Schizophrenia and Homelessness

A diagnosis of schizophrenia can bring about a limitless number of changes to a person’s life. Schizophrenia can significantly impact all the dreams, goals and future plans for those who have to live with the illness. Frightening hallucinations and delusions are a common part of the illness. They may hear voices trying to convince them that the very people who care about and love them are plotting against them or trying to control them. It is thus understandable why the person with schizophrenia often disconnects and withdraws from life, including relationships with others.

Factors which may lead to homelessness

Schizophrenia typically begins to appear in late adolescence or early adulthood, with the first major psychotic break usually occurring between the ages of 18 to 31. It is during these years that most people are continuing with their education or laying the ground work for their career and family goals. When schizophrenia takes hold during this chapter in life, it can be nearly impossible to accomplish those goals or stay on the same life path. This is not only devastating to the person suffering from the illness, but also to their family, spouse, and others who care for them. Even when the initial symptoms are treated effectively, it may still always be a struggle for the person to communicate with others, have successful relationships, care for oneself and maintain any motivation to succeed or accomplish anything.

This major upset in one’s normal life and outlook can easily lead to a downward spiral which all too often results in homelessness. The lack of social connection, work skills, and ability to focus and communicate clear ideas and goals leads to withdrawal from everyone and everything they may have held dear. The schizophrenic may also show very little emotion or concern. This can make it difficult for loved ones to continue supporting him/her. A person with schizophrenia also tends to isolate, often making it hard to keep track of him/her at all.

Statistics

Homelessness can happen even to those who otherwise had their life together prior to the onset of schizophrenia. It is estimated that 20 to 25% of homeless people in the U.S. are severely mentally ill 1. Of those who are diagnosed with schizophrenia, 6% of patients are homeless at any given time 2.

Treatment issues

Schizophrenics do not end up homeless overnight. Since paranoia is often a part of the illness, they may eventually distrust those who really have their best interests at heart. They may take it upon themselves to stop treatment. As a result, they can’t cope with the consequences. Without a willingness to accept help and without any supervision over their treatment, schizophrenics can run out of alternatives to living alone, ending up lost on the streets.

Once homeless, it can be even more difficult to stick with a support program or treatment. They will not only have a harder time getting medication, and if they do, they won’t have the proper supervision to take it correctly. Once homeless, schizophrenics may suffer from lack of sleep, poor hygiene and vulnerability to becoming a victim of violence. All of these factors can make a psychotic episode more likely. Without any treatment or support, reversing homelessness for schizophrenics is very difficult. Treatment and support early and consistently can keep the rate of schizophrenic homelessness down.

References

  1. Mental Illness and Homelessness (pdf from NationalHomeless)
  2. Homelessness-Schizophrenia

written by Dr. Cheryl Lane, PsyD