The 2003 Metro Atlanta Tri-Jurisdictional Collaborative Homeless
Census and Survey report dated November 7, 2003 states that:
“….. it is important to understand the reasons
for, and causes of, homelessness. Homeless survey respondents
self-reported a number of reasons for their condition.”
The report states “Survey respondents were asked what factors
had contributed to their homelessness. The number one answer, provided
by 38% of respondents, was alcohol or drug use. Other leading responses
included unemployment (29%) and inability to pay rent or mortgage
(12%). Many respondents indicated that their homelessness had been
caused by an illness or medical problem (12%) or an argument with
family or friends (11%). Some respondents identified mental illness
(6%) or family violence (5%) as causes of their homelessness.” Please
note that this survey of almost 1000 of the 6956 individuals counted
in the census was based entirely on self-reporting. Though those
surveyed were not randomly selected which may have skewed the results,
the results are probably reasonably accurate.
The generally agreed upon estimate by most experts nationally
is that about a third of homeless people have a mental illness.
A NAMI (National Alliance for the Mentally Ill) Helpline publication, “Facts
and Figures About Mental Illness” states: “Approximately
one-third of the estimated 600,000 homeless people in the United
States have a severe mental illness. However, only one in 20 persons
with a severe mental illness is homeless.” Likewise, the
National Center for Mental Health Services (CHMS) reports “Approximately
600,000 Americans are homeless on any given night. An estimated
one-third of these people have serious mental illnesses, and more
than one-half also have an alcohol and/or drug problem.”
The NAMI fact sheet quoted above also states “Twenty-three
percent of American adults (ages 18 and older) suffer from a diagnosable
mental disorder in a given year, but only half report impairment
of their daily functioning due to the mental disorder.” This
helps to explain why the self-reporting incidence of mental illness
by homeless people (6.2%) with a mental illness in the 2003 census
of metro Atlanta is much lower than the more objective estimates
by mental health professionals (about 33%).
The 2003 census also asked the question: “What do you think
would be the most help to you in getting out of homelessness.” *
About 4% mentioned ”disability/SSI”, *About 2% mentioned “peace
of mind/solid/foundation/emotional support/friends” *1% said,
counseling/ professional help” and *1% listed “more
help for the disabled”. None of the 924 people who answered
this question specifically mentioned getting help for mental illness
or depression, etc.
Thirty-eight percent of homeless men and women mentioned alcohol
or drug use as being the primary cause of their homelessness. Like
mental illness, the self-reported percents are lower than estimates
by most national experts on the subject. .” The National
Center for Mental Health Services (CHMS) reports that “more
than one-half” of the 200,000 homeless Americans with a serious
mental illness “have an alcohol and/or drug problem.” A
1999 survey conducted under the auspices of the Homeless Action
Group revealed that in the opinion of many key homeless service
providers, 69% of men, 55% of single women, and 46% of mothers
with children they served had an addiction to drugs or alcohol.
Many people say the fundamental causes of homelessness in Atlanta
are essentially economic—an unlivable federal minimum wage
and unaffordable housing. In short, if homeless people were paid
a living wage and could afford housing, they would no longer be
homeless. They acknowledge that mental illness and drug addiction
exists among homeless people but do not think they are primary
reasons why people become and remain homeless and they tend to
use percents of homeless who are addicted or mentally ill that
are lower than what is accepted by the majority.
Most chronically homeless men and women who have a chronic addiction
to drugs or alcohol and who are without money or insurance, without
friends or family to provide major support, are not able to maintain
housing, not able to maintain employment, not able to maintain
relationships because. It is their addiction that is the primary
disruption in their lives and until they are in recovery and concurrently
have housing associated with their recovery, it is extremely hard
to keep housing or a job. Most addicts who do not have a severe
mental illness can work and if in recovery, can keep a job and
find their own housing. It is their addiction that needs to be
addressed above all else.
Despite differing emphases on the causes of homelessness, it appears
everyone can agree that whatever the actual percents, drug and
alcohol addiction and mental illness are major problems that must
be given very high priority. And thus the Atlanta community should
all be willing to work together to make the most severely addicted,
the most severely mentally ill, and especially those who have both
an addiction and a mental illness, three of the highest priorities
in efforts to end homelessness.
How we as a community view the primary causes of homelessness
will determine our success in ending homelessness It is critical
that our local planners of homeless services use the most accurate
estimates of homeless people with a serious mental illness, with
an addiction to drugs or alcohol or both (called dual diagnosis)
so that the need for services to them will not be underestimated.