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The Intersection of Homelessness, Racism, and Mental Illness

  • Jeffrey Olivet
  • Marc Dones
  • Molly Richard
Chapter
Part of the Current Clinical Psychiatry book series (CCPSY)

Abstract

People of color are dramatically more likely to become homeless in the USA than are their white counterparts. In particular, black and Native Americans experience disproportionately higher rates of homelessness. While this disproportionality has been well documented for decades, national and local responses to homelessness have been slow to approach the problem with attention to racial equity. Additionally, health disparities, particularly in mental health and substance use disorder treatment, complicate potential exits from homelessness for racial and ethnic minorities. This chapter describes the racial dimensions of homelessness with attention to the historical policy decisions that laid the groundwork for contemporary homelessness among people of color. The authors conclude with recommendations for research, practice, and policy.

Keywords

Homelessness Housing Racism Discrimination Mental health Substance use Minority stress Health equity Public health Public policy 

References

  1. 1.
    Kusmer KL. Down and out, on the road: the homeless in American history. New York: Oxford University Press; 2002. 360 pGoogle Scholar
  2. 2.
    Leginksi W. Historic and contextual influences on the US response to contemporary homelessness. In: Locke DG, Khadduri J, editors. Toward understanding homelessness: the 2007 National Symposium on Homelessness Research. Washington, DC: US Department of Housing and Urban Development (HUD); 2007. p. 1.1–1.36.Google Scholar
  3. 3.
    US Department of Housing and Urban Development (HUD). The 2016 annual homeless assessment report to Congress: part 2—estimates of homelessness in the US. Washington, DC: US Department of Housing and Urban Development (HUD); 2016.Google Scholar
  4. 4.
    United States Census Bureau. Current population survey. Washington, DC: United States Census Bureau; 2013.Google Scholar
  5. 5.
    Carter GR III. From exclusion to destitution: race, affordable housing, and homelessness. Cityscape. 2011;13(1):33–70.Google Scholar
  6. 6.
    Jones MM. Does race matter in addressing homelessness? A review of the literature. World Med Health Policy. 2016;8(2):139–56.CrossRefGoogle Scholar
  7. 7.
    Voices of Youth Count: linking evidence and action to end youth homelessness. Chicago: Chaplin Hall at the University of Chicago; 2016. Missed opportunities: youth homelessness in America. National Estimates; 2017. http://voicesofyouthcount.org/brief/national-estimates-of-youth-homelessness/. Accessed 2017 Dec 15.
  8. 8.
    Culhane DP, Metraux S. Assessing relative risk for homeless shelter usage in New York City and Philadelphia. Popul Res Policy Rev. 1999;18(3):219–36.CrossRefGoogle Scholar
  9. 9.
    US Department of Housing and Urban Development (HUD). The 2015 annual homeless assessment report to Congress: part 2—estimates of homelessness in the US. Washington, DC: US Department of Housing and Urban Development (HUD); 2015.Google Scholar
  10. 10.
    Whitbeck LB, Crawford DM, Sittner Hartshorn KJ. Correlates of homeless episodes among indigenous people. Am J Community Psychol. 2012;49(1-2):156–67.CrossRefGoogle Scholar
  11. 11.
    Owen G, Shelton E. Homeless and near-homeless people on Northern Minnesota Indian reservations. Wilder Research: St. Paul; 2007.Google Scholar
  12. 12.
    Baker SG. Homelessness and the Latino paradox. In: Baumohl J, editor. Homelessness in America. Phoenix: Oryx Press; 1996. p. 132–40.Google Scholar
  13. 13.
    Aranda E, Vaquera E. Racism, the immigration enforcement regime, and the implications for racial inequality in the lives of undocumented young adults. Sociol Race Ethn. 2015;1(1):88–104.CrossRefGoogle Scholar
  14. 14.
    Mallon G. We don’t exactly get the welcome wheel: the experiences of gay and lesbian adolescents in the child welfare system. New York: Columbia University Press; 1998.Google Scholar
  15. 15.
    Choi SK, Wilson BDM, Shelton J, Gates G. Serving our youth 2015: the needs and experiences of lesbian, gay, bisexual, transgender, and questioning youth experiencing homelessness. The Williams Institute: Los Angeles; 2015.Google Scholar
  16. 16.
