Mental Health
Mental health and treatment utilization among adults experiencing homelessness in California Anna Krasnova* Anna Krasnova Krasnova Krasnova Krasnova Krasnova UCSF Benioff Homelessness and Housing Initiative
In 2024, over 187,000 people experienced homelessness (PEH) on one night in California, representing 24% of PEH in U.S. There is a bidirectional relationship between homelessness and mental health; people with mental health problems are at higher risk of experiencing homelessness and homelessness worsens mental health problems and impedes treatment. In the largest representative study of homelessness in 30 years, we describe the prevalence of mental health symptoms and treatment utilization. The California Statewide Study of People Experiencing Homelessness used a multi-stage, venue-based sampling frame enhanced by respondent driven sampling to create a representative sample (2021-2022). We calculated weighted population prevalence estimates to describe self-reported symptoms of depression, anxiety, and hallucinations; post-traumatic stress disorder (PTSD) diagnoses, and lifetime suicide attempt. We described past 30 days outpatient mental health treatment or medication and past 6 months psychiatric hospitalization. Among 3,200 adults, the mean age was 46.1 years, 67.2% were cisgender male, 26.3% Black, 26.4% Latine, and 27.9% white. In the past 30 days, 67.2% of participants reported any mental health symptoms, 48.7% symptoms of depression, 50.9% anxiety and 12.5% hallucinations. A quarter (25.4%) reported a PTSD diagnosis and 31.3% a lifetime suicide attempt. Among those with any mental health symptoms, 12.6% had received recent outpatient treatment or medication; among those with symptoms of depression, anxiety and hallucinations 25.7%, 24.7% and 36.9% had, respectively. In the past 6 months, 5.3% reported a psychiatric hospitalization; among those with hallucinations, 22.2% had. Mental health symptoms were more prevalent, while treatment utilization, including psychiatric hospitalizations, was less prevalent than previously reported estimates from the last nationally representative study in 1996. There is an unmet need for mental health services for PEH in CA.
