OBJECTIVE: Research on homelessness among persons with severe mental
illness tends to focus on aspects of demand, such as risk factors or
structural and economic forces. The authors address the complementary role
of supply factors, arguing that "solutions" to residential
instability-typically, a series of institutional placements alternating
with shelter stays-effectively perpetuate homelessness among some persons
with severe mental illness. METHODS: Thirty-six consecutive applicants for
shelter in Westchester County, New York, in the first half of 1995 who were
judged to be severely mentally ill by intake workers were interviewed using
a modified life chart format. Detailed narrative histories were constructed
and reviewed with the subjects. RESULTS: Twenty of the 36 subjects had
spent a mean of 59 percent of the last five years in institutions and
shelters. Analysis of the residential histories of the 36 subjects revealed
that shelters functioned in four distinctive ways in their lives: as part
of a more extended institutional circuit, as a temporary source of
transitional housing, as a surrogate for exhausted support from kin, and as
a haphazard resource in essentially nomadic lives. The first pattern
dominated in this group. CONCLUSIONS: Shelters and other custodial
institutions have acquired hybrid functions that effectively substitute for
more stable and appropriate housing for some persons with severe mental
illness.
Abstract Teaser