Homelessness and mental health linkages: review of national and international literature
Current research highlights the interaction between individual and structural factors as contributing to the high rate of mental illness among people who are homeless. However, the direction of causality between risk factors and homelessness is less clear. Drug abuse, social isolation and mental disorders are plausible consequences as well as causes of homelessness. The constant fear, danger and victimisation may result in people becoming emotionally distressed and the development of a mental illness. There is also evidence that severe mental disorders, such as psychotic illnesses, are a risk factor, rather than a consequence of homelessness (Herrman & Neil, 1996). As stated earlier, hallucinations, disruption of thoughts, disorientation, paranoia, anxiety, loss of motivation or interest in their own welfare, and other disability may contribute to an increased vulnerability to homelessness (Breakey & Thompson, 1997).
In addition, lack of employment opportunities, limited housing options, stigma and discrimination associated with having a mental illness may contribute to the risk of homelessness, while also being a consequence of the homeless state.
More recently the debate about individual and structural risk factors has shifted to a focus by researchers and policymakers on the continuum that crosses over individual and structural issues. The concept of a continuum enables us to examine factors that precipitate homelessness, the causes and consequences of homelessness as well as the factors that may inhibit or exacerbate the homeless trajectory (Greenhalgh, Miller, Mead, Jerome, & Minnery, 2004).
A coherent response to the general problem of homelessness requires an understanding of the interaction between individual characteristics and social factors (Main, 1998). Risk factors for homelessness will be examined in terms of the individual and structural associations of homelessness, the interaction between the two, and the influence of a mental illness on these risk factors.
1.5.1 Individual characteristics
1.5.2 Social factors