There are more than a half million homeless people in the United States; more than half of them sleep unsheltered each night, while the other half use emergency shelters and transitional housing.
Research demonstrates that 30 to 40 percent of homeless people have a cognitive impairment, including traumatic brain injury, learning difficulties, intellectual disabilities, autism spectrum disorder, and attention deficit hyperactivity disorder.
A systematic review published this year takes a more careful look at how intellectual disabilities affect the homeless and what interventions could help. The review includes 13 studies from developed countries across the globe. Its findings provide a road map of how to help homeless people with intellectual disabilities.
Not surprisingly, the evidence shows that having an intellectual disability is a risk factor for homelessness, but that it can be difficult to identify. Homeless people with intellectual disabilities were more likely to be Black and more likely to be male. They were more likely to have dropped out of school, and to experience other problems related to homelessness including substance abuse and other mental health issues.
In one study, participants with intellectual disabilities were the only ones who reported wanting to remain homeless. Study participants with intellectual disabilities were less likely to remember their original home address and less likely to reintegrate with family members.
People with intellectual disabilities are more likely to become homeless at an older age due to the breakdown of a relationship or the death of a primary caregiver. They are more likely to have difficulty accessing health care services because of their disabilities.
People with intellectual disabilities may not be aware of or may not be able to describe their disability, posing extra challenges for health care providers and those offering social service supports. A simple solution to this problem is to provide screening to homeless people whenever they access new services.
The review also found that it may be possible to prevent people with intellectual disabilities from becoming homeless by paying special attention to their needs after the death of a caregiver or loved one. Offering coordinated health care and social services at this major turning point is a particularly powerful way to keep people with intellectual disabilities in stable housing. Encouraging agencies and systems to work together — including criminal justice, social services, health care, and housing — is an important component of providing the support necessary to prevent homelessness among those with intellectual disabilities.
The take-home message: People with intellectual disabilities are at a greater risk of becoming homeless. But with a coordinated support system, it's possible to help them remain in stable housing and potentially transition out of homelessness.