The Chicken and Egg Problem of Mental Health Issues and Homelessness

I recently wrote about the challenges of mental health and homelessness, and how sometimes homelessness itself causes mental health disorders in individuals. In general, we assume that people become homeless because they have mental health disorders, not that homelessness causes people to have mental health disorders. Elliot Liebow looks at the issue with a much more careful eye in his book Tell Them Who I Am. Liebow writes,
“Mental health problems and homelessness stood in a chicken-and-egg relationship to one another. Homelessness was seen as a cause of mental health problems just as often as mental health problems were seen as a cause of homelessness. Indeed, it was not uncommon for the women to use their homelessness to explain their sometimes ungenerous behavior.”
Being homeless is stressful. Homeless individuals cannot maintain many basic possessions. They face uncertainty with meals, where they will sleep, how they will go to the bathroom, and whether they will be in danger from weather, animals, or other people. They don’t have a lot of people, besides other homeless individuals, to speak to and get support from. Liebow writes about the ways this stress can boil over for the homeless, and how sometimes the women he profiled for his book would lash out or act irrationally and blame it on the stress of homelessness. With no safe places, shelters that impose rules and ask prying questions, and with little to keep one’s mind engaged and hopeful for a better future, it is not hard to imagine how the stress of homelessness could become overwhelming and spark mental health problems.
At the end of the day, however, this chicken-and-egg relationship should be encouraging. Not all the people who end up homeless have mental health problems – at least not when they initially experience homelessness. This means that early interventions and support can help keep people from developing worse mental health problems that prevent them from rejoining society. It also means that providing stable housing and shelter can help reduce some of the mental health problems that the homeless face, easing their potential reintegration into society. We can also look at the relationship between mental health and homelessness to see that providing more mental healthcare to people currently working and maintaining jobs may support them and keep them from becoming homeless. Preventative mental health care can prevent stress and anxiety worsening to drive someone into homeless where their mental health could further deteriorate. The key idea is that we shouldn’t dismiss the homeless as helpless crazy people. We should see investments in mental healthcare at all levels of society as a beneficial preventative measure to reduce and address homelessness.

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