Multidimensional Approach Needed to Treat People Who Are Homeless

SPS: Alcohol, Tobacco, and Other Drugs

People experiencing chronic homelessness who also live with co-occurring serious mental illness (SMI) and substance use disorders (SUD) are among the most vulnerable and hardest-to-reach populations. Their experiences, strengths and needs vary widely, as do the pathways into homelessness, which are complex and multifaceted.

The relationship between chronic homelessness, substance use disorders, and serious mental illness is bidirectional, shaped by both structural conditions and behavioral health needs, says an article posted in the latest Section Connection newsletter of the NASW SPS for Alcohol, Tobacco, and Other Drugs.

“Untreated or undertreated SUD and SMI can make it more difficult to navigate fragmented systems, keep appointments, secure income, or meet rigid program requirements, thereby prolonging homelessness,” says the author, Darilynn Cardona-Beiler, MSSA, LCSW, senior vice president of adult systems of care at Meadows Mental Health Policy Institute.

This does not necessarily mean all homelessness is “caused” by mental illness or substance use; rather, the causes are multifactorial, often rooted in long-standing barriers to housing, education and employment.

“Addressing complex behavioral health needs for people experiencing chronic homelessness therefore requires a multidimensional approach: one that meets immediate needs and removes barriers to engagement while also confronting the structural conditions that perpetuate housing instability,” Cardona-Beiler states.