Are most of homeless people mentally ill?

I sometimes see them talking to the air (when no one is around them) or laughing for no apparent reason. I believe most of them are mentally ill.

Are they homeless because they are mentally ill, or they are mentally because they are homeless (the state of being homeless driving them mad)

Talking to the air, or using their phones with bluetooth?

In summary, the 3 D’s

Destitute
Dependent (drugs)
Demented

The original core of the modern American homeless began in the early 1980’s when Reagan cut off Federal money to the “insane asylums” and the patients were simply kicked out. Most had family, some had church, some could get into VA programs - but absolutely nobody had plans for every mental patient being dumped at once.
Thousands “fell through the cracks”.

After “the homeless” became considered “they will always be with you” and ignored, the addition of the long-term unemployed was not noticed. Druggies have always been marginal - quite possibly homelessness is a net boom for them. As druggies they wouldn’t get much help. As homeless, they can now at least get in the line.

I was going to make a stupid wisecrack, but usedtobe nailed it. Just another benefit bestowed on us by St Ronald. Anybody with half a brain saw it coming and said that we had confined those people for a reason and asked where the hell are they going to live, but we got hemming, hawwing, and platitudes about private and religious charity for an answer. Didn’t work. :frowning:

As much as I hate defending Reagan, I always heard that he did that as Governor. Never heard the federal version
Thread on Snopes message board. Has a differen5t take on the matter.

Not all the blame can be put on Reagan. Ken Kesey deserves at last half of it.

Seriously, what you had was a confluence of two movements: People who thought “One Flew Over the Cuckoo’s Nest” was a documentary, and bean counters who saw a buck to be saved/spent on something else.

Reagan did that as governor of Ca. I don’t believe he did it federal.

Mea culpa. :frowning: Still don’t like him.

PBS had a documentary about losing the asylums/institutions. It was fascinating.

I’m an MSW, and I worked at… okay, name withheld, in Portland. They have a lot of different branches. I did supported employment and skills training at a transitional housing in a suburb (the worst traffic nightmare location ever. Portlandians, you may have figured out where this is!!) The criteria were that on admission, people had to be homeless with a co-occurring addiction and SPMI diagnosis. (can’t ever remember if “co-occurring” is correct in
this context, or if it refers to developmental disabilities and a concurrent addiction… anyway…)

But here’s the thing. When we’re talking about SPMI’s in homeless people, it’s never some kind of “uncomplicated” case of, say, schizophrenia. There’s always a huge trauma element. About 25% of all homeless people today are veterans, and what we’re really looking at here is PTSD. So the picture is much more complicated than we are often led to believe.

I’m wondering how a study could be done on this. It’s not exactly easy or ethical to take a large group of random people and force half of them to be homeless for a few years and then bring them back and evaluate them for newly developed mental disorders. E.g. “We had 1000 test subjects with no history of mental illness. 500 were kept as a control group and the other 500 were promised $100,000 if they would live on the streets of Boston for five years. 20 of them died of hypothermia, 5 were murdered, 30 quit and went home, and 10 were dropped after they left the permitted zone and became homeless in Southern cities. At the end of five years, we gathered up the remaining participants. 66 had developed OCD, 101 had clinical depression, 93 had Bipolar I, 25 had Bipolar II, and 4 had Somatoform Disorder Not Otherwise Specified. The researcher regretfully reports that 107 of the test subjects who developed mental disorders have been deemed unlikely to ever return to gainful employment and will likely be public charges for life. Twenty three test subjects were deemed to be a Danger to Self or Society under the Mental Health Act of 1994 and are being held indefinitely at the State Psychiatric Hospital in Capital City.”

From the other direction, a study seems more reasonable. Take a group of people with and without mental disorders and check up on them over the years and determine if and when any of them become homeless.

There are the chronic homeless mostly due to drug and mental issues and the transitional homeless mostly due to economic issues caused by a confluence of bad luck, and often some measure of poor decision making.

I assume you are talking mainly about the chronic homeless. In those scenarios it’s mainly about substance abuse and mental issues. Where one ends and the other begins is hard to ferret out. With help and therapy some of that population can get out of that rut, but it’s very hard. Eventually IMO all the hardcore, long term homeless are going to have serious mental issues of some kind or another just due to the lifestyle.

Back when I volunteered with homeless outreach, I’d say a small percentage (single digits) of the homeless I worked with had clear mental illnesses. But there were areas that I wasn’t willing to visit, due to safety issues. I might have been selecting for the more ‘sane’ ones.

