National Recovery Month and Intersections with Ending Homelessness

National Recovery Month, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) and observed every September since 1989, spreads the message that:

• Behavioral health is essential to health
• Prevention works
• Treatment is effective
• People recover

This year’s theme, Join the Voices for Recovery: Our Families, Our Stories, Our Recovery!, emphasizes the important role that individuals in recovery play as change agents and advocates in their social networks and communities. 

Recovery and Homelessness

By now, the intersection between homelessness, mental illness, and substance use disorders is well documented and established. According to HUD’s 2015 Annual Homelessness Assessment Report, of the 564,708 persons experiencing homelessness during the 2015 Point-in-Time count, nearly 208,000 had a severe mental illness or chronic substance use disorder. A significant proportion of people who enter emergency shelter or transitional housing programs have spent time in, and may even be coming directly from, institutional settings, including substance abuse treatment centers, psychiatric facilities, hospitals, and jails. Adults with disabilities, which includes chronic mental illness and substance use disorders, are far more likely to be in a shelter program than adults without disabilities.

We also know that the impact of substance use disorders and mental illness is more pronounced in certain populations, including Veterans and active duty service members, LGBTQ youth, and trauma survivors. According to research by the Rand Corporation, approximately 18.5% of service members returning from Iraq or Afghanistan have posttraumatic stress disorder (PTSD) or depression, and 19.5% report experiencing a traumatic brain injury (TBI) during deployment. LGBTQ youth, who experience homelessness at disproportionately high rates, also experience higher rates of mental health and substance use problems, suicidal acts, and violent victimization.

Guiding Principles of Recovery Align with Ending Homelessness

In August 2010, leaders in the behavioral health field, including individuals with lived experience and SAMHSA, developed a common working definition of recovery with four major dimensions and 10 guiding principles. Examining just a few of these guiding principles calls to light the similarities between the vision for recovery and for ending homelessness.  

Recovery occurs via many pathways – There is no single pathway into or out of homelessness, and each individual and family has a unique set of needs, strengths, values, and goals that will influence their path. Interventions must be culturally appropriate, trauma-informed, and tailored to meet people where they are. As with mental health and substance use treatment, a combination of interventions, such as rapid re-housing assistance and connection to mainstream benefits, is often more effective than one single intervention. Communities must have a full range of program types to be able to provide many different options for pathways and to fully respect the choices of people exiting homelessness.

Recovery is person-driven – For every pathway out of homelessness that is created, we must keep the person at the center of the decision-making process, and respect each individual’s preferences and choices. The homelessness services system must respect and value the agency and resiliency of each person experiencing homelessness, and support their capacity to identify the pathway out of homelessness that will best help them to achieve their goals. Assessment processes and services planning should have client-centered practices and protocols, providers should actively engage people into voluntary services programs, and program-imposed requirements should be minimized as much as possible.

Recovery emerges from hope – Perhaps most importantly, we have a responsibility to ensure that people experiencing homelessness have hope that they can end their homelessness, and are given real opportunities to do so. While each individual must find his or her own pathway out of homelessness, we have a responsibility to make those pathways quick, and much easier to navigate by developing coordinated crisis response systems that streamline the delivery of housing assistance and other supports. Hope for a better future is a catalyst for change in all of our lives. It is our shared responsibility to foster that hope and ensure that people experiencing homelessness have opportunities to harness their own strengths, resiliency, and ability to rebuild their lives.