Asking for Change: Homelessness and Mental Health

May 2019

Homelessness is a term that varies from country to country. The U.S. Department of Housing and Urban Development describes a homeless person as someone who “lacks a fixed, regular, and adequate nighttime residence.” Roughly 553,000 Americans experienced homelessness on a single night in 2018 (2018 Annual Homelessness Assessment Report). Of those, 37,800 (6.8%) were homeless veterans. In the collection presented below, the first two articles focus on U.S. Department of Veterans Affairs services for homeless veterans and the effect of homelessness on mortality. Homelessness has multiple etiologies, among them economic difficulties, cognitive impairment, mental illness, and substance use disorders. The next two articles, about Supplemental Security Income/Social Security Disability Insurance Outreach, Access, and Recovery (SOAR) and emergency department use, examine the characteristics of people accessing these services. Several articles in this collection focus on the effects of housing, including Housing First models, which help reduce homelessness and decrease use of nonroutine health services. Interventions to prevent homelessness are explored, including critical time intervention. Two studies examined the relationship between housing and forensic encounters and how community integration affects homeless individuals who have severe mental illness. This collection offers the opportunity to better understand the social contexts and challenges this unique population faces, as well as some exciting ideas as to how these challenges can be addressed.

Alan Tomás Rodríguez Penney, M.D.
Lisa B. Dixon, M.D., M.P.H.

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Descriptive Studies

National Utilization Patterns of Veterans Affairs Homelessness Programs in the Era of Housing First
Jack Tsai, Ph.D., and Thomas H. Byrne, Ph.D.
2019, Volume 70, Issue 4, pp. 309–315

Also featured in the Homelessness and Mental Health: Part 1 collection.

Increased Mortality Among Older Veterans Admitted to VA Homelessness Programs
John A. Schinka, Ph.D., Robert M. Bossarte, Ph.D., Glenn Curtiss, Ph.D., William A. Lapcevic, M.P.H., M.S., Roger J. Casey, Ph.D.
2016, Volume 67, Issue 4, pp. 465–468


SSI/SSDI Outreach, Access, and Recovery (SOAR): Disability Application Outcomes Among Homeless Adults
Evan M. Lowder, Ph.D., Sarah L. Desmarais, Ph.D., Shevaun D. Neupert, Ph.D., Melissa A. Truelove, B.A.
2017, Volume 68, Issue 11, pp. 1189–1192


Factors Affecting Emergency Department Use by a Chronically Homeless Population
David Thomas Moore, M.D., Ph.D., and Robert A. Rosenheck, M.D.
2016, Volume 67, Issue 12, pp. 1340–1347

Preventing Homelessness and Retaining Housing

Opening More Doors to End Homelessness Through a Shared Housing Approach
Molly Brown, Ph.D.
2016, Volume 67, Issue 10, p. 1161

Also featured in the Homelessness and Mental Health: Part 2. The Impact of Housing Interventions collection.

Factors Associated With Premature Exits From Supported Housing
Sonya Gabrielian, M.D., M.P.H., Alaina V. Burns, M.D., M.P.H., Nupur Nanda, B.A., Gerhard Hellemann, Ph.D., Vincent Kane, M.S.W., Alexander S. Young, M.D., M.S.H.S.
2016, Volume 67, Issue 1, pp. 86–93

Also featured in the Homelessness and Mental Health: Part 2. The Impact of Housing Interventions collection.

Randomized Trial of Critical Time Intervention to Prevent Homelessness After Hospital Discharge
Daniel B. Herman, D.S.W., M.S., Sarah Conover, M.P.H., Prakash Gorroochurn, Ph.D., Kinjia Hinterland, M.P.H., Lori Hoepner, M.P.H., and Ezra S. Susser, M.D., Dr.P.H.
2011, Volume 62, Issue 7, pp. 713–719


Community Integration of Formerly Homeless Men and Women With Severe Mental Illness After Hospital Discharge
Joy Noel Baumgartner, Ph.D., M.S.S.W., and Daniel B. Herman, Ph.D.
2012, Volume 63, Issue 5, pp. 435–437


A Multiple-City RCT of Housing First With Assertive Community Treatment for Homeless Canadians With Serious Mental Illness
Tim Aubry, M.A., Ph.D., Paula Goering, R.N., Ph.D., Scott Veldhuizen, M.A., Carol E. Adair, M.Sc., Ph.D., Jimmy Bourque, Ph.D., Jino Distasio, Ph.D., Eric Latimer, Ph.D., Vicky Stergiopoulos, M.D., M.H.Sc., Julian Somers, Ph.D., David L. Streiner, Ph.D., Sam Tsemberis, Ph.D.
2016, Volume 67, Issue 3, pp. 275–281

Also featured in the Homelessness and Mental Health: Part 1 collection.

Outcomes of Housing Programs

Effects of Housing First on Employment and Income of Homeless Individuals: Results of a Randomized Trial
Daniel Poremski, Ph.D., Vicky Stergiopoulos, M.D., Erika Braithwaite, M.Sc., Jino Distasio, Ph.D., Rosane Nisenbaum, Ph.D., Eric Latimer, Ph.D.
2016, Volume 67, Issue 6, pp. 603–609

Also featured in the Homelessness and Mental Health: Part 2. The Impact of Housing Interventions collection.

Housing Programs for Homeless Individuals With Mental Illness: Effects on Housing and Mental Health Outcomes
Elizabeth A. Benston, M.S.W., L.S.W.
2015, Volume 66, Issue 8, pp. 806–816

Also featured in the Homelessness and Mental Health: Part 2. The Impact of Housing Interventions collection.

Life Changes Among Homeless Persons With Mental Illness: A Longitudinal Study of Housing First and Usual Treatment
Geoffrey Nelson, Ph.D., Michelle Patterson, Ph.D., Maritt Kirst, Ph.D., Eric Macnaughton, Ph.D., Corinne A. Isaak, M.Sc., Danielle Nolin, Ph.D., Christopher McAll, Ph.D., Vicky Stergiopoulos, M.D., M.H.Sc., Greg Townley, Ph.D., Timothy MacLeod, M.A., Myra Piat, Ph.D., Paula N. Goering, R.N., Ph.D.
2015, Volume 66, Issue 6, pp. 592–597

Also featured in the Homelessness and Mental Health: Part 2. The Impact of Housing Interventions collection.

Homelessness and Forensic Encounters

Criminal Behavior and Victimization Among Homeless Individuals With Severe Mental Illness: A Systematic Review
Laurence Roy, Ph.D., Anne G. Crocker, Ph.D., Tonia L. Nicholls, Ph.D., Eric A. Latimer, Ph.D., and Andrea Reyes Ayllon, M.Sc.
2014, Volume 65, Issue 6, pp. 739–750

Also featured in the Homelessness and Mental Health: Part 1 collection.

Associations of Housing First Configuration and Crime and Social Connectedness Among Persons With Chronic Homelessness Histories
Elizabeth Whittaker, B.A., B.Bus.Man., Paul Robert Flatau, M.Ec., Ph.D., Wendy Swift, Ph.D., Timothy A. Dobbins, B.Math., Ph.D., Lucinda Burns, M.P.H., Ph.D.
2016, Volume 67, Issue 10, pp. 1091–1097

Also featured in the Homelessness and Mental Health: Part 2. The Impact of Housing Interventions collection.

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