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Serious Mental Illness among People who are Unsheltered in Los Angeles 

Abstract

In Los Angeles, 45,021 people experiencing unsheltered homelessness received street outreach services between July 1, 2019 and June 30, 2020. Supporting and housing unsheltered residents is an urgent priority in Los Angeles, and it is imperative to better understand the challenges that individuals are facing. Questions persist about the size and unique needs of the group of individuals who are unsheltered and diagnosed with a serious mental illness (SMI). This is because unsheltered individuals experiencing serious mental illness, and particularly those individuals with a diagnosis of a psychotic spectrum disorder (“PSD”), may experience symptoms that could cause or contribute to losing housing and that could lengthen the duration of homelessness. This group often needs intensive, specialized, and coordinated care in order to exit homelessness. To better understand the prevalence of psychotic spectrum disorders (“PSD”) among those who are unsheltered, the California Policy Lab (CPL) linked homeless outreach service records found in the Los Angeles Homeless Services Authority’s (LAHSA) Homeless Management Information System (HMIS) to service records at the LA County Department of Mental Health (DMH) and the LA County Department of Health Services (DHS). We used the linked data to estimate the number of people who are enrolled in a street outreach program and who had a service visit for serious mental illness (“SMI”) in the five years prior to their street outreach enrollment. We then stratified this group into two distinct groups: those with service visits with a diagnosis of PSD and those with service visits with a diagnosis of a serious mental illness without psychotic symptoms (“Other SMI”). We analyzed these data to show how many people in these groups were enrolled in interim or permanent housing within one year of their enrollment in street outreach services, and we break down interim and permanent housing enrollments by race and ethnicity. Our analysis also shows how many street outreach participants did not have service records for PSD or Other SMI within the five years prior to enrolling in street outreach.

This work has been supported, in part, by the University of California Multicampus Research Programs and Initiatives grants MRP-19-600774 and M21PR3278.

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