No Fixed Address · Episode 4 of 11 · 46 min
Mental Illness, Addiction, and Homelessness: Cause or Consequence?
Roughly a third to a half of homeless people live with a serious mental illness, a substance-use disorder or both, but much of it follows from the trauma of life on the street. The episode separates who ends up homeless, where illness and addiction matter, from how many, where housing cost matters. It discusses mental illness, addiction and overdose.
Who's who
- Gregg Colburn+2 more episodesCo-author of Homelessness Is a Housing Problem, source of the scale-versus-who distinction
- Clayton Page Aldern+2 more episodesCo-author of Homelessness Is a Housing Problem
- Mark HorvathFounder of Invisible People, which records first-person testimony
Timeline
- 2013-2023The fentanyl era drives overdose deaths to record highs, hitting unsheltered people hard
- 2023HUD data show about 21% report serious mental illness and 17% chronic substance abuse
- 2024A record 771,480 are homeless; overdose deaths begin a sharp decline of about 24%
- 2025Johns Hopkins reasserts the housing-cost thesis; the first national dip since 2016
Still debated
Prevalence estimates vary widely by method and definition, and in any individual life the illness-homelessness arrow may run either way. Whether coercive treatment helps, and whether to treat or house first, are fiercely disputed.