participants that agreed to take part in the Toronto study. The total population was of 575 individuals. 

• The majority of participants were male (69%)
•  aged >40 years (53%)
•  single/never married (69%)
•  without dependent children (71%)
•  born in Canada (54%)
•  and non-white (64%)
•  substance dependence (38%)
•  psychotic disorder (37%)
•  major depressive episode (36%)
•  alcohol dependence (29%)
•  post-traumatic stress disorder (PTSD) (23%)
•  mood disorder with psychotic features (21%)
•  two-thirds of the participants indicated some level of suicidality (65%)

Conclusion

    

    From the study done in Toronto we can see evidence that the Housing First Model can benefit the mentally ill in the homeless community. The applicants recruited for the Toronto site of the AH/CS project appear to characterize an appropriate group for the assessment of a Housing First intervention for people who experience homelessness and mental illness. Targeted recruitment policies ensured that the sample was typical of the ethno-racial variety of Toronto and the characteristics of its homeless population. Results from the Toronto site of AC/HS will offer policy makers and facilities providers with significant data on the success of a highly promising intervention to meet the needs of various populations experiencing homelessness and mental illness, predominantly in large service-rich urban centers worldwide. We must come to the realization that this problem will not be corrected unless we do something about it. Homeless shelters don't provide the services needed for extreme cases of mental illness within the homeless community. So, it is time we stop looking away and face this problem head on.

Sources

Pearson, Carol L., and United States. Department of Housing Urban Development. Office of Policy Development Research. The Applicability of Housing First Models to Homeless Persons with Serious Mental Illness: Final Report. Washington, D.C.: U.S. Dept. of Housing and Urban Development, Office of Policy Development and Research, 2007. Web.

Hwang, Stephen W, Stergiopoulos, Vicky, O'Campo, Patricia, and Gozdzik, Agnes. "Ending Homelessness among People with Mental Illness: The At Home/Chez Soi Randomized Trial of a Housing First Intervention in Toronto." BMC Public Health 12.1 (2012): 787. Web.

https://www.latimes.com/california/story/2019-10-07/homeless-population-mental-illness-disability

https://abc7.com/la-county-homelessness-socal-homeless-crisis-economic-roundtable-population/9601083/#:~:text=Most%20alarming%20is%20the%20predicted,roughly%2015%2C000%20chronically%20homeless%20individuals.