The Myth of Mental Illness Causing Homelessness

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After years of steady decline, homelessness is again on the rise in the United States. On any given night, more than half a million individuals sleep either in temporary homeless shelters. Or they sleep outside.

Some say the problem isn’t a lack of affordable housing. Instead, they believe the problem is mental illness, substance abuse, or just “laziness.” However, homelessness is a complex problem. This makes it difficult to provide one-size-fits-all explanations for why it exists and why it’s growing.

Statistics reveal that many common assumptions about causes of homelessness and how to address them are false. At worst, these assumptions undermine the situation further. To better understand the truth behind homelessness, DignityMoves has begun a series of blog posts debunking the pervading myths surrounding homelessness.

In this post we’d like to focus on the myth that homeless individuals are more often than not severely mentally ill (because why else would someone actually “choose” to live on the streets?)

Homelessness Often Causes Mental Illness
The prevailing notion that people who live on the streets or in homeless shelters more often than not have an underlying mental illness is categorically incorrect. But the stigma stands. That is because homeless individuals often do, in fact, suffer from mental instability. This is  sometimes from the trauma of having to survive on the streets. In most situations, the opposite is true: the struggle and strain of homelessness cause and/or exacerbate mental illness.

People on the street experiencing homelessness often encounter social exclusion, limited access to treatment resources, crime, stress, violence, and trauma. All of these things can adversely affect their mental health. Imagine the anxiety of not knowing where a meal or shelter will come from. Or, imagine fearing someone will hurt you as you sleep curled up on the side of a parking lot. Additionally, homelessness exacerbates preexisting mental illnesses and can result in additional disorders. The stress of homelessness can lead to anxiety, depression, paranoia, insomnia, and substance abuse.


Two-Way Street Between Homelessness and Mental Illness
Research indicates a complicated, two-way relationship between homelessness and mental illness. A mental illness may cause cognitive and behavioral problems. These problems can make earning a stable income or carrying out daily activities difficult. However, evidence shows that individuals with mental illnesses are often homeless primarily because of poverty and a lack of affordable housing.

The mass closure of mental institutions in 1970 was initially considered a primary cause of the rise of homelessness. But the fact is that these closures actually occurred long before the sharp increase in homelessness in the 1980s. Federal support for affordable housing, which was cut sharply in the 1980s, is precisely when homelessness in the U.S. exploded.

Seeing No Solutions Makes Mental Health Worse
Housing and homelessness are naturally related. But many often overlook the strong relationship between health and homelessness. While chronic illnesses and diseases like asthma, high blood pressure, and diabetes worsen when a person cannot maintain a healthy diet or take their medication, mental health conditions also almost always worsen when there is no solution in sight.

When faced with a threat, people’s adrenaline and cortisol levels increase. It is only after the threat ends that their hormone levels return to normal. However, homelessness is accompanied by constant threats-from inhospitable living conditions to crime and violence. These things can lead to chronic stress, which negatively impacts mental and physical health.

Stable Housing Gives People a Chance to Recover
Access to stable housing offers more than just privacy and safety. It also serves as a place for individuals to recover and recuperate from various health issues. It serves as a place where they can stop worrying about where they will sleep or find their next meal. Homelessness often forces people to make difficult choices between basic survival needs and accessing essential mental health care and social services. Even the most coordinated and comprehensive medical services can be ineffective. This is true if the harsh conditions of the streets or shelters constantly undermine a patient’s health. Inpatient hospitalization or residential treatment for drug addiction and mental health issues may not have a lasting impact if a patient returns to homelessness upon discharge.

Despite healthcare providers’ efforts to alleviate the negative impacts of homelessness, no amount of medical care can replace the fundamental need for stable housing.

The Root Cause of the Issue is Lack of Affordable Housing
Investing in affordable housing can improve health outcomes, prevent homelessness, and decrease public costs. According to a Health Policy Brief published by, there is compelling evidence demonstrating the link between housing and health (including mental health.) The quality, stability, safety, and affordability of housing, as well as the physical and social features of the surrounding neighborhood, all influence health outcomes. Therefore, to effectively address the mental health of homeless individuals, the focus should be on addressing the root cause of the issue: the scarcity of affordable housing.

But keep in mind, it’s not just any long-term housing option. While some believe a homeless person or family doesn’t have the luxury to pick and choose a permanent dwelling, the importance of a clean, safe, warm, and affordable home in a safe community makes a difference.

The Moving to Opportunity for Fair Housing Demonstration Program analysis presents compelling evidence regarding the influence of neighborhoods on mental and physical health. The program, a landmark federally funded initiative, randomly assigned participants to either receive financial and other aid for relocating to lower-poverty areas or not. The study found that adults who moved experienced long-term improvements in mental health and some aspects of physical health. This was as compared to those who remained in high-poverty areas. The research revealed that children who moved to low-poverty neighborhoods before the age of 13 have an increased probability of attending college and higher lifetime earnings.

DignityMoves is changing the narrative on homelessness by creating clean, rapid-response, interim housing. Our goal is to help unhoused individuals escape the mental stress of living on the streets. Our four proof-of-concept villages in San Francisco, Rohnert Park, Santa Barbara, and Alameda, CA have provided hundreds of people with a place they can call home and begin to heal from their trauma of the streets. Their mental healing begins when they sleep in a bed with a room with a locking door and know they have a safe place to begin to recover.

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