Abstract

Homelessness is a present and concerning issue without a clear solution due partly to barriers in public policy, as well as challenges in homelessness research. Research seems to indicate that barriers to effective research on homelessness include inconsistent and incomplete data on homelessness prevalence, a lack of consistency in defining homelessness, and lack of generalizable research (Hossain et al., 2020). This is especially true when it comes to the intersection between homelessness and mental illness. While research has been done on interventions for unhoused individuals (Morton et al., 2020; Ponka et al., 2020), studies often fail to address the complex needs of unhoused individuals experiencing mental illness when it comes to intervention effectiveness. The primary aims of this systematic review were to identify the symptom presentations within the unhoused population and identify mental health interventions for unhoused individuals experiencing mental health concerns. Data was collected from five electronic databases and included peer-reviewed, English language articles published between 2010-2024. The review also included studies that focused on substance use disorders and excluded studies that did not use valid and reliable screening measures as well as studies that did not answer both research questions. A total of 26 studies were included in this systematic review; four of which focused on psychological intervention as a primary modality of treatment while 22 included psychological interventions nested within a larger housing or community program. Results showed that while primary psychological intervention for unhoused individuals resulted in a reduction of symptoms and gains in functioning, there was little significance in symptom reduction between targeted or general interventions. This may suggest that nonspecific therapeutic factors such as engagement, cognitive learning, affective experiencing, self-efficacy, and structure are powerful, underlying mechanisms of change. Additionally, studies reported significant challenges in participant engagement and attrition. Results inform discussion on how to best adapt treatment interventions for unhoused individuals, the effect of supportive housing programs on intervention research, the use of straightforward screeners as tools to identify symptoms in the unhoused population, as well as gaps in the current literature regarding homelessness and mental health intervention.

Library of Congress Subject Headings

Homeless persons—Mental health; Homeless persons—Services for; Homelessness

Date of Award

2025

School Affiliation

Graduate School of Education and Psychology

Department/Program

Psychology

Degree Type

Dissertation

Degree Name

Doctorate

Faculty Advisor

Melissa Wasserman

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