Our current approach to mental health labelling and diagnosis has brought benefits. But as a practising doctor, I am concerned that it may be doing more harm than good
Do you have a source for that? I know the issues within homelessness are complex but I haven’t seen any data to suggest that a majority of homeless people are severely disabled.
A peer reviewed article of a meta analysis of many studies shows a whopping 76% of all homeless people have a mental illness. The majority are alcohol or other substance abuse problems followed by schizophrenia. These can all be incredibly disabling conditions. Something like social anxiety disorder, for example, while can be very disabling on the extreme end, does not cause difficulty caring for basic functioning of yourself. Alcohol/substance abuse problems and/or untreated schizophrenia are incredibly significant conditions which are severely disabling.
I have a friend with schizophrenia which has been thankfully successfully managed. I have known her for a long time and it was very scary watching her develop it and at first and for professionals to struggle to help her treat it. She would also periodically do this thing where she felt she didn’t need her medications because she felt better. So she would stop taking them periodically and go back to having severe issues before everyone managed to convince her to go back on them. It’s actually an incredibly common phenomenon and one of the reasons why it’s a difficult disorder to treat. She is one of the success stories because she has had a lot of help and support and access to very intensive mental health care. Many do not, unfortunately.
I agree that giving all homeless people homes isn’t just going to fix any underlying mental health problems, but I think there’s an argument for recognising that in some cases mental health conditions are a response to environment, rather than having a purely pathological cause. Addressing those environmental factors (like no access to stable housing) can make a huge difference.
And even if access to stable housing doesn’t resolve the major cause of someone’s mental health issues it’s still going to be of benefit alongside other treatment options.
Edit: also I’m glad your friend is doing well in her treatment. I’ve seen how difficult it is to treat.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8423293/
A peer reviewed article of a meta analysis of many studies shows a whopping 76% of all homeless people have a mental illness. The majority are alcohol or other substance abuse problems followed by schizophrenia. These can all be incredibly disabling conditions. Something like social anxiety disorder, for example, while can be very disabling on the extreme end, does not cause difficulty caring for basic functioning of yourself. Alcohol/substance abuse problems and/or untreated schizophrenia are incredibly significant conditions which are severely disabling.
I have a friend with schizophrenia which has been thankfully successfully managed. I have known her for a long time and it was very scary watching her develop it and at first and for professionals to struggle to help her treat it. She would also periodically do this thing where she felt she didn’t need her medications because she felt better. So she would stop taking them periodically and go back to having severe issues before everyone managed to convince her to go back on them. It’s actually an incredibly common phenomenon and one of the reasons why it’s a difficult disorder to treat. She is one of the success stories because she has had a lot of help and support and access to very intensive mental health care. Many do not, unfortunately.
Thanks, that’s really helpful.
I agree that giving all homeless people homes isn’t just going to fix any underlying mental health problems, but I think there’s an argument for recognising that in some cases mental health conditions are a response to environment, rather than having a purely pathological cause. Addressing those environmental factors (like no access to stable housing) can make a huge difference.
And even if access to stable housing doesn’t resolve the major cause of someone’s mental health issues it’s still going to be of benefit alongside other treatment options.
Edit: also I’m glad your friend is doing well in her treatment. I’ve seen how difficult it is to treat.