    Shinn M. International homelessness: policy, socio-cultural, and individual perspectives. J Soc Issues. 2007;63(3):657–77.CrossRefGoogle Scholar
  17. 17.
    Massey D, Denton N. American apartheid: segregation and the making of the underclass. Cambridge: Harvard University Press; 1993. 304 pGoogle Scholar
  18. 18.
    Sturgis AH. The trail of tears and Indian removal. Westport: Greenwood; 2007. 192 pGoogle Scholar
  19. 19.
    Burnett PH. Governor’s annual message to the legislature, January 7, 1851. In: Journals of the Senate and Assembly of the State of California, at the Second Session of the Legislature, 1851–1852. San Francisco: G. K. Fitch, V. E. Geiger, State Printers; 1852. p. 15.Google Scholar
  20. 20.
    Johnson-Dodds K. Early California laws and policies related to California Indians. California State Library: Sacramento; 2002. 55 pGoogle Scholar
  21. 21.
    Forquera R. Urban Indian health. Kaiser Family Foundation: Melno Park; 2001. 23 pGoogle Scholar
  22. 22.
    Zerger S. Health care for homeless Native Americans. Nashville: National Health Care for the Homeless Council; 2004. p. 40.Google Scholar
  23. 23.
    National American Indian Housing Council and National Community Reinvestment Coalition (NAIHC/NCRC) News Release. June 24, 2003. Survey reveals predatory lenders discriminate against Native Americans; interest rates as high as 30 percent offered in tribal areas.Google Scholar
  24. 24.
    Turner MA, Ross SL. Discrimination in metropolitan housing markets: phase 3—Native Americans. Washington, DC: Office of Policy Development and Research; US Department of Housing and Urban Development; 2003. 91pGoogle Scholar
  25. 25.
    US Commission on Civil Rights (USCCR). A quiet crisis: federal funding and unmet needs in Indian Country. Washington, DC: USCCR; 2003. www.usccr.gov/pubs/na0703/na0731.pdf.
  26. 26.
    Wandersman A, Nation M. Urban neighborhoods and mental health. Am Psychol. 1998;53(6):647–56.CrossRefGoogle Scholar
  27. 27.
    Jones-Rounds ML, Evans GW, Braubach M. The interactive effects of housing and neighborhood quality on psychological well-being. J Epidemiol Community Health. 2014;68(2):171–5.CrossRefGoogle Scholar
  28. 28.
    Standley FL, Pratt LH, Baldwin J. Conversations with James Baldwin. Jackson: University Press of Mississippi; 1989. 304pGoogle Scholar
  29. 29.
    Oh SJ, Yiger J. What have we learned from paired testing in housing markets? Cityscape. 2015;17(3):15–60.Google Scholar
  30. 30.
    Rothstein R. The color of law: a forgotten history of how our government segregated America. New York: Liveright; 2017. 368pGoogle Scholar
  31. 31.
    Alexander M. The new Jim Crow: mass incarceration in the age of colorblindness. New York: New Press; 2016. 290pGoogle Scholar
  32. 32.
    Sampson RT, Janet LL. Racial and ethnic disparities in crime and criminal justice in the United States. Crime Justice. 2007;21:311–74.CrossRefGoogle Scholar
  33. 33.
    Bertrand M, Mullainathan S. Are Emily and Greg more employable than Lakisha and Jamal? A field experiment on labor market discrimination. Am Econ Rev. 2004;94(4):991–1013.CrossRefGoogle Scholar
  34. 34.
    Decker SH, Ortiz N, Spohn C, Hedberg E. Criminal stigma, race, and ethnicity: the consequences of imprisonment for employment. J Crim Just. 2015;43(2):108–21.CrossRefGoogle Scholar
  35. 35.
    Hall WJ, Chapman MV, Lee KM, Merino YM, Thomas TW, Payne BK, et al. Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. Am J Public Health. 2015;105(12):e60–76.CrossRefGoogle Scholar
  36. 36.
    North CS, Smith EM. Comparison of white and nonwhite homeless men and women. Soc Work. 1994;39(6):639–47.PubMedGoogle Scholar
  37. 37.
    Leda C, Rosenheck R. Race in the treatment of homeless mentally ill veterans. J Nerv Ment Dis. 1995;183(8):529–37.CrossRefGoogle Scholar
  38. 38.
    Schwartz RC, Blankenship DM. Racial disparities in psychotic disorder diagnosis: a review of empirical literature. World J Psychiatry. 2014;4(4):133.CrossRefGoogle Scholar
  39. 39.
    Rosario M, Schrimshaw EW, Hunter J. Homelessness among lesbian, gay, and bisexual youth: implications for subsequent internalizing and externalizing symptoms. J Youth Adolesc. 2012;41(5):544–60.CrossRefGoogle Scholar
  40. 40.
    Kuno E, Rothbard AB, Averyt J, Culhane D. Homelessness among persons with serious mental illness in an enhanced community-based mental health system. Psychiatr Serv. 2000;51(8):1012–6.CrossRefGoogle Scholar
  41. 41.
