Mental Illness and Homelessness: A Cry for Help

Chidinma Nwanekpe, RN, BSN, MPH, GAC Commissioner, Mental Health Nurse

By Chidinma Nwanekpe, RN, BSN, MPH

GAC Commissioner, Mental Health Nurse at St. Joseph’s


Working on my unit has exposed me to a lot of issues our mental health patients go through, but the most prominent one is homelessness.

For example, here’s a patient we’ll call “Mr. J.” Mr. J had been in the hospital for seven days when I arrived at work one day. In a mental unit, it’s not uncommon for patients to be reported as loud, upset, disrupting unit activity, and not heeding re-direction. Mr. J said he had been in the hospital for quite a while, didn’t know where to go after he was discharged because he was homeless.

I tracked down his social worker who worked with him to figure out where he would be sent post-discharge. He said that he was worried about ending up in the street again, but he had found a new place to go and was grateful. Mr. J was discharged the next day, and he was excited to go to treatment.

One in every three homeless people suffer from mental health problems and substance abuse ( As a nurse who works in a mental health unit, most of the patients admitted on my unit have ongoing issues with mental health disorders such as schizoaffective disorders, chronic depression, and anxiety disorders. In the majority of cases, they are either admitted in the hospital or at treatment centers, and these patients may not be able to hold down a regular job.

About 90 percent of patients in our mental health unit are stressed like Mr. J was. They don’t know where they are going after discharging from the hospital. Some of them live with family; some live in government-funded apartments. While they are in the hospital, there is a high chance that their apartment will be taken away or their family will kick them out.

It is critical to have a state- or federally-funded system that educates and ensures that these clients still have their apartments, even if they are hospitalized for long periods. Next, if they are discharged to a treatment center, the center should accommodate them for three months. This would be long enough to be sober and look for a job to augment the funds from the state for rent and food. This will eliminate the worry about having a roof over their heads and will make a huge difference in the recovery process. Establishing treatment centers that have curriculum to teach carpentry, pottery, blanket-making, painting or any craft that keeps them occupied and trained will go a long way toward making them feel that they can contribute their skills to the community and not feel they are a burden to society.

Finally, we must always remember to show compassion and empathy to those who are suffering, not frustration.

As nurses, we see the effects of our broken mental health system every day. There aren’t enough beds, doctors, or permanent housing for them to return to after treatment. These patients are getting lost in this broken system, and we know they deserve better.