On Mental Health Day, It's Time To Talk About How Homeless Women Aren't Getting The Care They Really Need

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In honor of World Mental Health Day, we’re shedding a light on the true story of homeless women across America. From the untold circumstances that brought it on, to the lack of trauma care given to them, the odds are stacked against these women. The topic: A look at the struggles homeless women with mental illness face — and how we can help them.

On a September night at The Dwelling Place of NY, the dining hall came alive with residents' excitement. In the transitional residence, founded 40 years ago to provide a space for homeless women to get the help and support they need, an actor visited to teach the ladies some of his best clown moves. As the women tried their hand at it, the staff joined in and, soon, the whole shelter was filled with laughter. As the night winded down, one of the residents made her way over to Sister Joann Sambs, the shelter's administrator. She said that for those 45 minutes, spent quite literally clowning around, her problems had slipped away. In those three quarters of an hour, she was not a homeless woman recovering in a shelter, but just another woman, enjoying her life.  

When Sister Joann relayed this story to me the following day, I was immediately heartened by the strength that these women, who have been through horrible ordeals, can still have to create a better life for themselves. Many of the women at the shelter not only deal with the economic issues of being homeless, but also the trauma that has come from the painful experiences they've faced.

Homeless women's struggles with mental health issues will be out of the spotlight, even though they're more likely to struggle with depression.

On October 10, over 100 countries, including the U.S., recognize World Mental Health Day, a day designated to increase mental health education and awareness globally. However, homeless women's struggles with mental health issues will be out of the spotlight, even though research shows they're more likely to struggle with depression. Homeless women are often treated as though they created their situation, with too many people questioning why they should be helped. In truth, most women have fled a horrific situation, with no other option than to become homeless. Nearly 50 percent of all women who are homeless report that domestic violence was the immediate cause of their homelessness. So this World Mental Health Day, it's time to put a stop to their invisibility and acknowledge the care these women need.

How Many Homeless Women Face Mental Health Issues?

As of 2015, the National Alliance to End Homelessness reported that about 565,000 people living in the United States were homeless on any given night. Of that number, an estimated almost 40 percent of those individuals are women. According to the American Psychological Association, 47 percent of those women are living with a major depressive disorder, which is double the amount of women in the general population who have a major depressive disorder.

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Even when facing a mental health issue not as severe as a major depressive disorder, homeless women often lack the resources to get help, which only exasperates their problem. Additionally, 85 percent of homeless families are headed by women, creating an extra burden for women who are mothers. "[The mental illness] may not be the most severe form but it certainly can be debilitating and it certainly can impact how well they can provide for their children and their functioning," Dr. Carmela DeCandia, licensed psychologist and professor in Boston College's mental health counseling program, tells Bustle. "And people don't necessarily want to look at that because they want to look at homelessness as basically just an issue of housing but it’s not just about housing, and the moms with trauma and depression really aren't getting the services that they need." To get help, women first have to find a shelter to take them in — something that has become increasingly difficult.

Mental Health Shelters Are Unable To Meet Demand

As time passes, things have only been getting worse for homeless women with mental illness. The Coalition For The Homeless (CFTH) reports that the amount of homeless New Yorkers currently sleeping in shelters is 77 percent higher than it was 10 years ago. The organization also reported that the amount of shelter beds provided for those requiring mental health support decreased from 26 percent to 24.3 percent between 2014 and 2016. While shelter capacity grew 17 percent, mental health capacity increased by only 12 percent.

Recognizing this lack of access, CFTH teamed with The Legal Aid Society to submit testimony to The New York City Council Committee on Mental Health, Developmental Disability, Alcoholism, Substance Abuse and Disability Services. The testimony explained that, while the need for additional mental health beds is increasing, the supply has not risen along with it. As a result, there's not enough room in shelters for homeless individuals affected by illness.

In another recent heartbreaking report, the City’s Department of Homeless Services found that out of the first 120 days of 2017, there were 35 days without a single mental health bed vacancy for homeless men and 18 days without a mental health bed available for homeless women.

Dealing with a mental illness while homeless is a challenge in and of itself but, the lack of shelter placements available has further exasperated these issues. "I mean, there's mental illness and then there's a form of stress and depression that sort of manifests itself," Ruth White, MSSA, Executive Director, National Council on Homelessness and Child Welfare, tells Bustle. "So, it's like, along the mental illness continuum, things get more and more exacerbated."

The testimony went on to explain that in place of a bed, people have had no other option but to sleep in a chair or face extremely unstable placements, like moving locations night after night or waiting for a mental health bed to become available.

Where Did Affordable Housing Go?

Even for the homeless women that do get into shelters, it's unlikely they'll know where they'll go from there. "When I started my social work career in the 90s, you didn't just have an emergency response, you could actually get someone into affordable housing," White says. "Housing was not so out of scale with income, so, at that point in history, women's mental illness would not become exacerbated and completely out of control, because of the stress. We could help them move into a shelter, then we could very quickly move them through the shelter system into affordable housing."

White believes that affordable housing is no longer a reality, meaning the option of a federal housing subsidy is ruled out as well. "If you're a social worker working with a family, that's not an option. But also, the affordable housing crisis is absolutely out of control," says White. "Even for working people who are doing pretty well, housing is becoming something like 50 to 70 percent of their income." A 2016 Harvard's Joint Center for Housing Studies report indicated that over 11 million Americans are spending over half of their income on rent with another 21 million spending at least 30 percent.

