Mental Health Issues Among People Who Are Homeless and Living With Disability in the US

Homelessness, coupled with disability and mental health, is one of the most sensitive issues affecting the public health of people in the United States, as these factors tend to compound the dilemma of affected individuals. Current homeless people and the ones with disabilities are more predisposed to mental disorders that adversely affect their ability to find homes and other necessities. They frequently deal with different types of psychiatric disorders, such as severe depression, anxiety, schizophrenia, and post-traumatic stress disorder, the majority of which receive a poor diagnosis and even poorer treatment because of the difficulties this population faces in accessing sufficient healthcare. In addition, they do not have any permanent homes or houses, and temporary homes or shelters make them unstable and affect their physical and mental health negatively through a continuous loop of homelessness and illness. This describes a complicated system of sociology and health that requires interventions from both medical and psychosocial, housing, and disability support services to remedy the source and prevent an extreme level of this psychosocial disease. Specifically, this paper shall seek to establish the different mental health disorders amongst homeless and disabled people in the United States, the various kinds of housing interventions employed in tackling the challenges above, and the political and service delivery repercussions.

Prevalence and Types of Mental Health Issues

The problem of homelessness increases the risk of developing various mental health disorders in people, and there is an intricate connection between a lack of a permanent address and mental illness. Hossain et al. (2020) assert that homeless people suffer from high rates of various mental health problems. These include depressive and anxious disorders, schizophrenia spectrum and psychotic disorders, bipolar and mood disorders, substance use disorders, and suicide risk. These mental health disorders are known to be comorbid, and developing both simultaneously leads to an exacerbated worsening of the condition, thus posing a more significant challenge in managing and treating these disorders. The review highlights mental health issues not only in homeless adults but also in children and adolescents, meaning that the problem is widespread and severe among this group of people. The presence of more than one mental disorder in homeless people has complex implications that are challenging when it comes to diagnosis and treatment and requires a multidimensional approach to health service delivery and support systems. This is why there is a need for effective prevention and early intervention programs as well as psychological response mechanisms for the homeless population, as their mental health crisis is widely documented and unprecedentedly severe.

The nature of mental health problems present in the homeless population with disabilities, combined with the length and severity of homelessness, makes this problem complex and challenging in many ways. Hence, disabled homeless women are not only homeless for longer durations but also report poorer mental and physical health than their non-disabled peers. This discovery of a connection between disability, long-term homelessness, and worsening mental health raises concerns as it seems that each of these states spirals the other. It prolongs the state of homelessness and consequently increases the chances of exposure to violent environments, drugs, and a lack of proper medical care that degrades both mental and physical health. For this reason, people with a disability are exposed to stressors and traumas related to long-term homelessness, and they experience worsening mental health conditions, complicating the process of recovery and stability (Guillén et al., 2021). This vicious cycle points to the requirement for specially designed measures that will not only respond to the basic needs of homeless individuals with disabilities but also their predisposing circumstances that contribute to their extended homelessness and deteriorating health. This is why there is a need for systematic and holistic approaches to empower this weak group of people.

Housing Interventions and Mental Health Outcomes

The interventions regarding housing have been crucial in the prevention and treatment of homelessness and its health implications, especially "Housing First." The program that provides housing for homeless people and does not have expectations for them to stop using alcohol or drugs or to agree to go for treatment has been deemed to be helpful when compared to the "Treatment First" model that lays down conditions that a person has to fulfill before s/he is given housing. Also, Peng et al. (2020) underscore that the Housing First approach was effective in addressing homelessness among persons with disabilities and enhancing their housing stability, in pled for the usefulness of this model for a population requiring permanent homes. In addition, the model has been validated as being associated with significant health impacts for some categories of persons. For example, using Housing First in persons with HIV has been linked with increased usage of the medication among the clients and reduced levels of viral load – implying an enhanced health status among such individuals. Hence, these findings indicate that it is possible to significantly strengthen tenure and health for homeless people by implementing Housing First, an approach that offers permanent housing and support.

