Information Center Bulletin
Volume 3, No. 1 Spring 1999

Reducing the Risk of Homelessness

Jenny, a 50-year-old recovering alcoholic with bipolar disorder, is accepted into a transitional housing program. After a few months, she shows signs of a return to drinking. Other residents complain she is borrowing but not repaying money. She may be evicted, possibly return to a shelter, or end up on the street.

Chuck’s schizophrenia requires that he live at home. His aging parents are having increasing difficulty dealing with his psychotic episodes. They worry they cannot care for him much longer, and they do not know what to do.

Jenny and Chuck are but two examples of people with serious mental illnesses who are at risk for homelessness. According to recent estimates, from 20 to 25 percent of homeless people have some type of severe and persistent mental illness. Many of these people became homeless in spite of receiving assistance through mental health service systems.

"We’ve all seen people on park benches or on sidewalk vents and are reminded of how dire the problem of homelessness is in this country. How many more are on the brink of losing their housing as well?" says Lawrence Rickards, Ph.D., of the CMHS Homeless Programs Branch.

To reduce the risk of homelessness for people like Jenny and Chuck, CMHS is exploring and evaluating three approaches:

1. Family intervention. Many people who have a serious mental illness live with family members, but as caretakers age or are no longer able to cope with the stress, the risk for eviction increases. To reduce this risk and prevent eviction, family members are provided with a "tool kit" of coping mechanisms. The tool kit can include respite care services, family education, and other supportive services.

2. Resource management. Some people with serious mental illness may misuse funds at times by making loans to friends, spending impulsively, relapsing into substance abuse, or forgetting to pay rent and other bills because of their psychiatric illness. A community mental health program in Chicago is using a "representative payee" model to support voluntary participants from among those receiving mental health care. The program participant works with a payee and case manager to budget expenses and track an in-house bank account. Some of the participants may eventually gain enough skills to eliminate the need for a payee; others may not be able to budget independently but will have support to prevent them from losing their housing.

3. Viability in housing. In New York City, an intensive case management model is being tried among people with serious mental illness who live in transitional housing, single-room occupancy residences, and independent housing arrangements. The idea behind the model is that frequent and regular contact with persons receiving mental health care can provide enough support to keep their housing from being in jeopardy.

"By trying new and innovative approaches to prevention," Rickards says, "perhaps the problem can be stemmed for more people who are at risk."

The evaluation phase of these approaches is in its early stages. An interim report is scheduled for the winter of 1998–99. Information about this report and other publications on homelessness and mental illness is available through the Information Center by calling toll free telephone (1-800-789-2647) or visiting the Web site (mentalhealth.samhsa.gov).

For more information, contact Lawrence Rickards, Ph.D., at CMHS, 301-443-3706.

Information Center Bulletin
Volume 3, No. 1, Spring 1999