2 and 3 million Americans experience homelessness
at some point each year. Of these, an estimated
20 to 25 percent have a serious mental illness
and up to half of those with a serious mental illness
also have an alcohol or drug use problem.
Chronic homelessness results from
a confluence of many factors, including lack of
adequate income, diminished social supports, and
a shortage of affordable housing. Serious mental
illness and substance use create additional risk
factors, affecting virtually every aspect of life,
including self-care, money management, schooling,
work, and social relations. Serious mental illness
and drug abuse not only increase risk factors,
they also increase the difficulty of overcoming
Since the passage of the 1987 Stewart B. McKinney
Homeless Assistance Act—the first comprehensive
Federal legislation to address homelessness—we
have learned much about effective ways to prevent
and overcome chronic homelessness. There is no
single, simple solution. Rather, success requires
engagement at many levels.
For example, any successful effort must involve
government at all levels, including Federal, state,
and local governments, as well as the private sector,
community organizations, service providers, consumers
of services, and family members.
Similarly, people who are homeless and have mental
illnesses and substance use disorders need a diverse
array of services in addition to treatment. These
include outreach, case management, housing options,
primary health care, and a range of support services
such as rehabilitation and employment counseling.
Finally, individuals with serious mental illnesses
and substance use disorders should not have to
negotiate multiple service systems in which health
care, mental health and substance abuse treatment,
social services, and housing services are separate
and uncoordinated. They must be able to access
these services from systems that are integrated
and easily maneuvered.
SAMHSA continues to prioritize the national goals
of ending homelessness through a rich array of
services grants and technical assistance activities.
To optimize our resources and staff talents, we
manage our homelessness portfolio through a matrix
approach relying heavily on each of SAMHSA’s
Centers and Offices.
Our vision at SAMHSA is to ensure that everyone
has an opportunity for a life in the community.
Clearly, the pillars of a fulfilling life must
be built on a foundation of safe, stable, and comfortable
At the same time, a life in the community means
not just a place, but also a sense of independence
balanced with a sense of belonging. The rewards
that accrue from a job, meaningful relationships
with family and friends, and having a little corner
of the world to call one’s own can replace
the walls of emptiness, isolation, and loneliness
created by mental illness, drug use, and homelessness,
and provide the key that opens the door to a new
life of recovery.
Charles G. Curie, M.A., A.C.S.W.