Editor’s note: The story is published through a pilot partnership with Community Impact and the University of Houston. Student reporters were compensated by UH's Cougar Initiative to Engage, or CITE, grant.

Over a third of individuals who experienced homelessness in the Greater Houston area reported mental illness in 2023; however, state data shows mental health resources aren’t being used by most experiencing homelessness.

Experts said the way these services are presented largely impacts how willing someone is to use them. As local nonprofits, such as the Coalition for the Homeless, work to provide services to the homeless community and educate them on their benefits, the organization’s annual point-in-time count of the homeless population is set to be released in June.
The gist

Thirty-five percent of adults experiencing homelessness in the Greater Houston area reported suffering from severe mental illness, a figure surpassing the national average of 26%, according to the Coalition for the Homeless’ annual count of homeless individuals, released in May 2023.

However, despite mental health services being available to those who are homeless, state data shows the majority are not accessing them, according to the Substance Abuse and Mental Health Services Administration. Data from the state agency’s Uniform Reporting System shows 48% of people experiencing homelessness in Texas accessed a mental health service in 2022.
Digging deeper

The Coalition for the Homeless serves as an intermediary for those struggling with homelessness, connecting people to services such as:
  • Shelter partners
  • Day center partners
  • Mental health services
It’s unknown why the percentage of mental illness in Houston's homeless population is higher, but experts said there may be several factors involved. Data from the coalition showed only 11% of unsheltered adults attributed their mental health as the primary reason for their homelessness, but other social determinants play a significant role in an individual’s mental state.

A 2017 study about how the quality of family relationships impacts mental health and general well-being, published by Oxford University, explains positive family interactions enhance mental and physical health, whereas relationship stress can undermine health through psychosocial, behavioral and physiological pathways.

Therefore, individuals with poor family relationships are more likely to experience poor mental health.

Additionally, the National Institute on Alcohol Abuse and Alcoholism’s website states other mental health disorders are likely to occur concurrently or subsequently to alcohol use disorder, with the most common disorders being depression and anxiety.

Nearly 27% of adults experiencing homelessness in Houston reported substance abuse disorder in 2023, according to the Coalition for the Homeless.
The approach

Other Houston-area organizations provide services to support homeless individuals as well, including the Harris Center for Mental Health and IDD. The Harris Center is dedicated to serving those with behavioral and intellectual needs, and provides services such as:
  • Peer support services, including supported employment services, substance use recovery services and P.E.E.R.S for Hope House—a nonclinical crisis respite program
  • Food assistance
  • Connection to health care and housing
  • Transportation to and from appointments
  • Therapy
However, providing mental health services to individuals experiencing homelessness is not as straightforward as it seems, said Amber Honsinger, program director for the Comprehensive Psychiatric Emergency Services Division for the center.

“Maybe they don’t know about mental health treatments or they’ve never been encouraged to seek mental health treatments. A lot of times it’s just access in general; they don’t have somewhere they can go and receive services nearby because they don’t have transportation to and from,” Honsinger said. “Sometimes it’s the mental health itself that is creating a barrier between them receiving these services. It’s much more complicated than what the general public sees.”

The Coalition for the Homeless reported 69% of unsheltered individuals in 2023 had been experiencing homelessness for at least a year, meaning they are chronically homeless.

“What generally tends to happen is people want to forget; they don’t want to feel the pain,” Honsinger said. “They can’t sleep because the train is too loud or it’s too cold outside, so they turn to drugs, if they were not already addicted when they came to the streets. It worsens their mental health symptoms, and it worsens their chances of getting off the streets. It’s a big factor at play.”

What’s being done

Presenting mental health services in a different manner might prove more effective in getting people to access them, said Quana Smith, manager of youth programs at the Coalition for the Homeless.

“Telling people if they would like to talk to someone instead of telling them that they need mental health services,” Smith said. “The words ‘therapy’ and ‘mental health’ might be a trigger for them. Instead, tell them: ‘Hey, would you mind having somebody come and talk to you?’”

Despite some people rejecting the opportunity to see a therapist, Smith said many of them eventually recognize their need for it.

“When they see that they are struggling to get a job because of a mental illness, that’s when they see that they might need to talk to somebody,” she said.

Smith said she believes prioritizing easy access to mental health services is a critical component of efforts to reduce homelessness and improve outcomes for these individuals.

“I believe that mental health is a huge thing that we need to continue to address and not stigmatize,” she said. “A lot of us have bipolar disorders, depression, and there’s nothing wrong with it, but we need to make the conversation to where people feel comfortable and make services more easily accessible”

What’s next?

The Coalition for the Homeless will release data from its annual point-in-time count—held Jan. 22-25—in June. For more information on the count and how to volunteer in the survey held every January, click here.