Am J Psychiatry 1992; 149:816-823
Copyright © 1992 by American Psychiatric Association
Homeless mentally ill or mentally ill homeless?
CI Cohen and KS Thompson
Department of Psychiatry, College of Medicine, State University of New York, Brooklyn.
Mainstream psychiatry conceptualizes people who are homeless and mentally
ill as distinct from other homeless persons because it is thought that
their status stems from their mental disorder and the poor implementation
of deinstitutionalization. The authors believe this dichotomy is illusory.
They present data indicating that recent socioeconomic and political shifts
contributed greatly to homelessness among all groups, regardless of mental
illness; that those with and without mental illness have similar
biographical and demographic profiles; that high levels of mental distress
are common to all homeless persons; and that few mentally ill homeless
persons require involuntary hospitalization. This perspective suggests
novel responses that de-emphasize clinical solutions and focus on
empowerment, consumerism, entitlement, community-level interventions, and
closer alliances with other advocates for the homeless.
