Why It’s Difficult To Treat The Homeless for Substance Use Disorders and Mental Illness

Why It’s Difficult To Treat The Homeless for Substance Use Disorders and Mental Illness

By Lester Long

I am writing this article to explain why I believe it is so difficult for the Homeless population to recovery from drugs/alcohol and mental illness. Without a doubt It can be extremely difficult to treat the this population for substance disorders and mental illness. One of the main reason for this is that without a stable place to live it can be difficult to get adequate sleep at night which often causes the potential client to be both agitated and irritable. Irritability and restlessness are among the chief motivators for increasing one’s desire to use a drug. Enlighten Solutions (ES) (2018) explains that when a person is addicted to drugs they already tend to be restless, irritable, discontent. Homelessness intensified these feelings causing a greater desire towards drug use to relieve these unpleasant feelings and for a person attempting to recover from drugs, this tends to be a recipe for disaster. In addition, homeless individuals tend to have a poor diet and are often hungry. How can anyone be expected to believe in a better life when they are hungry? But probably the greatest reason why it is difficult to treat the homeless is that homelessness teaching them, in general, not to trust people and in many cases, this is aimed at health care providers. Some may even feel that their homeless is a result of poor health care treatment or that it has, at least, contributed to their continuous homelessness. The National Coalition for the Homeless (2017) estimates that 38% of the homeless are addicted to alcohol and 26% are addicted to other drugs and out of those desiring recovery, only a very few receive adequate substance abuse treatment opportunities.

The National Center for Biotechnology Information (NCBI) (2015) points out that homeless people have higher rates of serious medical problems than those in the general population. These include mental health and substance-related problems, hypertension, diabetes mellitus, upper respiratory infections, gastrointestinal and podiatry problems. However, seeking treatment for these illnesses among this population is very low. The reason: A lack of trust in health care systems. NBCI further explains that trust is important in health care services because it gives the provider-patient relationship meaning, offers a motivational underpinning to patients’ willingness to seek out care, assisting the patient in revealing private information, and helps them with compliance to continuous treatment. NCBI explains” provider’s trust builds on the patient’s expectations through technical competence, openness, concern, and reliability” (p.1). Homeless people often feel rejected and placed as secondary citizens. Therefore, when they see others receiving the care they believe they should but are not; they stop trusting the system. Once this trust is lost it is very difficult to revive. This results in a homeless resistance to treatment even with the best-intended services. Therefore as a counselor in the health care delivery field, it would be important to practice a Client-Centered Therapeutic approach to the fullest and hopefully help to reestablish trust among one’s homeless clients. This is extremely necessary in order to bring about trust in the recovery process specially and the health care system in general.


Enlighten Solutions (2018), Being Restless, Irritable, and Discontent. Retrieved January 30, 2019, from https://www.enlightensolutions.com

NCBI (2015) Trust in Health Care Providers: Factors Predicting Trust among Homeless Veterans over Time. J Health Care Poor Underserved 201 25(3): 1278–1290.

National Coalition for the Homeless (2017), the Connection between the Homeless and Addiction. Retrieved January 16th, 2022, from https://www.addictioncenter.com.   


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