Homelessness is closely related to the deterioration of physical and mental health; homeless people experience high rates of health problems, such as HIV infection, alcohol and drug abuse, mental illness, tuberculosis and other conditions. A study on the treatment of chronic pain among the homeless found that treatment is a challenge due to the stress of living on the street or in shelters, the inability to afford prescription medications, and poor sleeping conditions. An acute physical or behavioral health crisis or any long-term disabling condition can result in homelessness; homelessness itself can exacerbate chronic medical conditions. The Presidential Working Group on the Contribution of the APA to Ending Homelessness, commissioned by James Bray, PhD during his term as president of the APA, developed the mission of identifying and addressing the psychosocial factors and conditions associated with homelessness and defining the role of psychologists in ending homelessness.
People who have serious mental illness are overrepresented in the homeless population, as they are often discharged from hospitals and prisons without adequate community support. Most communities have federally qualified health centers and, more specifically, health care clinics for the homeless, which provide some basic health services at no substantial cost. People who have mental health and substance use disorders and who are homeless are more likely to have immediate, life-threatening physical illnesses and to live in hazardous conditions. For chronically homeless people, permanent supportive housing intervention provides stable housing along with necessary support services, a cost-effective solution to homelessness for people with the most serious health, mental health and substance abuse problems.
Psychologists, such as doctors, researchers, educators and advocates, must expand and redouble their efforts to end homelessness. When housing is a platform, people with substance use disorder who are homeless have the opportunity to fully participate in treatment without the added stress of living on the street. Over the past two decades, much research has been dedicated to exploring the relationship between health and homelessness. Housing stability is a key factor for long-term recovery and reduces relapses among the homeless.
Being homeless makes reproductive conditions, such as pregnancy, even more stressful, because they already have compromised health and lack of support systems. The Canadian Homeless Observatory is the largest national research institute dedicated to the homeless in Canada. Remediating homelessness involves focusing on the risk factors that contribute to homelessness, as well as advocating for structural change. The rates of mental illness among the homeless in the United States are twice the rates found in the general population (Bassuk et al.