Mental Health and Homelessness: What Funders Should Know (Part 1 of 3)

[This post originally appeared on Mindful Philanthropy]

Homelessness has long been a complex social issue that funders have cared about, and national data suggests that homelessness in the United States has grown in recent years. In this three-part blog series, we explore the complex relationship between homelessness and mental health, as well as key facts that funders should know if they want to make a difference at this crucial intersection.

A Challenging Problem to Measure 

On any single night, the overall homeless population represents 0.2% of the U.S. population, or 17 people per 10,000. The most recent national data available indicates that in January 2020, the number of people experiencing homelessness increased to 580,000, up by 13,000 from the prior year. This increase marks the fourth straight year in a trend of incremental growth in the population experiencing homelessness. 

Homelessness is predominantly measured by annual point-in-time counts, which assess how many people in a community are experiencing homelessness across both sheltered and unsheltered conditions on a single night. Sheltered counts are relatively straightforward, as administrative records help indicate how many people utilize emergency shelters and other forms of transitional and supportive housing. Unsheltered counts seek to estimate the number of people living in places not meant for regular shelter. As a result, there can be greater variation in the methodology year-to-year within and across communities. In recognition of the dynamic nature of homelessness, a growing number of communities are opting to measure homelessness using by-name lists. By-name lists are updated in real-time with the names and details of every person in a community experiencing homelessness to track the changes in the needs, size, and composition of the homeless population. Researchers are also developing novel ways to predict and track homelessness, such as computer models.

There are a number of additional challenges associated with measuring homelessness. Youth are often underrepresented in counts because they may not engage with traditional shelters and assistance programs and congregate in different areas than older adults experiencing homelessness. Counts can also fail to identify individuals who are homeless but find temporary, insecure accommodation like couch surfing, squatting, or sleeping in cars.

The Relationship Between Mental Health and Homelessness 

The relationship between mental health and homelessness is complex and bi-directional. Serious mental illnesses can disrupt people’s ability to carry out essential aspects of daily life, such as maintaining an income, self care, household management, and other activities that facilitate stable housing. Poverty, a shortage of affordable housing, and a lack of affordable and accessible mental health care also compound these stressors. As a result, along with the personal and financial stresses of living with a mental disorder, people with mental illnesses are more likely to experience homelessness than the general population. 

Research indicates that homelessness is a traumatic event that can exacerbate an individual’s existing mental illness or cause new symptoms to emerge. Having experienced homelessness is also related to higher levels of psychiatric distress and lower levels of perceived recovery in people with previous mental illness. The relationship between addiction and homelessness is also complicated and greatly disputed. While many people who experience addiction never become unhoused, people who are poor and experience addiction to drugs or alcohol are at an increased risk of experiencing homelessness.

Many studies have shown that the public costs of maintaining homelessness are much greater than the costs of ending it through the provision of rent and services. Without stable housing, individuals experiencing homelessness cycle in and out of emergency rooms, inpatient hospital stays, treatment programs, and jails, driving high public costs to the taxpayer. This is especially true for individuals experiencing homelessness who also have intensive service needs due to mental health and/or substance use issues. In most cases, it is less expensive to provide supportive housing that enables someone to maintain housing and health stability than to house them in a mental hospital or medical hospital. For instance, placing an individual experiencing chronic homelessness into permanent supportive housing reduces public costs by 49.5% on average. As a result, it’s essential that philanthropy consider the bi-directional relationship between homelessness and mental health and approach these issues in tandem. 

Read Part 2 in this series to learn more about the categories of homelessness and consider how you might focus your support for mental health and homelessness. To explore working with Mindful Philanthropy on mental health and homelessness, contact us at info@mindfulphilanthropy.org. 

This blog is an original work of the attributed author and is shared with permission via Foundant Technologies' website for informative purposes only as part of our educational content in the philanthropic sector. The views, thoughts, and opinions expressed in this text belong solely to the author and do not necessarily reflect Foundant's stance on this topic. If you have questions or comments, please reach out to our team.