Although we don't have a vaccine for mental health or substance use disorders, we do have practical and effective solutions. They are the effective and evidence-based practices we know work — access to treatment, harm reduction services, mental health support, peer support groups, and perhaps most importantly, educating our community to reduce stigma and promote compassion.
Andrew Bove, Preble Street Vice President of Social Work
Mental health and homelessness are interconnected, and many people Preble Street serves have complex mental health needs. This May, duringMental Health Awareness Month, we are exploring the relationship between mental health and homelessness, with insights from survey data, research, and our nearly 50 years of working experience.
How does mental health impact people experiencing homelessness?
People experiencing homelessness reporthigher rates of serious mental illness(e.g. schizophrenia, bipolar disorder, etc.) than the general public. However, the number of people who report a serious mental illness are still a small percentage of the overall number of people experiencing homelessness.
To address the needs of the entire homeless population and undo misconceptions about homelessness, we must acknowledge that NOT all unhoused people have a serious mental illness.
of unhoused people in Maine reporting a serious mental illness
0%
of unhoused people in the U.S. reporting a serious mental illness
~0%
What is the relationship between homelessness and mental illness or substance abuse?
There are many misconceptions about the relationship between homelessness and mental illness. People can lose housing for many reasons – economic reasons, death of a family member, domestic violence, end of relationship, etc. – and research shows that increases in homelessness are not strongly connected with the number of individuals who have mental illnesses or substance abuse disorders. In fact, mental or behavioral health disorders and substance abuse are many times outcomes of experiencing homelessness. The stress and trauma of homelessness makes it a known risk factor for creating the conditions for mental illness and substance abuse disorders (3).
If not mental illness or substance abuse, what is the best indicator we have for rises in homelessness?
The best predictor we have for homelessness is a lack of affordable housing in an area (4). High rent prices and low vacancy rates are shown to increase homelessness, while mental illness and substance abuse do not have a demonstrated connection to increases in homelessness rates (5). Survey data from the last 10 years also supports this. When asked, people say economic reasons are the cause for losing their housing – job loss, eviction, rent increase, money challenges, etc. –not mental illness (6-7).
Who does Preble Street serve?
Preble Street serves some of the most vulnerable members of the unhoused community, with the highest need. This population has complex mental health needs and many times substance abuse disorders as well.
In some cases, Preble Street serves people who can’t receive services from other providers in Portland. This is because some people don’t trust the medical or social work community, or they’re barred from accessing services after previous altercations with staff or other community members.
People who have experienced chronic homelessness and who have a mental health and/or substance abuse disorder require lots of care, treatment, and patience from service providers, as transitioning them into housing is a long and extensive process. Preble Street has various programs, working to address the distinct needs of different populations in Portland and beyond. To read more about what we do, clickhere.
What are the solutions?
For there to be any real “solution” to homelessness, we must focus on prevention and establishing more durable systems of care. Social and economic factors, like adverse childhood experiences, lacking mental health services, racial inequities, economic inequality, the rise of housing costs, etc., all contribute to rising rates in homelessness, especially among people with mental illness, and must be addressed with joint policy and advocacy efforts.
Moving people into housing, there is no one-size-fits-all solution for people experiencing homelessness, but the Housing-First model, which prioritizes access to permanent, stable, and affordable housing, has proven effective, especially for people with different needs who have experienced chronic homelessness. Preble Street’s three Site-based Housing-First programs,Logan Place,Florence House, andHuston Commons, as well as Rapid Rehousing, an evidence-based program, using a Housing-First approach to help people return to housing quickly, all demonstrate the effectiveness of the Housing-First model in stably housing people with different needs. With Housing-First and usingestablished social work practices, we find receptiveness from people who have experienced chronic homelessness, transitioning them into housing for the long-term.
1. U.S. Department of Housing and Urban Development (2023). Part 1 – Point in Time Estimates of Homelessness. Abt Associates.
2. MaineHousing (2023). 2023 Point in Time Count. Maine State Housing Authority.
3. Goodman, Lisa A, Leonard Saxe, and Mary Harvey (1991). Homelessness as psychological trauma. American Psychologist, 46(11): 1219–1225.
Corcoran, C., Walker, E., Huot, R., Mittal, V., Tessner, K., Kestler, L., & Malaspina, D. (2003). The stress cascade and schizophrenia: Etiology and onset.Schizophrenia Bulletin, 29(4): 671–692.
Castellow, Jennifer, Bret Kloos, and Greg Townley (2015). Previous homelessness as a risk factor for recovery from serious mental illnesses.Community Mental Health Journal,51: 674-684.
4. Shinn, Marybeth, Jim Baumohl, and Kim Hopper (2001). The prevention of homelessness revisited. Analyses of Social Issues and Public Policy,1.1: 95-127.
Shinn, Marybeth (2009). Ending Homelessness for Families: The Evidence for Affordable Housing. Washington, DC: National Alliance to End Homelessness and Enterprise Community Partners.
Colburn, G., & Aldern, C. P. Homelessness is a housing problem: How structural factors explain US patterns. Univ of California Press, 2022.
National Coalition for the Homeless (June 2007).Why Are People Homeless? National Coalition for the Homeless.
5. All Home & Applied Survey Research (2019). Count Us In: Seattle/King County Point-In-Time Count of Persons Experiencing Homelessness.
6. Snow, David A. and Rachel E. Goldberg (June 2017). Homelessness In Orange County: The Costs to Our Community.
7. Applied Survey Research (2022). 2022 Alameda County Homeless Count And Survey Comprehensive Report.
We need landlords to end homelessness
May 28, 2024No Comments
To address homelessness and housing insecurity in Maine, the help and support of landlords is critical. Preble Street works closely with landlords to identify and maintain stable housing for clients. Their partnership is crucial to successfully housing people, who are transitioning from shelter or the street. Veteran’s Housing Services(VHS), in particular, frequently works alongside landlords
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Mental health and homelessness – know the facts
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Although we don’t have a vaccine for mental health or substance use disorders, we do have practical and effective solutions. They are the effective and evidence-based practices we know work — access to treatment, harm reduction services, mental health support, peer support groups, and perhaps most importantly, educating our community to reduce stigma and promote
Read More »
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What does a low-barrier shelter look like? At a time when unsheltered homelessness is increasing exponentially in our community and the shortage of low-barrier shelter beds has created a state-wide homelessness crisis, Elena’s Way and Florence House are a model for how we can take care of the most vulnerable people in our community. The
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Celebrating advocacy wins
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Low-barrier shelters receive funding for the next three years… On April 22, 2024, Governor Janet Mills signed the supplemental budget into law, which includes three years of $2.5M in annual funding — a total of $7.5M — to directly support emergency low-barrier shelters. This funding will be incredibly impactful for Maine’s five privately operated, low-barrier
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19 years of Site-based Housing First at Logan Place
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“For me, eventually, is a key word. It’s my first apartment in 14 years,” shares Kabir. Kabir is the newest resident of Logan Place, Maine’s first Site-based Housing First building, which opened 19 years ago this month. Logan Place has 30 efficiency apartments, with 24-hour on-site support for adults who have experienced chronic homelessness. Kabir
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The Importance of Low-Barrier Shelters in Our Community
February 28, 2024No Comments
What does a low-barrier shelter look like? At a time when unsheltered homelessness is increasing exponentially in our community and the shortage of low-barrier shelter beds has created a state-wide crisis, Elena’s Way and Florence House are a model for how we can take care of the most vulnerable people in our community. The staff
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