According to a survey by the Substance Abuse and Mental Health Services Administration, roughly 22.7 million people every year need treatment for a drug or alcohol problem. Almost 90% of them will never get it. One reason is the high cost. While luxury centers charge up to $80,000 a month, even standard drug treatment costs from $2,000 to $25,000 a month. People without insurance are priced out of these treatment programs, particularly the homeless. As a result, they often go from incarceration to the streets to emergency rooms and back to the streets. In fact, the Los Angeles Homeless Services Authority (LAHSA) found that 60% of L.A.’s homeless population has cycled through the criminal justice system.
Traditional medical care is not enough to care for a population disconnected from health care and social networks. Reducing the high number of homeless takes trust and collaboration between people experiencing homelessness (PEH) and a network community professionals. For homeless people with alcohol, drug, and mental health disorders, the nonprofit behavioral healthcare field is a safety net.
Since substance use and mental illness are both a cause and a result of homelessness, both issues need to be addressed simultaneously – an evidence-based practice. Publicly-funded treatment programs, like L.A. CADA, use evidence-based recovery practices as a condition of funding and a matter of course. However, substance use treatment or mental health counseling on their own is inadequate – they must be combined with housing opportunities. In fact, stable housing during and after treatment is proven to decrease the risk of relapse.
In addition to providing housing during treatment, publicly-funded behavioral healthcare programs offer services such as case management to facilitate linkage to all needed care. Agencies like L.A. CADA also provide HIV/AIDS services, coordination with physical healthcare, as well as education and employment opportunities, peer support, and education for daily living skills. Successful treatment programs also provide outreach and engagement workers on the streets and flexible, culturally-competent and gender-/gender-identity competent treatment options. Evidence-based treatment also helps people reintegrate into their communities via multiple services, including Recovery Bridge Housing and family reunification.
In the end, it’s important to remember that homeless people are not what they do. People who are homeless are sons, daughters, mothers, fathers, students, employees, and some are future leaders. Homeless is not who someone is; rather, it’s their current circumstance. For those with alcohol, drug, and/or mental health disorders, behavioral healthcare can help them take their places in our community.
Next week, we’ll take a look at specialty practices in behavioral healthcare that are working for homeless people.