NetHomeless

The NOFO is Correct: Now is the Time to Make the Connection Between Housing and Behavioral Health

Homelessness itself is a traumatizing experience. Add COVID-19 to the picture, and it should be readily apparent that we urgently need to connect people experiencing homelessness to both housing and behavioral health supports.  Research has shown that the pandemic, coupled with the related economic downturn, has negatively impacted people’s mental health and created new barriers in terms of access for people already suffering behavioral health issues. 

COVID-19 has also placed a spotlight on deep-seated racial and ethnic disparities in health care, including behavioral health.  While the data shows that rates of behavioral health disorders are similar across demographics, Black and Latino populations have substantially lower access to mental and substance abuse treatment.  Black and Brown people are also more likely to experience homelessness.  

Strengthening Behavioral Health Partnerships 

It’s timely for the Department of Housing and Urban Development’s (HUD’s) FY 2021 Notice of Funding Opportunity (NOFO) to incentivize partnerships between health organizations and Continuums of Care (CoC). So often, people think of physical health when talking about health partnerships, but voluntary behavioral supports can be just as important to housing stabilization, especially during times of extreme crises.   

We, in the homelessness field, know very well that a disproportionate number of people experiencing homelessness (even before COVID-19) have higher rates of chronic and co-occurring health conditions, mental and substance use disorders, and are at greater risk of trauma and incarceration. A coordinated and integrated approach with multiple service resources, including behavioral health supports, is an effective way to improve outcomes for vulnerable, unhoused people.   

Using Federal Funds for Behavioral Health 

States are now in the process of strategizing about big housing opportunities through once-in-a-lifetime funding from relief bills like the American Rescue Plan Act (ARPA). As a result, CoCs should be:  

  1. working to build partnerships and collaborations with state and local entities to house people experiencing homelessness with these new resources, and  
  2. working to access funding for behavioral health services that are on the table as well.   

The ARPA, for example, through the Substance Abuse and Mental Health Services Administration (SAMHSA) distributed $3 billion to states and territories to support mental health and substance use programs.  This funding can cover employment and housing assistance, case management, peer support, and the like. Congress also passed additional stimulus bills to address mental health and substance use services that include things like expanded coverage for telehealth. But how well are CoCs equipped to coordinate with the health sector to provide people experiencing homelessness with the full scope of care they might need? 

Now is certainly the time for CoCs to consider these questions, especially in preparing their NOFO application: 

  1. Are you addressing housing and care needs concurrently for people experiencing homelessness with unique challenges? 
  2. Do service providers know how to help individuals access federal or local benefits to improve both behavioral health outcomes and housing stability? 
  3. Is your response system evaluating client access to mental health, substance use, medical care, and social supports in an equitable way and making necessary adjustments to improve outcomes? 
  4. Is your CoC utilizing all available resources to end homelessness? 

 Ending Chronic Homelessness 

The lingering pandemic will likely continue to have implications for mental health and substance use, particularly for groups like people experiencing homelessness (who are at risk of co-occurring mental health disorders) and those facing barriers to accessing care.   

As policymakers continue to introduce bills that address public needs associated with COVID-19, it is crucial that CoCs take advantage of every opportunity to help end chronic homelessness. When CoCs can end chronic homelessness it prevents people cycling in and out of jail for largely nuisance convictions (like loitering, sleeping outside, drinking, etc.), and expands housing options such as permanent supportive housing and rapid rehousing (which also help reduce stigma by de-emphasizing institutional care).  

As the latest NOFO suggests, making strategic connections between housing resources and mental health and substance use supports is a step in the right direction. 

 

 

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