Nevertheless, the nature and impact of housing intervention upon more broad-based mental health patterns remain a matter of considerable debate and could benefit from further research. Nonetheless, such housing interventions as PSH bring about a substantial improvement in housing results, which, in turn, is believed to set about an improvement in mental health and a rise in life quality among the participants; the beneficial effect falls differently on every participant. This may suggest a much bigger picture. As simple as it seems that shelter is one of the necessities of man and one of the most critical indicators of a healthy life, it does not automatically mean we are expecting a corresponding improvement in the mental and psychological well-being or the overall quality of life of the people in question. The implication of the findings of the study, therefore, points to the fact that while PSH reflects on the need for safety while exploring ways of enhancing the stability of homes of the homeless beneficiaries, it perhaps lacks the capacity, in its capacity; to solve all the multifaceted and fundamental expressions and manifestations of mental health disorders among the homeless populace. Therefore, there is the need for a multimodal intervention strategy that includes housing alongside health and other multiple and integrated services, such as mental, substance use disorder, and psychosocial services, to meet the multifaceted needs of homeless or homeless-at-risk patients/clients (Onapa et al., 2022). This perspective regarding mental health concerns acknowledges the difficulties of addressing these clients and the imperative of appreciating multifaceted strategies for effecting meaningful, enduring modifications in the standard of living of such persons.

Barriers and Challenges

There are, therefore, various factors that hinder the efficient utilization of housing and health services for people experiencing homelessness with a disability. The services provided are mainly service providers that enable people to achieve a subsistence level of existence without helping them achieve a higher quality of life. In their study, they found various types of capability deprivations such as the limitation in capability to access proper nutrition or lack/poor social association and inability to access leisure. Thus, these outcomes show that the current service models are helpful for simple existence instead of flourishing. The following are the ways the homeless, mentally ill, and disabled persons are locked out of the services they need because of a negative perception: The homeless persons undergo prejudice. They are believed to be undeserving of care; they may refrain from seeking assistance Kerman and Sylvestre (2020). The continued social prejudice alongside the general absence of structures and facilities, including cheap accommodation and healthcare, particularly for mental disorders, negates the effectiveness of current attempts.

Implications for Policy and Practice

Mental health disorders as a problem in homeless people who have a disability must be tackled more responsively and holistically because of their complexity. Government officials have to focus on promoting housing programs that would allow the implementation of housing as the most critical element in mental health and general human welfare. The above housing solutions should go hand in hand with mental health and social support services so that recipients of those solutions are provided with what they require to cope with their needs. More programs like Housing First, where people are placed directly into permanent housing with no prerequisite, are strongly encouraged. However, such programs should also incorporate services that provide support beyond the scope of overcoming housing barriers and aim to treat the mental health disorders that many homeless and disabled people experience. These are psychiatrists, psychologists, drug and alcohol counselors, and other specialists in social services. First, these people can assist the target group in getting reabsorbed back into society. However, there has been a call for more investment in ways that would help in researching the specific needs of homeless individuals with disabilities. Further research should target the recipients of housing interventions and address not just the changes to the housing stock but their consequences in terms of the durability of the fixes or the changes in beneficiaries' mental health, employment, and social inclusion. Furthermore, future research should further examine multisystem integration that goes beyond providing housing services and includes the following: health care and medical, employment, and social, with a vision of implementing a comprehensive support system that will cover all domains of the individual's life. With a comprehensive strategy that includes both decent and accessible shelter for mentally ill homeless people and extensive research, we increase the chances of relieving their plight while finding out more of the underlying causes of homelessness of such people.

Thus, it could be firmly concluded that mental health disorders are very high among homeless persons with disability in the United States in general, hence requiring appropriate intercessions. Thus, This group is at a higher risk of encountering extraordinary and complicated issues that require the involvement of many sectors. There are positive impressions of some of the particular strategies, like Housing First, for changes in housing status. However, they have further impacts on mental health with a slightly negative influence and do not consider the needs of tenants in a person-centered way. From the portrayal above, it is evident that the mere provision of shelter is inadequate in addressing the issue and thus requires a complex and structural approach. This should have been done alongside the provision of housing as some of the measures to accomplish health and social needs to enhance the lives of these affected individuals. Thus, it is crucial to guarantee the inclusion of mental health, substance use disorder, vocational, and social services into such services. Again, it is expected that there should be a close working relationship between governments and providers to come up with effective strategies since the issue involves homelessness, disability, and mental health. Similarly, more cross-sectoral approaches should be made by the best. They should focus on developing policies that are effective long-term for the offenders' independence, rehabilitation, and reintegration into society. From the above analysis, it is feasible to infer that a more systems-oriented and Inclusive approach can bring positive changes and improve lives for homeless people with disabilities to strengthen societies' fabric and stock.