Mental illness and homelessness are connected. But not how you might think

Even as Los Angeles starts a $1.2-billion homeless housing construction program, residents from Temple City to Venice are fighting to keep homeless projects out of their neighborhoods.

But since 1995, chronically homeless mentally ill people — a widely shunned subgroup — have been living in Santa Monica’s Step Up on Second apartments, a block from the tourist-friendly Third Street Promenade and close enough to the beach to feel the salt air.

“Look around. It’s here,” Rep. Timothy F. Murphy (R-Pa.) said during a recent visit, describing why he sees Step Up’s residential programs as a national model.

Murphy, author of a major 2016 mental health reform bill, was in Santa Monica to tour three of Step Up’s permanent supportive housing buildings, which offer apartments and counseling, case management and substance abuse treatment to 267 formerly homeless people with mental health issues.

During the visit, The Times interviewed Step Up Executive Director Tod Lipka, staff members and residents. Dennis Culhane, University of Pennsylvania professor and homelessness researcher, and Andrew Sperling, legislative advocacy director for the National Alliance on Mental Illness, were interviewed later.

Below are their edited responses to common questions about mental illness and homelessness:

Are most homeless people mentally ill?

A relatively small percentage of all homeless people nationwide — 13% to 15% — are mentally ill, but their symptoms — paranoia and delusions — draw attention and mislead others into thinking their numbers are greater, Culhane said.

However, Los Angeles’ homeless population skews heavily to single adults who have lived in the streets a year or longer — a subgroup with a high incidence of mental health issues. Local authorities estimate that 30% of the county’s homeless people have serious mental illness.

Does chronic homelessness cause mental illness, or is it the other way around?

Lipka said employees at his agency don’t see people developing serious mental illness by virtue of their homelessness. But “I do believe long-term isolation can lead to mental illness,” said Steve Elam, Step Up lead life skills coordinator.

Culhane said severely mentally ill people sometimes get treatment and aid that prevents them from becoming homeless.

How many homeless people are physically or mentally disabled?

Culhane said half the country’s homeless people have a physical or mental disability, or both. But they don’t necessarily qualify for federal disability payments, which in any case are too low — about $800 a month — to cover rent, utilities and other needs, even with food stamps tacked on, he added. Welfare reform in 1996 made it difficult for people whose impairment stems largely from substance abuse disorders to receive federal disability aid, Culhane said.

“Instead of looking at individuals and their biographies and conditions, the question is why is the disability system failing?” Culhane said.

learn more

Chris Alexakishealth, housing