Reforming Homelessness: A Comprehensive Approach to Addressing Mental Health

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The Depth of Homelessness and Untreated Mental Illness

Homelessness plagues the streets of every urban area in the United States; many of these people have health issues that have been left untreated. “Approximately one-third of the total homeless population includes individuals with serious, untreated mental illnesses according to a research summary compiled by the Treatment Advocacy Center” (Treatment Advocacy Center). With a lack of government and community assistance, how are these people supposed to re-establish themselves as members of society?

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The Decline in Mental Health Support

This is not a new issue, years of neglect have caused a plethora of issues that all need to be addressed:

A 2017 analysis of psychiatric inpatient capacity by the National Association of State Mental Health Program Directors (NASMHPD) detailed a 77.4 percent decline in psychiatric beds since 1970. Similarly, my organization found that state psychiatric hospital beds are now at their lowest level since the 1850s, with less than 12 such beds per 100,000 population nationally.

With advances in medicine, more educated doctors, access to statistics, insurance, and government officials that have ways of helping these individuals, something must change. Fellow citizens are willing to help those caught in this situation. The logic behind not providing more assistance is we are saving money, and our taxes should be used to fund other things, such as roads. However, it is much more expensive to deny help to those that need it.

Local Initiatives in Addressing Homelessness

Though officials believe that they are saving money by releasing patients from mental hospitals, there is a significant cost to the patient and to society at large. “In 2001, a University of Pennsylvania study that examined 5,000 homeless people with mental illnesses in New York City found that they cost taxpayers an average of $40,500 a year for their use of emergency rooms, psychiatric hospitals, shelters, and prisons.

This doesn’t just affect those that are homeless; their families and loved ones feel the impact and see the unfairness that has been allowed to happen:

Over the past 20 years, my organization, the Treatment Advocacy Center, has worked with more than 30 states to modernize their civil commitment standards to include factors beyond overt dangerousness. This reform effort gained vital advocacy support from families who had faced the nightmare of seeing an obviously ill loved one denied care simply because they had not yet become violent. As evidenced by these families’ experiences, demanding immediate evidence of danger delays the provision of care, often leading to unjustifiable deterioration and unnecessary criminalization. Mental health and other disabilities can be linked to homelessness; state and local governments must balance tax budgets to give assistance to those that are incapable of finding places to live.

As stated before, families don’t want to see their loved ones neglected. However, you don’t have to be related to someone in order to have sympathy for them. “This study measured Americans’ willingness to pay an additional $50 in taxes to improve health care and social services for individuals with serious mental illness”. Obviously, without government intervention, our taxes will not suddenly make a change and create ways to assist the homeless.

In some places, like Seattle, they are taking this problem head-on. “Create 15,000 units of affordable, workforce, and permanent supportive housing to move people off our streets and under a permanent roof”. This is simply the best solution; if people are homeless, create homes for them. The same principle is applied to the workforce; if people need work, they create jobs. It seems simple, but it is the way to go our solving it. This isn’t the most unique solution, but it still has the potential to assist a lot of people in their journey to making a life of their own. Seattle knows that you must not only address the current issue. They must also prevent the issue from getting worse, so they chose to take another step:

But the City of Seattle is deploying new and unprecedented resources in coordination with our partners at King County to make progress – from doing more to prevent people from falling into homelessness to building thousands of new affordable housing units to deploying new bridge housing and shelter units, picking up trash and waste. With faith in his citizens’ vitality, Seattle’s Mayor, Mark Leno, is willing to put in a huge amount of money to force change:

On December 18, 2017, Mayor Jenny A. Durkan announced more than $100 million in investments to build and preserve 1,450 affordable homes in neighborhoods across Seattle, including the construction of 896 new homes in nine new buildings. These Office of Housing investments represent a spectrum of different housing types for low-income residents, including permanent supportive housing for those experiencing homelessness, apartments for low-income individuals and families, transit-oriented development, and homes for first-time homebuyers.¨

Naturally, not everyone can agree on a solution, no matter the problem. Higher taxes have always been, and likely always will be, opposed by the citizens paying them. In the words of Jeff Stein:

¨The abrupt reversal enraged some supporters of the ‘head’ tax, who argued that wealthy corporations in the city could afford to pay more to address homelessness. The measure, passed unanimously by the city council last month, levied a $275-per-employee tax on companies with at least $20 million in gross annual revenue.

Clearly, it is stated that the vote passed, but it didn’t come without backlash. Big businesses are established to make money, and if you tax them, they will oppose. The cost, besides the money, is that the rich will be slightly less rich. This does not outweigh the aid it will give. But even after the new revenue is becoming available, will the government use it correctly? Some people doubt that.

