Helping the Homeless Who are Mentally Ill (Part 1)

Nearly one in four homeless individuals suffers from a severe mental disability(1).   People with various forms of mental illness frequent urban missions for temporary food and shelter. Some express a desire to participate in long-term rehabilitation and recovery programs.   The most common forms of mental illness among the homeless are schizophrenia and the affective disorders (bipolar and major depression).(2)   Because I have recently received so many inquiries regarding how to best minister to the mentally ill in a urban mission setting, we will dedicate the next few installments of this column to this subject.

A.       Why so many of the mentally ill are homeless  – Over the past thirty years, we have seen a a trend of “deinstitutionalizing” the mentally ill. It was determined that with the proper support and therapy, as well as the right combination of medicines, the mentally ill could function better within society and achieve an independent life.(3)   Theoretically it sounds like a good idea.   The goal has been to give the mentally ill more dignity and independence by placing them in a supportive community setting instead of a hospital.     In too many situations, the mentally ill were released from institutions without proper support networks in place, and as a result, become homeless.   Additionally, the very nature of mental illness causes sufferers to lose the ability to function in a socially-acceptable manner. When their families and other social networks cannot (or will not) support them any longer, they find themselves on the streets.   The latter situation is especially true for those who are referred to as “dual diagnosis” – suffering from both mental illness and drug/alcohol addiction.

B.       We can help the homeless who are mentally ill  
– According to the Federal Task Force on Homelessness and Severe Mental Illness, only 5-7% of homeless persons with mental illness need to be institutionalized; most can live in the community with the appropriate supportive housing options (Federal Task Force on Homelessness and Severe Mental Illness, 1992).   The problem is, so many do not have access to supportive housing and/or other treatment services like case management, housing, and treatment.

The severe forms of mental illness are caused primarily by chemical imbalances that interfere with normal brain activity.   Major advances in psychiatric pharmacology have resulted in highly effective medications that can help mentally ill people live relatively stable lives.   A carefully regulated regimen of proper medications can even allow them to successfully participate in long-term rehab/recovery programs.

C.       Developing a “team approach”  – Few urban missions have medical professionals on their staffs to diagnose mental illnesses and prescribe the proper treatment for the various psychiatric disorders.   Therefore, it is absolutely essential that mission staff members become acquainted with local mental health providers.   In larger cities, there can be a number of options available, which can make it easier to find mental health professionals who share our values.   Even where options are limited, most Christian workers will find that a good working relationship can be established, especially if an effort is made to keep the lines of communication open between the urban mission and the mental health facility.

D.       Knowing when a mental health referral is needed  – Too often, urban mission workers who have not learned to recognize the symptoms of mental illness have become frustrated and discouraged in their efforts to help those who suffer.   Understanding is the key to effectively ministering to those who suffer from mental disabilities.   In upcoming articles, we will look at the most common forms of mental illness – depression, pyschosis, schizophrenia and bi-polar disorder.   We will also discuss the most common medications used to treat these diseases and how urban missions can help those suffering from mental illness to attain a satisfying life.

See also, Helping the Homeless Who Are Mentally Ill (Part 2)


1.       Waxman LD, Peterson K, McClure, M. A Status Report on Hunger and Homelessness in America’s

2.       Fischer P, Breakey W. Homelessness and mental health: an overview. International Journal of Mental Health. 1986;14:6-41.

3.       Stubbs, Pat (1998). Broken promises:The story of deinstitutionalization.1998, September 25.

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