How Homelessness Impacts Mental Health

An estimated 2% of the global population is homeless, with many countries suffering more than others. Very often, a country’s high rates of homelessness reflect their overall poverty levels. This isn’t the case with the United States. The United States is the 12th richest country in the world, and yet in 2019, half a million people were homeless on any given night.

There are many reasons for the high rates of homelessness in this country, including home displacement, domestic abuse, substance misuse, and in the case of youths, family rejection. Family rejection in particular can lead to higher rates of depression, difficulty trusting others, and reduced resilience to stress.

Homelessness and Mental Health

Homelessness is defined by the U.S. Department of Housing and Urban Development (HUD) as "[lacking] a fixed, regular, and adequate nighttime residence."

Homelessness often means spending nights under a bridge, in a doorway, at a homeless shelter, on a stranger’s couch, or in an insulated hut.

Matt Pisani, an actor and LGBTQIA+ activist, was kicked out by his mother in the winter of 2017. Before he became homeless, he experienced domestic abuse, as well as various heart complications and anxiety due to stress, among other mental health issues, and was active in therapy and on medication. “I never imagined being kicked out,” Pisani said. 

For months, Pisani slept on trains, at New York’s Penn Station, on friends’ couches, and in strangers’ homes. He was abandoned by his family and he was separated from the comfort of his bedroom (which had become his safe haven) and his emotional support animal, which ultimately led Pisani to battle suicidal thoughts. “I felt hopeless,” said Pisani. “I had no idea where to go from there.” 

“Financial hardship or natural disasters, or other types of significant loss of home, family, and/or community [can] lead to homelessness, and homelessness will absolutely create its own kind of trauma thereby leading to a deterioration of both physical and mental health,” says Sovine.

“[Being homeless is] isolating and disenfranchising, serving only to compound what might already be a pre-existing mental illness or substance use disorder,” says Sovine, but often “trauma impacts the brain more than homelessness itself,” making it hard to determine if the mental illness existed before the homeless state or not.

At-Risk Communities

Studies show that homeless veterans have higher rates of chronic disease and comorbidities than their non-veteran counterparts. Over half experience at least one chronic health or mental health condition, including diabetes, heart disease, hypertension, cancer, bipolar disorder, PTSD, schizophrenia, and more.

Though there has been a decline in the prevalence of homeless veterans, it is clear that American veterans are at a high risk of homelessness, with more than 37,000 veterans experiencing homelessness on any given night in the United States.

“In my experience, there is not a [single] diagnosis that is common among our veteran population. I know of people with substance use disorders, a broad range of mental health conditions that include anxiety, and depressive disorders, along with post-traumatic stress disorder,” said Greg May, administrative director of adult services at Centerstone, a social services agency with locations in four states.

He believes that the reason so many veterans become homeless is due to a “lack of affordable housing, criminal records, past evictions, past due utility bills,” and so forth. 

Homelessness is also prominent in America's youth populations. An estimated 4.2 million youths and youth adults experience homelessness each year. Among the homeless youth population, 50% have been in the juvenile justice system or jail, and 69% report mental health problems. 

“Most of our youth have experienced complex trauma,” says Daniel Ballin, LCSW, director of clinical services at Covenant House California (CHC). 

Trauma can occur from domestic abuse, neglect, natural disasters, school violence, loss of a loved one, loss of a pet, parental divorce or separation, substance use disorder, bullying, and more. For many, that trauma goes unnoticed and therefore untreated, and this can very easily put youth at risk for homelessness.

How to Support Homeless Individuals

“Shelters need to have the supportive services to help homeless youth eventually transition to independent living in the community,” says Ballin. “Services need to include education, employment, health, and mental health.”

Unfortunately, as of 2021 there are only 11,241 community housing and homeless shelters throughout the country, and not all offer the support that homeless individuals need, such as counseling, health care, job support, financial guidance, tutoring, hygiene products, and even something so simple as open beds.

Sovine explains that being homeless makes one susceptible to becoming a victim of crime, witnessing violence, and becoming unseen and/or ignored by the rest of the community. This is why it’s so important for community members to recognize the problem and support the homeless. 

According to Sovine, you can hand out cards with information on shelters and/or other local support services, offer water and healthy snacks, or, at the very least, make eye contact and be kind.

Other ways you can support: offer tutoring services, donate clothing, volunteer to serve food, or donate to local shelters who need the financial support to continue helping the community.

A Word From Verywell

Even if you have temporary access to a shelter or bed, homelessness can be draining, dangerous, and harmful to one’s overall health and well-being. It’s important to support those in the homeless community, but also those at greatest risk of becoming homeless.