Homelessness and Mental Health: Part 1

Homelessness has been defined as “lacking a fixed, regular and adequate nighttime residence.” Prior to the COVID-19 pandemic, over a half-million individuals were estimated to be experiencing homelessness in the United States. The number homeless may increase with the hardship of COVID-19, which has disproportionately affected already vulnerable populations. Over 60% of those who experience chronic homelessness also have a mental health condition. As mental health providers, we have an opportunity and responsibility to understand the relationship between homelessness and mental illness, address risk factors for homelessness, and provide evidence-based interventions for our patients experiencing homelessness and mental illness. In this collection, we highlight several studies and commentaries that explore unique challenges and solutions to addressing homelessness, particularly for people with mental illness. Articles in this collection describe the impacts of COVID-19, suicidality, childhood adverse experiences, and victimization on the mental health and psychosocial well-being of people experiencing homelessness. This collection also offers concrete solutions to these complex challenges, including housing-first models, which can lower shelter use; Medicaid demonstration waivers supporting housing; and peer navigation models that lead to improvements in general medical health and mental health. Now more than ever, our patients and communities experiencing these dual challenges deserve our attention and support.