StudyCorgi Health & Medicine

Homeless People with Mental Illness and Healthcare


The topic of the interventions available for homeless individuals who are mentally challenged has ignited a heated debate among scholars. On one side of the debate, a section of the scholars argues that uniform approaches should be applied to all the homeless people, irrespective of their mental health status. On the other side of the debate, other scholars argue that the interventions adopted for the mentally challenged people need to be unique whereby the group is addressed separately, as opposed to being managed together with other healthy people (Zerger et al. 7). The study seeks to answer the following research question: How should homeless people with mental illness be addressed? This research paper argues that although it may sound cost-effective to address homeless people with mental illness together with other healthy individuals, it is crucial to note that the approach may not capture the specific needs that the group faces and hence the need to deal with the group separately. The paper adopts a systematic literature review approach in which articles in support of the highlighted thesis statement are reviewed.

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Literature Review

Generally, mental illness incapacitates people to the extent that they are deprived of their ability to take care of themselves. Consequently, they have to rely on family members and relatives for their upkeep (Somers et al. 17). Failure by the family members to support their mentally challenged members may cause the persons to develop severe mental illnesses, which may result in homelessness. The view is informed by the fact that serious mental illness may cause the affected individual to exhibit undesirable behaviors such as violence, which may scare away potential caregivers. What compounds the problem further is that people with serious mental illnesses tend to misinterpret the motives of the caregiver and that they may react irrationally to some kinds of care. The irrational reaction by the mentally challenged individuals to a certain stimulus often causes caregivers to abandon the victims for fear of harm (Stergiopoulos et al. “Effectiveness of Housing First” 12). Given that family members and the society are the central caregivers of the mentally challenged people, the body that is tasked with resettling the homeless mentally ill persons must ensure that the individuals receive the right treatment to avert the fear of harm. Additionally, the government must educate the families of the affected persons on the importance of taking care of their family member victims. Such treatments and education are irrelevant to people who are not suffering from mental disorders.

In addition, Moussa argues that homeless persons who also suffer from mental disorders are highly likely to have a negative attitude towards mental healthcare (76). The negative attitude is attributed to the stigmatization and negative past experiences with health care providers. It is important to note that in some severe mental illness cases, healthcare facilities are forced to use crude methods to prevent the concerned patient from causing harm to other patients. Such methods include tying the patient with ropes or using psychiatric medications, which may produce negative side effects on the patient. Consequently, they tend to resist such care, a situation, which may lead to the deterioration of their mental conditions. If such patients are provided with a house later, they will tend to avoid healthcare, which is crucial to their ability to take care of themselves. Milbourne and Cloke argue that homeless individuals who suffer from mental illnesses need to undergo medical and behavioral treatment to support them to live independently in their houses (67). Based on the view, it is important for the government to avail counseling to all the newly housed persons who exhibit symptoms of mental illness.

Other scholars such as Kauppi et al. support the idea that the homeless mentally challenged persons should be handled separately base their argument on the ability of the group to support themselves economically (21). Kauppi et al. assert that persons with mental disabilities are likely to face discrimination from employers due to their incapacitation, unlike the healthy homeless people who only fail to secure jobs for the reason that they lack the relevant residency documents that employers demand (19). Skosireva et al. observe that most governments and non-governmental organizations that undertake to house the homeless people in the society do so by establishing cheap houses or offering subsidized houses (376). Consequently, failure to secure employment by the mentally challenged people may be a barrier to living in their new houses. This situation underscores the need for the government and the NGOs to provide the homeless mentally challenged persons with a source of reliable income to empower them to pay their bills. This goal may be achieved by either assisting the concerned group to secure employment after undergoing the necessary treatments or providing houses that do not attract monthly rent. Such interventions are only necessary for people with mental illness.

Another argument used to support special interventions for homeless people suffering from disability is that they may not remain in their newly provided houses in the absence of medical and behavioral interventions. Generally, the community is reluctant to embrace the mentally ill persons due to the perception that they (psychologically incapacitated people) tend to exhibit violent behaviors (Stergiopoulos et al. “Moving from Rhetoric to Reality” 12). Additionally, there is a stereotype that the mentally challenged people are dependent on others. Such a view creates a negative perception towards the mentally ill individuals. Community-based treatment of the mentally disabled persons is central to their welfare. Somers et al. argue that the psychologically challenged people tend to recuperate faster when community-based treatments are integrated with medical treatments (13). Therefore, the reluctance by the community to embrace the mentally ill persons is a major setback towards achieving their welfare. Healthy homeless people may not face such challenges since they are readily accepted back into the community once they secure homes.