Research is also complicated by the fact that some - not all, but some - homeless people feign mental illness periodically. When I was in my psych rotation, it was remarkable how many of the patients had started hearing voices around the 15th of the month and were admitted through the ER, and then miraculously got better on the 3rd when SSI and SSDI checks arrived. Then when the money ran out a couple of weeks later, the voices came back…

Hell, I can’t even really blame them. They felt the shelters unsafe, and it gets cold out there during Chicago winters. Mention that the voices are telling you to hurt yourself again, and you get three meals and all the snacks you can eat, heat, and nice bed with hardly any bugs in it and security guards to keep the peace.

So those patients all have official diagnoses of mental illness…but how many of them truly have mental illness? Hard to tell.

Another aspect of the whole homeless picture is that you only see homeless people who haven’t the ability to be invisible. You don’t see the mom with the three little kids who all live in the car, or the day laborer who shaves every morning in the public library bathroom and sleeps in church basements. They spend all their energy coping with their situation and trying to look – and be – as normal as possible. Most of the homeless are there by virtue of misfortune and a shitty economic environment, not craziness.

The people in filthy rags wheeling grocery carts full of plastic bags full of nameless items, muttering – that’s the tip of the iceberg.

We figure out here the Chronic Homeless are* about* 1/3 or so. The Homeless by choice are about 1/3*, and the “one check away from being homeless and they lost that check homeless” are about another 1/3. This last group are often living in their cars, or “couch surfing”.

  • you see them begging but they usually live in “homeless camps”, some beg, some do day labor, almost all get some sort of assistance, unless they are illegal aliens, and even they can get food.

There’s a couple of things I’d like to mention. First, when I was 19, I was making $14,200 a year, and I rented a one-bedroom apartment in San Francisco for $350 a month. Nowadays, I doubt that same position I held in a reinsurance brokerage pays a whole lot more than it did then – but that same apartment probably costs five times as much.

Second, there’s something almost no one seems to know about homeless people, but I know it’s true because I was homeless myself on and off for quite awhile, and I have many friends who were or are homeless too:

Being able to get up at the same time every day, and go to the same place, and do the same thing, is a separate skill that not everyone has. It is nothing to do with laziness. Many of my homeless friends work much harder than the average person just keeping themselves fed and safe and warm at night. They will walk all over creation collecting recyclables, or jump through ridiculous hoops just to use somebody’s shower, or build themselves an invisible camp someplace where there’s some trees and have to go through all kinds of motions to avoid being detected. They don’t steal, and they pay sales tax when they buy things just like everyone else. Many of them get no government assistance at all. What they have is a constitutional inability to regiment themselves to a sufficient degree to hold down a regular job. Is that a mental illness? I don’t know; but I’ll bet if you ask those “homeless by choice” folks, you would find that some of them would love to be indoors somewhere, but they know themselves well enough to know that they just can’t do the 9-5 thing. Probably the only reason I’ve been housed for more than 10 years now is that I found a job where my hours are very, very flexible.

Remember that, like so many aspects of our modern lives, living by the clock and dull, repetitive labor (i.e., low-paying type jobs) are relatively recent additions. (Subsistence farming, which most humans have done throughout most of our history, may be repetitive, but it’s not dull.) Interpersonal politics, like getting along with the jerks at work, and trying to blend in with people who really are not like you , are also things that not everyone can do. Sure, you may have been getting up every weekday at 6am for 20 years with no problem, but that doesn’t mean it’s a basic human skill like tying your shoes.

In any society where you pretty much are forced to accept a narrow selection of lifestyle options, there will always be a certain percentage who just don’t fit. It’s not their fault, and they’re not doing it on purpose.

I don’t mean to say that this is true of all homeless people. I will say that I think it’s a much bigger factor than anyone has noticed.

Based upon my personal experience (as a volunteer) at shelters, I would say that the majority of the homeless are severely mentally ill. Many “self medicate” via alcohol or drugs, and some are completely out of it. The real issue is the closing of the state mental hospitals-these people were supposed to be treated at community health centers-but they cannot be made to take their medications, so they avoid any treatment. A tragic situation, but inevitable, given the impossibility of hospitalizing someone against their will. A few years ago, in Cambridge MA, my wife recognized an ex-patient of here-this woman was hosed in a hospital for the criminally insane-and here she was walking the streets. She was severely delusional, and thought that the CIA was trying to kill her.

Every single country I have been in, including ones with generous social safety nets like Germany, have had a homeless/vagrant population. I disagree with the idea that lack of housing is the sole problem, it is mental illness along with or alongside hard core drug addiction. And unless you plan to force people into institutions at gunpoint you’re never going to eliminate the issue.

There are a lot of homeless that aren’t even severely mentally ill(totally delusional stuff like the CIA after them etc) they are just “off” enough that it prevents them from getting an entry level job and they have no support like family etc.

Entry level jobs are actually much more demanding and harder to get them skilled jobs, having Aspergers or high functioning autism can just lock you out. I think a lot of people know someone who has never worked a day in their life, now imagine they didn’t have a family to support them and where would they be?