For example, Bruce Miller was quoted saying, ¨Bruce Miller, a Seattle resident since 1971, said he traditionally supported tax levies, but no longer will. “I feel like city government doesn’t understand and respect taxpayer dollars, and doesn’t take responsibility for them,” said Miller, to applause”. This is not the case with more money; local governments are using the money they are receiving to fund what they are saying they will fund. It is time to trust local governments with our money and allow them to provide for those that the citizens cannot.

Public Housing and Preventative Measures

Another approach to solving homelessness is to create public housing for people who can’t afford their own. Seattle is not the only major city battling homelessness. New York is also searching to find their own way of addressing this expanding issue. The city has been happy with the results of its new program and continues to expand it. So much so they are using their permanent housing as a way to prevent the further fall of those who were neglected. The Coalition for Homelessness says this: “Another proven solution developed in New York City and replicated nationwide is the “housing first” approach to street homelessness, which builds on the success of permanent supportive housing”.

The second alternative is to fight the problem before it happens. By having the housing, you can almost count on people still becoming homeless. So to prevent the issue from growing, they chose to help prevent addiction, help victims of abuse, and raise awareness of what really causes homelessness.

An organization known as “Raising the Roof” is helping to spread this message by saying, “Primary Prevention is an “upstream” approach that targets groups who are at risk of becoming homeless due to factors such as abuse, addiction, and unemployment. This model minimizes entry into homelessness by offering targeted awareness campaigns and support” (Raising the Roof). With these two methods combined, New York is on its way to pulling the homeless off the street and helping those in damaging environments to recover.

As great as it would be to be able to provide a house for someone until they can get back on their feet, there is no way to give every single person a house of their own. The mentally ill, drug addicts, alcoholics, and victims of abuse could potentially all be in the same house. Without much thought, red flags go up in a person’s mind, even those who need a place to live. Even those who support public housing are weary of it. “I’ve learned that many communities are still engaged in the so-called “Housing First’ debate.”

Communities continue to examine whether Housing First is the right way to address homelessness, saying things like, “We already have a Housing First program; we don’t need any more.” Or “One size doesn’t fit all. Housing First isn’t for everyone.” Or even, “It’s immoral and harmful to put people who drink into housing.” ( While it is a legitimate concern, it has been discussed and decided the benefit it would offer outweighs the danger. The housing would be supervised, would the residents would be encouraged to beat their addiction and become a functioning members of society.

The other two solutions show promise and have benefits of their own none of them would be possible without funding. As the saying goes: money doesn’t grow on trees, so a tax would have to be implemented to make these things possible. Funding this noble cause will not only benefit the city’s culture but will also help businesses by giving them employees to help them grow. The following quote still reigns true:
Though officials believe that they are saving money by releasing patients from mental hospitals, there is a significant cost to the patient and to society at large. “In 2001, a University of Pennsylvania study that examined 5,000 homeless people with mental illnesses in New York City found that they cost taxpayers an average of $40,500 a year for their use of emergency rooms, psychiatric hospitals, shelters, and prisons.

We must use our benefits to help those that lack the ability to help themselves. Without doing so, who is to say that you might have a mental breakdown, fall into addiction, and have nowhere else to turn? Essentially we are creating a safety net for ourselves while lifting those around us. The stereotype of homeless people, who are lazy and let themselves get there, is plaguing society; some people are just trying to get by and have a better future. They may have lacked the knowledge of what it truly took to reach their dreams, but why should we, the people reaching our dreams, not want others to succeed? Take this quote as your proof that not all homeless people are slackers:

The fact that our City sidewalks are home to families and children is unacceptable. In 2016 nearly 2,100 students in San Francisco were identified as homeless. These are children who are being educated in our schools during the day yet have no permanent place to call home at night to eat dinner, do homework, or rest. This must change. Not only must we do what we can to assist parents, but we must also focus on the impacts of homelessness on children and offer support services that meet students where they are and lift them up to where they can and should be” (Leno).

Our own students seeking and striving for education are left with little to no money and no place to sleep. How, as a society, can we allow them, who we encouraged to get a higher education, to fall into a broken system? A system that requires nearly perfect execution of loans, debts, and personal accounting to live in poverty. Join the movement, donate if you are not required by the tax, don’t judge those who have been forgotten, see them in a new light, and help them obtain what you have worked hard for. They will surprise you with what they are willing to do for another chance in the land of opportunity.


  1. Treatment Advocacy Center.
  2. Leno, Mark.
  3. Raising the Roof.

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Reforming Homelessness: A Comprehensive Approach to Addressing Mental Health. (2023, Aug 11). Retrieved from

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