Ornelas et al. explore the interventions available for mentally challenged individuals who are homeless from the veterans’ perspective (43). A considerable number of veterans in the US are homeless, a situation that is attributed to their poor mental status. Most veterans suffer from mental disorders, which manifest in the form of Posttraumatic Stress Disorder (PTSD). If the condition is not treated in time, it results in complications, which may lead to mental incapacitation. The problem is compounded by the fact that most veterans abuse drugs and other substances to relieve themselves from stress. This state of affairs increases their chances of becoming homeless in the future if the appropriate treatments are not available in a timely manner. Nurses and other medical staff engaged in the provision of medical treatment of veterans are well versed in the stressful situations that the veterans pass through. Research indicates that treatment is more effective when both PTSD and drug addiction interventions are run concurrently, as opposed to dealing with each problem at a time (Kauppi et al. 8). Treatment of the stated problems is continuous and more vigorous among veterans who abuse drugs. Therefore, to handle the issue of homelessness among veterans, the government must not only provide houses for them but must also offer the necessary treatments to help them in getting rid of addiction. If the problem of addiction is not solved, such veterans may result in abandoning their homes again soon after their settlement.

Hwang et al. explore the effect of drug use on the mental health of the homeless individuals and the approaches that could be adopted to permanently house such individuals (14). The author claims that most homeless individuals abuse drugs. This situation may interfere with their psychosocial development. Psychosocial growth is a continuous developmental process that occurs continuously in one’s lifetime. However, the development may be altered by certain factors, which include stress, addiction, and exposure to traumatic incidences, all of which are evident among homeless mentally challenged people. However, addiction is the most notable cause of retarded psychosocial development. Most people who suffer from addiction are prone to this problem. Persons with addiction and mental disorder problems tend to avoid intimate relations. Instead, they often prefer living alone. Addiction and mental disorder lead to low self-esteem among the affected persons. In most cases, they tend to live in isolated places to avoid mixing with other members of society. Given that housing such individuals may be likened to reintegrating them into the society, the government or the organization responsible for the reintegration must prepare the person to face the society. This goal can be achieved by offering the right medical and psychiatric care, which may not be necessary for the mentally healthy homeless people. The finding reveals the difference in the approaches needed to house the two groups of people.

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The systematic literature review has presented evidence that shows that indeed mentally challenged individuals who are homeless need special interventions. Such interventions should be primarily developed separately for this group of people since homeless people with mental illness are unable to live by themselves. In other words, homeless individuals who suffer from mental illnesses actually need specialized care to prepare them for their reintegration into their communities. One of the reasons why specialized interventions are needed for the identified group is that they require medical and behavioral interventions that must not be offered to their mentally healthy homeless counterparts. Research indicates that although mental disorders are chronic, specialized treatments result in improved welfare for the concerned persons (Hwang et al. 13). The interventions are more effective when both medical and behavioral therapies are administered concurrently. Such interventions are necessary to prepare the homeless mentally challenged individuals to assume their new homes.

The other reason why the mentally challenged homeless individuals need to be addressed differently and separately is that they need to establish long-term therapeutic treatments with their healthcare providers to facilitate their stay in their new homes. In the recent past, health care providers have realized the need to embrace continuous treatments, especially for people suffering from chronic illnesses. Nurses are increasingly establishing long-term relations with their patients under the continuum of care approach. Given that mental disorder is a chronic illness, healthcare providers need to establish lasting relationships with the patients of mental disorders to facilitate treatment (Milbourne and Cloke 45). Such long-standing relations are central to the successful stay of the mentally challenged individuals in their homes. While healthy homeless people may only need one-time counseling to prepare them for their new lives, those who are mentally challenged require continuous care to completely adapt to their new lives. This situation creates a difference in the kind of interventions that may be applied to the two groups regarding their housing.

