For many people in North America the issue of home-lessness is closely tied to the phenomenon of deinstitutionalization, which refers to the process of having people who were hospitalized with psychiatric problems leave the hospital in order to live in the community. In the United States and Canada, the movement away from long-term hospital stays in favor of short-term, crisis-oriented hospitalizations and then community placements occurred in force during the 1960s and 1970s. Life in the community was considered more humane than life in the large psychiatric institutions. However, approximately 10 years after the community placements began, there appeared to be a visible segment of former patients wandering the streets and generally not being cared for by "the community." The early placements in group homes, boarding houses, and apartments fell into disarray (or were tenuous at best in the first place). The former patients wandered away from the placements, and many stopped taking their medications. How many of the homeless population really are mentally ill became an object of great interest in the research community and in the general public during this time period.
When rates of mental illness among the homeless are contrasted with rates in the general population, we find that most studies with good methodology report that 20-50% of the homeless population in the United States suffer from severe mental illness (i.e., schizophrenia, major affective disorders, paranoia and other psychoses, and personality disorders) in contrast to 1% in the general population (Burt, 1992, pp. 108-109). Although much attention has been given to the effect of the deinstitution-alization of the mentally ill on rates of homelessness, researchers were reporting a 20% rate of severe mental illness among skid row residents even in the 1950s, before the era of returning the hospitalized mentally ill to the community (Burt, 1992, p. 109).
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