Homelessness and mental health: Are we neglecting this grave issue?

According to the United Nations, "absolute homelessness" describes the condition of people without physical shelter who sleep outdoors, in vehicles, abandoned buildings or other places not intended for human habitation. "Relative homelessness" describes the condition of those who have a physical shelter, but one that does not meet basic standards of health and safety. It is alternately defined as a "condition and social category of people without a regular house or dwelling because they cannot afford or are otherwise unable to maintain regular, safe, and adequate housing, or, fixed, regular and adequate night time residence." However, the legal definition varies from country to country. The United States Department of Housing and Urban Development (HUD) defines a "chronically homeless" person as an unaccompanied homeless individual with a disabling condition who has either been continuously homeless for a year or more, or has had at least four episodes of homelessness in the past three years. An estimated 100 million people are homeless throughout the world, the majority of them women and dependent children whereas at least 600 million people live in shelters that are life threatening in the cities of developing countries. According to UN Habitat report 31.6% of the world's total urban population live in life-and health threatening homes mostly in Asia, Africa and Latin America. World literature does indicate a close association of mental illness with homelessness that needs attention. A 2007 survey of 23 cities conducted by the US Conference of Mayors revealed 30% of the homeless population has mental illness. Senator Kirby of mental Health Commission of Canada stated that "an estimated 25-50% of homeless people have a mental illness and up to 70% of those with a severe mental illness also abuse substances. One in seven users of emergency shelters across Canada are children and almost a third of Canada's homeless are youths aged 16-24."

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Journal of Pakistan Medical Association