Other than the health needs of the group in question, various economic concerns necessitate the adoption of special methodologies for handling homelessness among the mentally challenged individuals. Generally, for people to effectively live independently in their houses, they need to have a reliable source of income to clear the bills (Moussa 56). Therefore, as much as the mentally challenged individuals may be housed, they need to be assured that their economic needs will be catered for to facilitate their stay in their respective homes. However, based on experiences, the governments of countries across the world only provide subsidized houses for the homeless while ignoring the fact that some of the homeless individuals cannot raise the subsidized rent. The problem is compounded by the fact that employers tend to discriminate against the mentally challenged individuals during the hiring process. This situation creates financial difficulties for the mentally challenged, hence prompting them to go back to the streets to look for a life away from their homes. For the healthy homeless person, housing may be the ultimate solution to their problem since they can easily acquire employment immediately after they obtain the relevant residential documents that employers request when hiring.

Lastly, the study found that although the mentally challenged individuals are in dire need of medical and psychotherapy, they are reluctant to accept such care. Additionally, such people are unenthusiastic to accept care from anyone, irrespective of the caregiver’s motive (Waegemakers and Rook 19). This finding is in contrast with the healthy homeless people who are ready and willing to accept any kind of help from anyone. This negative attitude towards both healthcare and societal-based support programs by the mentally challenged persons necessitates specialized interventions for them. The government must enroll the mentally ill homeless individuals into the relevant rehab for the necessary special psychotherapies before housing them.


The results obtained from this study confirm the hypothesis that mentally challenged individuals who are also homeless need specialized interventions, as opposed to mere housing. Therefore, the government and other humanitarian groups that seek to end the homeless problem should not utilize similar approaches to solving the problem for both groups. Housing alone cannot solve the problem of homelessness among the mentally challenged individuals since they require ongoing health monitoring to ensure that they are sober enough to take care of themselves. The government should integrate medical and behavioral treatments with the settlement plan to ensure that the program is successful.


In the recent past, new evidence has emerged connecting homelessness with mental disability. The connection between mental disability and homelessness has ignited research to unravel the best methods to deal with the issues among the mentally challenged. Several scholars have hypothesized that the interventions for the mentally challenged individuals must not match those of the healthy people. The study reported in this paper has confirmed that, indeed, homeless people suffering from mental disorders require special interventions, which must be different from those applied to healthy groups. The reasons why such difference must be observed include the healthcare needs for the mentally challenged, their increased economic needs, and their reluctance to embrace care or take care of themselves.

Works Cited

Hwang, Stephen, et al. “Ending Homelessness among People with Mental Illness: The at Home/Chez Soi Randomized Trial of a Housing First Intervention in Toronto.” BMC Public Health, vol. 12, no. 1, 2012, pp. 1-16.

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Kauppi, Carol, et al. Homelessness in Timmins. January 2011 Final Report. Laurentian University, 2012.

Milbourne, Paul, and Paul Cloke. International Perspectives on Rural Homelessness. Routledge, 2013.

Moussa, Abdulla. The Effect of Housing First on Psychiatric Symptoms of Homeless Individuals with Mental Illness in Vancouver. Diss. University of British Columbia, 2013.

Ornelas, José, et al. “Housing First: An Ecological Approach to Promoting Community Integration.” European Journal of Homelessness, vol. 8, no. 1, 2014, pp. 29-56.

Skosireva, Anna, et al. “Different Faces of Discrimination: Perceived Discrimination among Homeless Adults with Mental Illness in Healthcare Settings.” BMC Health Services Research, vol.14, no. 1, 2014, pp. 376-376.

Somers, Julian, et al. “Vancouver At Home: Pragmatic Randomized Trials Investigating Housing First for Homeless and Mentally Ill Adults.” Trials, vol. 14, no. 1, 2013, pp. 1-20.

Stergiopoulos, Vicky, et al. “Effectiveness of Housing First with Intensive Case Management in an Ethnically Diverse Sample of Homeless Adults with Mental Illness: A Randomized Controlled Trial.” PloS One, vol. 10, no. 7, 2015, pp. 1-25.

Stergiopoulos, Vicky, et al. “Moving from Rhetoric to Reality: Adapting Housing First for Homeless Individuals with Mental Illness from Ethno-racial Groups.” BMC Health Services Research, vol. 12, no. 1, 2012, pp. 1-14.

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Waegemakers, Jeannette, and John Rook. Housing First-Where is the Evidence? Canadian Homelessness Research Network, 2012.

Zerger, Suzanne, et al. “Differential Experiences of Discrimination among Ethnoracially Diverse Persons Experiencing Mental Illness and Homelessness.” BMC Psychiatry, vol. 14, no. 1, 2014, pp. 1-11.

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