Posted on May 26, 2022 by Taysha Milagros Clark May is Mental Health Awareness Month, and too often, we hear people conflate mental illness and homelessness, thereby perpetuating harmful stereotypes. Such misconceptions deflect attention from the root causes of homelessness and obscure the underlying structural and systemic inequities that cause it to persist. Many people are homeless primarily because they cannot afford housing, and not all people who are homeless have a mental illness. However, untreated mental illnesses can contribute to and prolong a person’s homelessness, and the trauma of homelessness can exacerbate mental health challenges. Many people sleeping in DHS shelters in 2020 reported serious mental illness diagnoses, including more than 6,500 people with bipolar disorder, nearly 3,500 people with schizophrenia, and more than 1,100 with schizoaffective disorder, as well as thousands more who reported other mental health conditions including post-traumatic stress disorder, anxiety, and depression. The solution to homelessness, for those with and without mental health challenges, is housing that meets people’s needs – be it supportive housing or permanent affordable housing. It is exceedingly difficult for people to manage mental illnesses if they do not have the stable foundation of decent, affordable housing. Supportive housing is a cost-effective solution proven to reduce homelessness and improve outcomes for people with serious mental illnesses, but the demand greatly exceeds the supply and the process of accessing supportive housing is rife with bureaucratic roadblocks. More broadly, far too many New Yorkers with mental illnesses are unable to access the basic care they need. As we explained in a Fact Check on Homelessness and Mental Health Care in December 2021, of the 93,925 adults eligible to receive mental health services in New York City under the State’s managed care program for those with serious mental illnesses, only 2.3 percent (2,179 individuals) actually received that care in the year prior – a statistic that speaks to the difficulties people face when seeking services. Our State of the Homeless 2022 report summarized the problem: “While much of the public discourse has centered around involuntary treatment, in reality many people with serious mental illnesses are not able to access care even when they seek it because of the loss of inpatient psychiatric beds, barriers related to managed care for outpatient services, and the failure to connect people to the long-term supports and stable housing they need to succeed.” We’ve heard verbal commitments to address mental health and homelessness from countless City and State officials, though these commitments are meaningless without sufficient investments in supportive housing and accessible health care for people with serious mental illnesses. Regrettably, rather than investing in housing and services for some of the most vulnerable communities, lawmakers too often criminalize and vilify people experiencing homelessness and/or mental health challenges. New York City Health Commissioner Dr. Ashwin Vasan recently spoke about this reality, acknowledging that housing is key to health, and highlighting the need for community investments in mental health services that match the scale of the need. Framing mental illness as a public safety issue rather than a public health issue places people at greater risk, engenders fear in the community, and perpetuates harmful stereotypes. Recent initiatives like Mayor Adams’ encampment sweeps and subway safety plan are counterproductive and fray the relationships between outreach workers and unsheltered New Yorkers, including those with mental illnesses. New York City and State officials must get serious about addressing mental illness and homelessness by discontinuing the culture of neglect and disinvestment, bringing solutions to scale, and taking actions that transform their rhetoric into a positive reality for all New Yorkers.
