Mental health issues, physical health care needs and substance abuse conditions are major causes of homelessness according to California Policy Lab at UCLA study.

Previously, Los Angeles Homeless Services Authority (LAHSA) reported people with serious mental illness and/or substance use disorder comprise up to 29% of the homeless population

The national study conducted by UCLA specifically finds people, not in homeless shelters are more likely to have mental health issues than sheltered individuals.

Janey Rountree, executive director of California Policy Lab, told Annenberg Media the purpose of the vulnerability index survey is to prioritize more vulnerable individuals, such as those experience mental health or substance abuse disorders, to receive housing resources. When highlighting gaps found between sheltered and unsheltered groups, Rountree referred to housing as an essential social determinant of health and solution to the existing problems.

In the study, 50% of individuals experiencing homelessness without access to a shelter reportedly suffer from a combination of a physical and mental health condition, as well as substance abuse. It is called a state of tri-morbidity, for which only 2% of those with access to homeless shelters report experiencing.

Data from the UCLA report also shows there is a certain population whose physical health and mental illness concerns are reported as the cause of their homelessness.

“In that case, we really want to think about prevention in the healthcare setting,” Rountree said. “What can we do to better connect very vulnerable people to urgent healthcare and to meet mental healthcare needs that they have, before they lose their housing.”

Rountree mentioned how LAHSA funds homelessness prevention services, which may include legal services, working with landlords and catering utilities to provide short-term financial assistance. The legal services may help people who face discrimination in workplaces and housing, or who need mediation to prevent an eviction.

Additionally, Rountree said prevention in the healthcare system will be a strategy of to deal with homelessness.

“I think prevention in the healthcare system is really untested,” Rountree said. “So that would be an important place to innovate in the future.”

According to LAHSA, prevention helped 5,643 people at risk of experiencing homelessness in 2018. Other approaches, such as outreach and engagement and interim and permanent housing placements, assisted four to seven times more individuals already experiencing homelessness.

Ahmad Chapman, director of communications at LAHSA, emphasized they continue to work on strategies that worked in the past. Sticking with a “housing first” policy, Chapman said health support services should come after people without housing find shelter, though “they both should be addressed.”

Some say housing alone is not as effective as it needs to be when dealing with individuals experiencing both homelessness and mental illness.

“One of the main reasons why LA has been struggling is that mental health has not been actively involved in dealing with the problem,” said Professor Seth Kurzban, a social work expert at USC Suzanne Dworak-Peck School. “We’ve been relying solely on homeless services, and that’s the problem.”

Though there is mental health advocacy in the county, Kurzban said it’s not at the rate and scale needed. When it comes to people experiencing homelessness, mental illness and even tri-morbidity, improvement of public health services should be prioritized more than housing, according to Kurzban.

While housing seems to be the priority in dealing with homelessness issues, more efforts have focused on addressing mental health, as well.

Clarification made 2:06 p.m. Oct. 9, 2019: We clarified statistics comparing the number of people helped through prevention methods versus through other approaches such as outreach, engagement, and housing placements.

Correction made 4:11 p.m. Oct 9, 2019: LAHSA, not the California Policy Lab, funds homelessness prevention services.