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  • Writer's pictureAsha Creary

Mental Illness: The Homelessness Pipeline

Updated: Nov 3, 2022


Homelessness is at an all time high, with major cities like Austin, Los Angeles, New York City, and many more reporting a spike in their homeless populations.

From the outside, most articles shedding light on homelessness are from an inflation perspective or through a housing crisis lens. In today’s article, I'm going to speak on homelessness from a mental health perspective.


Homelessness has been on the rise since the 1970’s due to the deinstitutionalization of the mental illness population and a number of other reasons like HIV/AIDs, federal budget cuts, a lack of affordable housing, and rise in the crack cocaine epidemic.


According to Psychiatric Times, homelessness and mental illness has proven to be correlated, so let's approach the topic from a clinical perspective.


In the past, those struggling with mental health related issues were institutionalized, so the homeless population was not nearly as prevalent because they had an asylum to remain in.

Of course we can get into the ethics of institutionalizing those with mental illness, but we'll leave that for another blog.


As a licensed therapist, I've found that my clients often do not know what their rights are regarding mental health and time off. I bring this up because it will best help to describe one way to prevent homelessness as we continue.


According to the Family & Medical Leave Act (FMLA), employees have the right for leave due to a mental health related disorder up to 12 weeks. And while small businesses may fall under FMLA rule exemptions, for the sake of this piece we will envision large corporations with more than 100 employees.

FMLA includes taking days, weeks, or months off from work due to certain forms of mental illness. And inn some instances, employees can request reduced work due to their disability.


The point here is that many people struggle with mental illness to a point that it affects their ability to perform at work. This of course makes those who are already some of society's most vulnerable additionally vulnerable to job loss and ensuing homelessness.



For example, when a person is experiencing depression they typically experience fatigue, loss of energy, insomnia/hypersomnia, low motivation, and a diminished ability to think or concentrate.

If we take those symptoms and apply them to the work environment, we can see how this may lead to low productivity and then job loss.


If I am fatigued and experience extreme loss of energy, I may not have enough energy to complete required tasks. If I am not motivated to do my job, I may begin to reduce my productivity. If I have a diminished ability to think or concentrate, I may start making an increased number of errors which then lead to increased write ups. If I am calling in because my depression is so severe, I may lose my job.


Thanks to FMLA though, with proper documentation a person can reduce their risk of job loss and homelessness. If my doctor or therapist deems that the onset of my symptoms last 3 days and I take three days off, I fall within FMLA guidelines.


That is not to say you can’t still lose your job for other reasons- but having official documentation to present an employer about the disability may reduce the risk.


Let's also consider those who have personality disorders, people who notoriously struggle maintaining healthy relationships. If a person has a personality disorder and they begin to create a toxic work environment or struggle to get along within their team, they are more likely to lose their job because of their difficulties communicating with others.


If they lose their job, they may be at risk of losing their home. And consider if they're dependent on others for their housing- if those relationships are strained too, that risk of a relationship falling apart and losing their home is all the more increased,


Most people are able to seek refuge with friends or family- but when someone with a personality disorder has burned all bridges they have nowhere else to go other than the street.


Substance use disorders are also a risk factor leading to homelessness. There are so many stories of individuals getting fired for being intoxicated or under the influence while on the job.


Other instances would be their addiction becoming such an expensive habit that they stop paying their bills, leading to eviction and home loss.



With all these examples of how mental disorders can create a pipeline to homelessness- I hope you found this discussion on the mental health-homeless link insightful.


As we continue to touch on this subject, let's remember this statement: “No person in their right mind would be okay with living on the streets. If they can’t stay with family or friends, they must be struggling with a mental health condition.”



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