32 percent of all adults admitted to shelters were treated for substance abuse problems. Culhane's study examined Philadelphia's homeless population between 1990 and 1993. A proportionately small group of people with a SMI become homeless. This suggests the need for an intervention to divert such persons from shelters, including a targeted crisis service, crises residential program, in-home support and stabilization services or transitional housing. Homeless people are significant consumers of health care services, particularly inpatient care for mental illness and substance abuse.
More research is needed to examine the impact of homelessness on services and costs.
This Issue Brief integrates the results of two studies, one on the rates of homeless and the other on the mental health of the homeless. Both were conducted by Dennis Culhane and colleagues in New York City and Philadelphia. The number of persons who become homeless has been vastly underestimated by previous research. A much smaller percentage of homeless adults have serious mental disorders than found in earlier studies. However, individuals with mental disorders are likely to have greater difficulty exiting the cycle of homelessness.