Chronic Homelessness: Is Mandated Treatment of Mental Illness and Substance Abuse Part of the Solution

NJCounts 2019 Found 1,462 Experiencing Chronic Homelessness; Could Expanding Housing First Vs. Involuntary Treatment Help?

A recent article, ‘”Gravely Disabled’ Homeless Forced Into Mental Health Care in More States,” published by the PEW Charitable Trusts chronicles the stories of individuals caught in the cycle of chronic homelessness and what some cities and states are doing in an effort to end chronic homelessness.

Chronic homelessness often involves cycling from life on the street, in jail or prison, back on the street, and in and out of psychiatric facilities or substance abuse treatment. Many indivdiuals with mental illness who experience homelessness are also substance abusers.

On the night of January 22, 2019, NJCounts 2019 found a total of 8,864 men, women and children in 6,748 households who were identified as experiencing homelessness in New Jersey. This number of the homeless was an overall decrease of 439 persons (5%) from the number of persons identified in 2018.

Those experiencing homelessness who were counted through NJCounts 2019 were asked to identify factors that contributed to their homelessness. A total of 32 indivdiuals experiencing homelessness reported release from a psychiatric facility, 644 reported drug and alcohol abuse, and 191 reported a mental illness as factors contributing to their homelessness.

The article highlights a program in San Francisco to mandate involuntary mental health and substance abuse treatment for individuals who could potentially be among the chronically homeless. While this program is a response to both the homeless and opioid crisis, critics of the program point out that these programs are a violation of the rights of these individuals. Furthermore, the program and law that would enforce it might disproportionately affect people color and there may not be enough treatment beds to serve those mandated for treatment.

And a program in Hawaii can order psychiatric treatment for indivdiuals who are found to be a “danger to themselves.”

NJCounts 2019 identified the number of people, 1,462 persons, in 1,351 households, experiencing chronic homelessness. This number was a 13.5% increase in chronic homelessness in New Jersey compared to the number of persons experiencing chronic homelessness in 2018

Almost half of those experiencing homelessness, 673 persons experiencing chronic homelessness, were living unsheltered without children.

Through NJCounts 2019, those experiencing chronic homelessness identified six types of disabilities that they had with 813 individuals reporting that they had a mental health issue and 624 reporting that they had a substance abuse disorder. These categories of disabilities are not mutually exclusive as respondents may have selected multiple options including 645 chronically individuals experiencing homelessness who indicated that they have multiple disabilities.

Looking at the numbers around chronic homelessness in New Jersey, can chronic homelessness in NJ be addressed through expanding the already successful best practice of Housing First? Offering housing and case management services first and then mental health and substance abuse treatment can help end chronic homelessness as a first alternative to mandating involuntary treatment.