Serving People Who Have Mental Illness and Homelessness
Summary
Services for people with homelessness and mental illness have evolved over three decades. A consensus has emerged concerning clinical approaches to this population. From a public policy perspective, we trace four developmental phases in the evolution of services for this population. We focus on homeless single adults, the group with the highest rates of serious mental illness, while also providing information on families with children, and youth, placing state-of-the-art interventions into historical and technological context. We subsequently detail three conceptual stages of clinical rehabilitation that service providers perform, regardless of where a homeless person is encountered: (1) engagement, (2) intensive care, and (3) ongoing rehabilitation. This stagewise process begins at the moment of first contact with a homeless person, and encompasses special skills and techniques of clinical engagement. This progresses to intensive multidisciplinary activities aimed at enabling a person to pursue goals that enable him or her to transition to an ongoing phase of recovery in which personal identity has been transformed. Finally, and with a focus on psychiatry, the authors discuss the role of administrative skills, academic activity, and advocacy in work with mentally ill homeless populations.
