Mental Illness and Homelessness: How Social Workers Help

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An estimated 144,000 people who are homeless on any given day also face mental illness.

Across the United States, an estimated 144,000 people who are homeless on any given day also face mental illness. A lack of adequate housing causes stress and isolation, and poor mental health negatively impacts physical health. The combination of homelessness and mental illness often results in a landslide of problems — including substance abuse and chronic unemployment — that proliferate into dire situations.

Social workers who try to break a cycle of residential instability, mental illness, poverty, and addiction often struggle to provide necessary services. To do the most effective job, social workers must connect homeless people having a mental illness with vital services. Social workers serve in emergency rooms, libraries, shelters, jails, and food banks to help those in need. They use every encounter to assist, the National Association of Social Workers said.

“It is a clinical social worker’s capacity to exercise clinical judgment across a variety of settings — taking advantage of any encounter, no matter how brief or long — that can play a critical role in the continuity of ongoing services for homeless and recently homeless people,” the organization said in its “Clinical Social Work with the Homeless” article.

Indeed, social workers who work with the homeless and people who have mental illness must have specialized skills to develop therapeutic relationships, evaluate for underlying problems, and find solutions. For social workers, a master’s in social work plays a critical role in learning and understanding the challenging connection between homelessness and mental illness.

Homeless in the United States

The most recent survey of the homeless population in the United States, taken in 2017, found about 554,000 people — including about 58,000 families — were homeless on any given night. The annual survey found an increase in the homeless population over the previous seven years.

At the same time, about one-third of the total homeless population in the U.S. is estimated to have untreated serious mental illnesses. Many do not realize their illness is severe or have access to services that can help. California and New York account for nearly 40 percent of the homeless population in the country. California also accounts for 49 percent of all unsheltered people (living on park benches, under bridges, and in vehicles) in the country.

Overall, the homeless population is made up of diverse groups that have distinct barriers to assistance. Some of the groups and barriers to service include:

  • Rural homeless

Rural homelessness, like urban homelessness, is typically a result of poverty and a lack of affordable housing. Studies show rural homeless individuals are more likely to be white, female, married, and employed. American Indians and migrant workers are also more likely to be homeless in rural areas.

When living in rural areas, individuals who are homeless typically have limited — if any — access to medical services. Researchers found that the homeless living in rural areas has higher rates of severe mental illness than those living in urban areas.

  • Chronically homeless

Anyone who has been homeless for a year or more or has had three episodes of homelessness in a three-year period is considered chronically homeless. The U.S. Office of National Drug Control Policy said about 30 percent of people who are chronically homeless have serious mental illnesses, and another two-thirds have substance abuse problems. Between the mental health issues and substance abuse, the chronically homeless typically have difficulty finding and maintaining housing.

  • Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth

About 31 percent of all homeless are youth age 14 to 24. Nearly two-thirds of them have a history of mental health problems including depression and anxiety. LGBT youth report high instances of bipolar disorder and post-traumatic stress disorder (PTSD) when compared to non-LGBT youth. Up to 73 percent of LGBT homeless youth report suicidal ideation, compared to 53 percent of their heterosexual peers.

Many LGBT youths who suffer from mental health problems won’t seek help because they distrust the system and worry about being labeled and objectified.

  • Veterans

Up to 8 percent of the homeless population are military veterans. About 80 percent of them have mental health or substance abuse problems. Many veterans suffer from the effects of depression, anxiety, and PTSD. While many veterans have access to healthcare, the VA healthcare system has severe shortages of providers and long waiting lists for services.

Despite the barriers to services that face all of the homeless groups, social workers are poised to provide help in various ways.

Helping the Population of Homeless People Who Have Mental Illness

For decades, community outreach organizations have been working to help the homeless who have mental health problems. Some of the practices that have helped include:

  • Direct housing

Housing First looks to provide an alternative to emergency shelters and transitional housing through direct access to permanent housing. Participants in the program are given access to safe, sustainable housing without preconditions for mental health or substance abuse treatments. Participants have access to supportive services for medical and mental health treatments.

  • Documented approach

The U.S. Interagency Council on Homelessness found documenting efforts to assist the homeless population decreases the chance of overlooking individuals. The systematic approach allows for collaboration between community partners and faster access to mainstream programs.

  • Collaboration with nontraditional partners

By teaming with nontraditional partners, such as hospitals, jails, and prisons, homelessness service providers are able to target individuals before they experience housing insecurity.

  • Healthcare Hotspotting

Through hot-spotting, or identifying geographic areas of high-needs individuals, social workers can methodically concentrate their efforts in communities. Hotspotters identify needy communities through data-driven research and proactively bring services to the areas.

In addition, social workers use other strategies to help people with mental illnesses who are homeless, including outreach programs and evidence-based practices. Earning an online master’s in social work provides vital information to reach vulnerable populations. The online Master of Social Work program at Ohio University allows graduates to expand their knowledge of social work to participate in a helping career.

About Ohio University’s Online Master of Social Work (MSW) Program

Ohio University’s online Master of Social Work program provides extensive educational experience for anyone who hopes to work to improve homelessness and mental illness issues. The program includes thought-provoking coursework that stimulates critical thinking and reasoning and field practicums that provide direct social work experience.

Ohio University’s MSW program is accredited by the Council on Social Work Education (CSWE) and meets the national standards in curriculum. The university is also accredited by the Higher Learning Commission, one of the leading accreditation agencies in the United States.


NASW, “Clinical Social Work with Homeless People, PDF”
Treatment Advocacy Center, “Serious Mental Illness and Homelessness, PDF”
HUD, “The 2017 Annual Homeless Assessment Report (AHAR) to Congress, PDF”
HHS, “Homelessness and Housing”
HHS, “West Virginia PATH Program Addresses Rural Homelessness”
Center for American Progress, “Seeking Shelter – The Experiences and Unmet Needs of LGBT Homeless Youth”
U.S. Department of Veterans Affairs, “Homeless Veterans”
U.S. Interagency Council on Homelessness, “The Role of Outreach and Engagement in Ending Homelessness: Lessons Learned from SAMHSA’s Expert Panel”