    Montross LP, Barrio C, Yamada AM, Lindamer L, Golshan S, Garcia P, et al. Tri-ethnic variations of co-morbid substance and alcohol use disorders in schizophrenia. Schizophr Res. 2005;79(2):297–305.CrossRefGoogle Scholar
  42. 42.
    Folsom DP, Hawthorne W, Lindamer L, Gilmer T, Bailey A, Golshan S, et al. Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system. Am J Psych. 162(2);370–6.CrossRefGoogle Scholar
  43. 43.
    Snowden LR, Cheung FK. Use of inpatient mental health services by members of ethnic minority groups. Am Psychol. 1990;45(3):347.CrossRefGoogle Scholar
  44. 44.
    Wong CF, Schrager SM, Holloway IW, Meyer IH, Kipke MD. Minority stress experiences and psychological well-being: the impact of support from and connection to social networks within the Los Angeles house and ball communities. Prev Sci. 2014;15(1):44–55.CrossRefGoogle Scholar
  45. 45.
    Williams DR, Neighbors H. Racism, discrimination and hypertension: evidence and needed research. Ethn Dis. 2001;11(4):800–16.PubMedGoogle Scholar
  46. 46.
    Kaholokula JK, Iwane MK, Nacapoy AH. Effects of perceived racism and acculturation on hypertension in Native Hawaiians. Hawaii Med J. 2010;69(5 Suppl 2):11.PubMedPubMedCentralGoogle Scholar
  47. 47.
    McClure HH, Snodgrass JJ, Martinez CR, Eddy JM, Jiménez RA, Isiordia LE. Discrimination, psychosocial stress, and health among Latin American immigrants in Oregon. Am J Hum Biol. 2010;22(3):421–3.CrossRefGoogle Scholar
  48. 48.
    Lee C, Ayers SL, Kronenfeld JJ. The association between perceived provider discrimination, health care utilization, and health status in racial and ethnic minorities. Ethn Dis. 2009;19(3):330.PubMedPubMedCentralGoogle Scholar
  49. 49.
    Peek ME, Wagner J, Tang H, Baker DC, Chin MH. Self-reported racial/ethnic discrimination in healthcare and diabetes outcomes. Med Care. 2011;49(7):618.CrossRefGoogle Scholar
  50. 50.
    Milburn NG, Batterham P, Ayala G, Rice E, Solorio R, Desmond K, Lord L, Iribarren J, Rotheram-Borus MJ. Discrimination and mental health problems among homeless minority young people. Public Health Rep. 2010;125(1):61–7.CrossRefGoogle Scholar
  51. 51.
    Douglas AN, Jimenez S, Lin HJ, Frisman LK. Ethnic differences in the effects of spiritual well-being on long-term psychological and behavioral outcomes within a sample of homeless women. Cultur Divers Ethnic Minor Psychol. 2008;14(4):344.CrossRefGoogle Scholar
  52. 52.
    Camacho A, Ng B, Bejarano A, Simmons A, Chavira D. Crisis visits and psychiatric hospitalizations among patients attending a community clinic in rural Southern California. Community Ment Health J. 2012;48(2):133–7.CrossRefGoogle Scholar
  53. 53.
    Nejtek VA, Kaiser K, Vo H, Hilburn C, Lea J, Vishwanatha J. Are there racial/ethnic differences in indigent inner-city clients with dual diagnoses? J Dual Diagn. 2011;7(1-2):26–38.CrossRefGoogle Scholar
  54. 54.
    Horvitz-Lennon M, Frank RG, Thompson W, Baik SH, Alegría M, Rosenheck RA, Normand SL. Investigation of racial and ethnic disparities in service utilization among homeless adults with severe mental illnesses. Psychiatr Serv. 2009;60(8):1032–8.CrossRefGoogle Scholar
  55. 55.
    US Department of Health and Human Services. Mental health, culture, race, and ethnicity. A supplement to mental health: a report of the Surgeon General. Rockville: US Department of Health and Human Services; 2001.Google Scholar
  56. 56.
    Nadeem E, Lange JM, Edge D, Fongwa M, Belin T, Miranda J. Does stigma keep poor young immigrant and US-born black and Latina women from seeking mental health care? Psychiatr Serv. 2007;58(12):1547–54.CrossRefGoogle Scholar
  57. 57.
    Gary FA. Stigma: barrier to mental health care among ethnic minorities. Issues Ment Health Nurs. 2005;26(10):979–99.CrossRefGoogle Scholar
  58. 58.
    Austin EL, Andersen R, Gelberg L. Ethnic differences in the correlates of mental distress among homeless women. Womens Health Issues. 2008;18(1):26–34.CrossRefGoogle Scholar
  59. 59.
    Chisholm J, Greene B. Women of color: perspectives on multiple identities in psychological theory, research, and practice. In: Denmark F, Paludi MA, editors. Psychology of women: a handbook of issues and theories. Westport: Greenwood; 2007. p. 132–40.Google Scholar
  60. 60.

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Center for Social InnovationNeedhamUSA

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