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Barriers to Care: Mental Health in the Unhoused Community

Posted on October 6, 2022

Have you ever had to fill out a mental health form with questions like, “In the past two weeks, how often have you felt down, depressed, or hopeless?” To make it easy for you, the form includes answers for you to circle: not at all, several days, more than half the days, or nearly every day.

If that sounds familiar, you’ve probably taken a depression screening test. Therapists use these often, but recently primary care doctors have begun using them to identify patients who need referrals to a mental health specialist. 

Today is National Depression Screening Day, which encourages people to screen themselves for depression. At Thrive DC, we support mental health awareness, as we see firsthand the impact that mental illnesses have on our clients. 

Homelessness is stressful, dangerous, and traumatic. Unhoused people face daily threats from food insecurity, weather, and other people. This environment does not support mental wellness, but instead fuels hopelessness, fear, and anxiety. 

As a result, unhoused people experience higher rates of depression than the general public. The American Psychological Association reports that 47% of unhoused women meet the criteria for major depressive disorder, which is twice the rate of women overall. And while depression is the most highly reported mental health condition among unhoused people, studies also show that unhoused people experience addictive disorders and schizophrenia spectrum disorders at a higher rate than the general public. 

Homelessness may trigger or make an existing mental illness worse, but it also creates barriers to treatment. Those experiencing homelessness already struggle to access healthcare in general. For many, mental healthcare is an extra hurdle because of the need for referrals and limited coverage by government health insurance. Access to mental healthcare is also more difficult for unhoused people because the common treatments, like therapy or medication, require consistency. When you have to move to different shelters or places to sleep frequently, it is hard to maintain consistency, especially when adding a mental illness into the equation. 

As a result, some people turn to drugs to self-medicate because they cannot access treatment from the professional routes. 

Regardless of personal struggles, Thrive DC is here for all unhoused people. We provide substance abuse counseling that also addresses mental health by exploring emotional health, negative emotions, and anger. Then, clients practice strategies for stress reduction, emotional communication, and sobriety. Thrive also provides food, showers, laundry, personal hygiene items, and a space for community, because we believe these are all aspects of a healthy life that promotes mental well-being

So, what can you do on National Depression Screening Day to help our unhoused neighbors?

  • Support expansion of government-funded healthcare
  • Support Thrive DC’s work by donating or volunteering
  • Share this post with a friend or family member to increase awareness of the barriers to mental health treatment

Thrive DC provides emergency services like food, showers, and community because we believe physical and social wellbeing is critical to mental wellbeing. We love to see how our services make clients like Miss Sylvia smile.

Finally, a helpful action you can do every day is to be kind and have compassion. There are many stereotypes about unhoused people regarding drug and alcohol use and mental health. Approach these ideas with nuance and kindness, remembering we are all people, and that the systemic issues in our country create barriers for unhoused people, precariously housed people, and people with mental disorders that are difficult to overcome. 

1525 Newton St NW
Washington, DC 20010
(202) 737-9311

Client Hours:
Tuesday - Friday
10:00 AM - 12:00 PM | 1:00 PM - 3:00 PM

Staff Hours: 
Monday – Friday
8:30 AM – 5:00 PM
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