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03/13/2009

Deinstitutionalization and Homelessness - A New Twist

Back in the 1980s, when homelessness was first gaining attention as a significant social problem, a common explanation for the increase in this problem was that many among the homeless population were refugees from a process called deinstitutionalization - where persons with mental illness were discharged into the community and, because there were inadequate services or supports available to them, they ended up on the streets and in shelters.  Now a study that I have recently completed updates this link between institutions and homelessness.

Looking at data from over 9,000 persons who used shelters in New York City shows that 28% of them entered shelter for the first time a short while after being discharged from either a hospital, a psychiatric facility, a jail, or a prison.  Interestingly, the psychiatric facilities that were seen as the culprit for much of the homelessness of the 1980s and 1990s were only responsible for a small amount of this percentage.  Most of the homeless who came directly from other institutions came either from hospitals, jails or prisons.  What this shows is that deinstitutionalization is still very much a problem, but one that has become more than just a psychiatric problem.  Especially as the number of persons who are incarcerated continues to increase, more and more people who are released from jails and prisons will be poorly prepared to reenter life in the community and will end up homeless. 

In asking what we can do to stop this link between leaving institutions and subsequent homelessness, we can learn lessons from the mental health system.  The primary lesson to be had here is the importance of stable housing, and that the criminal justice system and other mainstream service providers can potentially reduce the number of persons who become homeless by over one-quarter by extending their jurisdiction to actively provide housing and social supports in the community.  The result will be substantially less homelessness as more people are able to successfully transition from various institutions back into the community, and less use of costly hospital, jail and prison services.

Stephen Metraux is an Assistant Professor in the Department of Health Policy and Public Health at USP.  His research interests center around urban health, especially in the context of issues such as homelessness and housing, community mental health, and incarceration and prisoner reentry. The paper he refers to is currently in review for publication at the Journal of Community Psychology.  A copy of the paper may be obtained by contacting Metraux at s.metraux@usp.edu

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