Homelessness and Severe Mental Illness: Challenges and Solutions

Optimal care of people with severe mental illness has always been a challenge. Deinstitutionalization in the second half of the twentieth century paved the way for community programs to help improve the lives of people with mental illness. However, a significant minority of people with severe mental illness continue to fail community housing and rehabilitative services and are falling through the cracks. They often end up in jails, prisons, streets, long-term inpatient psychiatric units, or are frequently admitted to acute inpatient units, leading to the revolving door phenomenon. This paper discusses the current challenges and shortcomings of the available programs for people with severe mental illness and proposes alternative care options for those who fall through the cracks. We propose to establish supportive housing attached to the long-term inpatient units for people with severe mental illness who fail other community programs.