Initiating Solutions to End Homelessness

Homeless Individuals in Massachusetts: An Overview

A Growing Population. Most homeless adults use emergency shelter beds and services that are funded by the Department of Transitional Assistance (DTA) but also by the Departments of Veterans Services and Public Health. Approximately 3,225 beds are available year round in the publicly funded shelter system. According to the nightly census of emergency shelter beds conducted by the Massachusetts Housing and Shelter Alliance (MHSA) since 1992, shelters have experienced overflow demand for 55 consecutive months and 63 of the last 66 months (April 2003).

Subpopulations of Homeless People. MHSA surveys adult shelters statewide on a monthly basis to identify populations emerging from state care and prior residence of newly homeless individuals. This information helps identify increases in specific subpopulations and sources of new homelessness. According to MHSA's Subpopulation Census, guests arriving new to reporting shelters in FY '02 included: ex-prisoners (6%); persons discharged from psychiatric hospitals (5%); persons discharged after detox (8%); young people ages 18-24, including those leaving foster care (14%); persons over age 60 (3%).

Length of Stay and Disability. National research by Dr. Dennis Culhane, the most widely recognized researcher on the adult homeless population, has provided a compass for policy and program development targeted to specific population profiles. Dr. Culhane's data show that about 10% of homeless adults who use the shelter system over the course of a year have long stays in homelessness, coupled with deep levels of mental and physical disability, including addictions. This is the most costly population due to their length of stay and the population most easily moved to supportive housing with services, thus reducing the public expense of acute care and emergency services.

An additional 10% experience multiple episodes of homelessness and are frequent users of other public systems, meaning that the prevention issues of appropriate discharge planning and residential resources can have the most impact on their "revolving door" homelessness. Some 80% of homeless individuals are one-time, short-term users of the system, homeless mainly due to safety net failures.

Mental Health. The Massachusetts Department of Mental Health relies on a 1992 Human Services Research Institute study of recognized prevalence estimates to calculate that about 2,000 homeless people have severe and persistent mental illness at any point. Of these, about 1,200 are in the Metro Boston Area.

Substance Abuse. According to the Massachusetts Department of Public Health, Bureau of Substance Abuse Services, 20% of all FY '02 admissions to substance abuse treatment services (or 24,851 admissions) were of homeless people; 80% were male. Homeless white males have been shown to have the highest rates of recidivism in treatment. Some 26% of DPH homeless admissions reported prior mental health treatment.

Health Insurance Status. Due to the health risks posed by living on the streets and in shelter, homeless individuals are the highest utilizers of health care, especially acute care. Prior to the end of MassHealth Basic, about 70% of individuals in shelter (point in time) were covered by some form of insurance.

Homeless Veterans. The VA's Health Care for Homeless Veterans Annual Report on Boston's homeless and at-risk veteran population showed that 70% of homeless veterans are diagnosed with a substance abuse dependency, 61% with a serious psychiatric disorder, and 48% are dually diagnosed with serious mental illness and substance abuse.

This information is provided by the Executive Commission on Homeless Services Coordination.