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Homelessness and mental health


In a study in Western societies, homeless people have a higher prevalence of mental illness when compared to the general population. They also are more likely to be alcoholics and suffer from drug dependency. It is estimated that 20–25% of homeless people, compared with 6% of the non-homeless, have severe mental illness. Others estimate that up to one-third of the homeless suffer from mental illness. Studies have found that there is a correlation between homelessness and incarceration. Those with mental illness or substance abuse problems were found to be incarcerated at a higher frequency than the general population. Fischer and Breakey have identified the chronically mentally ill as one of the four main subtypes of homeless persons; the others being the street people, chronic alcoholics, and the situationally distressed.

The first documented case of a psychiatrist addressing the issue of homelessness and mental health was in 1906 by Karl Wilmanns.

In the United States, there are broad patterns of reform within the history of psychiatric care for persons with mental illness. These patterns are currently categorized into three major cycles of reform. The first recognized cycle was the emergence of moral treatment and asylums, the second consists of the mental hygiene movement and the psychopathic (state) hospital, and most recent cycle includes deinstitutionalization and community mental health. In an article addressing the historical developments and reforms of treatment for the mentally ill, Joseph Morrissey and Howard Goldman acknowledge the current regression of public social welfare for mentally ill populations. They specifically state that the "historical forces that led to the transinstitutionalization of the mentally ill from almshouses to the state mental hospitals in the nineteenth and twentieth centuries have now been reversed in the aftermath of recent deinstitutionalization policies". Ultimately, Morrissey and Goldman argue that while each transition expanded the American mental health system into today's "pluralistic patchwork of public and private" structural efforts, each failed to make lasting effects on the societally debilitating nature of chronic mental illness, including the linked effects of poverty and homelessness.


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