Video: Mental Health

Of the almost 600,000 people experiencing homelessness nationally, 25 – 30% have a severe mental illness (categorized as schizophrenia, bipolar disorder, or severe depression). The chronic stress of homelessness can worsen existing mental health conditions or, in some cases, lead to the development of new diagnoses. Take a moment to listen to youth with lived experience talk about accessing mental health care while living on the streets.

Many youth share concerns about access to mental health professionals, which can make long-term maintenance of mental health conditions difficult. Without easy access to a care provider, it can be difficult to initiate treatment as well. Medication management can be challenging if individuals are experiencing homelessness, even more so than the general population. Undesirable side effects such as drowsiness can have implications for personal safety. Additionally, many psychiatric medications, such as Adderall, are desirable as street drugs. This can leave individuals who need them in a precarious situation where they are vulnerable to theft from others.

Barriers to accessing physical health care that were discussed in Module 4, such as high cost, insurance, and disability status, are equally applicable to accessing mental health care. Mental health care providers are also often located in different facilities than primary care clinics. For many, the prospect of traveling to two locations to access care may not be realistic.

Co-Occurrence with Substance Use

Substance use and mental illness commonly co-occur in the general population. In one national survey, 75% of those with a substance use disorder also reported having a comorbid nonsubstance-related mental illness. Unfortunately, data on the rate of substance use for individuals living on the streets is sparse. However, many researchers believe the rate is the same or higher than that of the general population.

The most recent estimate from SAMHSA in 2003 indicated that nationally, 38% of those experiencing homelessness were dependent on alcohol and 26% were using other drugs. Age may be an influencing factor when it comes to usage on the street. One study found that alcohol usage was more common in older adults, while other drug usage was more common in homeless youth and young adults.

Activity

ACTIVITY: Imagine you have a diagnosis of bipolar disorder and are alcohol dependent while living on the street. Research your local area to answer the following questions.

Where can you seek free or low-cost care for your bipolar disorder? For your alcohol dependence?
What barriers did you find as you were searching for resources?
What is one area of need you found and how would you fill it?