As it's become harder to find a sustainable housing solution, women are remaining in shelters. Some women are even forgoing a shelter and staying in abusive relationships because they don't see a way out. Each factor leads to these women's mental health being compromised as the stress and inability to control their fate weighs down on them.

"Just because it might not be as dramatic as something that you might see, doesn't mean it's not there."

While the shortage of beds is certainly to blame, the lack of urgency to find solutions for homeless women dealing with mental health issues also contributes to the problem. "I think, even in our society, people don't recognize that women struggling with domestic violence or interpersonal trauma and, even a mild level of depression, affects [their] functioning,"  Dr. DeCandia says. "You might not be walking around the street, but you may keep having trouble holding a job, you might be having trouble meeting all your kids needs, you may have trouble sleeping at night, or be in a relationship and kind of having trouble functioning over time. Even finishing school perhaps. So, just because it might not be as dramatic as something that you might see, doesn't mean it's not there. And I think we have to really get serious about acknowledging that." Luckily there are places that do acknowledge that all forms of mental illness must be taken seriously, and open their doors to help.

Where Homeless Women Can Get Help

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Luckily, there are shelters dedicated to providing their residents with the mental health care they need. The Dwelling Place brings in a psych practitioner to meet with any women suffering who are not already in a mental health program.

Sister Nancy Chiarello, one of the founders and a case worker, initially noticed the variety of living options for homeless men, but that the same ones didn't exist for women. Today, the space holds up to 14 women who each stay, on average, for six months to a year. The organization is prides itself on providing a space where women can rediscover their inner strength and create the life they want. An emphasis is placed on the importance of learning how to cope with mental illness in order to achieve this life.

As for the way these women manage their mental health, it's not much different from anyone else. "Getting counseling, getting therapy, getting support and getting on the right medication," Sister Joann tells Bustle about the women's treatment. Even within the shelter's walls, where proper mental health care is taught, the women still feel the stigma that's wrongly placed on them.

Erasing The Stigma Around Mental Illness

While the discussion focused on medication as a treatment for mental illness has increased, the stigma against it still remains strong. It's still hard for people to know how to talk about it like we talk about other ailments.

"If someone has cancer everyone gathers around and supports them but, if someone is mentally ill, it's like, 'what's wrong with that person?'"

"When we think of people with mental illness we want to run away from it," says Sister Joann. "If someone has cancer everyone gathers around and supports them but, if someone is mentally ill, it's like, 'what's wrong with that person?' Or they have fear or shame. Many of the women come with the shame of being homeless and the shame of maybe being depressed or not being able to get your life together. It weighs heavy on them. So they need people to help them slowly work beyond that and look into themselves and find where their strengths are."

All of this mental illness stigma and disregard does is stand in the way of homeless women getting the help they need and leads them to feel ashamed even if they do take action to improve their mental health.

"If you take medication for diabetes, nobody stigmatizes that," says Sister Joann. "But, if you have depression or other mental health issues, personality disorders, and things like that — or stress and tension — sometimes it [medicine] just helps. And it's OK to say, I need that, and to be under a doctor's care and get the support that you need. So you can live a quality life, which is so important."

After The Dwelling Place, some of the women who require mental health care will transition into a supportive housing unit in the city. At a supportive housing unit, residents have private rooms but are provided meals and have help with tasks such as monitoring their medications.

"We all go through dark times in our life, but you can rise above it," says Sister Joann. "You don't have to stay there. There are ways to rise above it and get help. For most of the women, it's a journey." When given support, their course can become quite a bit easier.

What Can We Do To Help Homeless Women Affected By Mental Illness?

There are so many ways to get involved and become a part of that support system. "I think advocacy is an important thing," Sister Joann says. "I think trying to break the stigmas and look at people for who they are and not the image that they have. Break some of those images. Another way to help is to offer to volunteer. Sometimes people come here and are volunteers who help serve dinner. Maybe get to know someone who's homeless. I think building awareness, advocacy, and teaching their children compassion for those who have less than they do. I think those are all things that can help."

It's time to change the way we talk about and treat those with mental illness. "I'm very worried about the future, about the next generation of marginalized families, because of what we're doing to the mothers in terms of stress and mental illness," says White. One way to help is by speaking out to ensure these women are given fair access to mental health care, so the next generation may not face the same issues as this one.

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When it comes to making donations, it's important to think outside the box about what women need. Contributing the most basic items can make the difference between a shelter continuing to run or having to shut down. "People come here and they volunteer or sometimes they donate ordinary, simple things to help us keep going like, you wouldn't think, paper towels and laundry detergent, toilet paper. All those kinds of things we need to create a home for these women. Coffee, tea, those are ways you can help," says Sister Joann. "Monetary donations help us keep the lights on, keep the heat and the air conditioning."

Contacting the government is also an extremely effective measure. "What people need to do is contact your local legislatures, raise the issues, say, 'what are you doing?'" says Dr. DeCandia.

Mental illness is already not discussed enough, and, when it comes to care for homeless women, the discussion barely reaches a whisper. These women are part of a community that has remained voiceless for far too long. The conditions they are subject to and the lack of trauma care given to them is, not only irresponsible, but inhumane. Every woman has a right to a better life, no matter her current circumstance. This Mental Health Day, it's time to remind the world of that.