The United States’ economy, recently on the brink of collapse, appears to be making a recovery. The poorest families haven’t yet seen the benefits of the recovery. The result is an increase of homeless children and adults. 
According to federal law, homeless children include those who lack a fixed, regular, and adequate nighttime residence. Although some students will volunteer their personal information, many homeless students will make oblique references to where they are staying.
Estimates show that nearly 1.4 million children are homeless in this country every year. In the 2011-2012 school year, 1,166,339 homeless children and youth were enrolled in public schools. This is a 71 percent increase since the 2006-2007 school year. The number of homeless children increased in 31 states between 2012 and 2013, with leaps of 10 percent or more in 13 states and Washington, D.C.. It is important to note that this number is not an estimate of the prevalence of child and youth homelessness; in fact, it is an underestimate, because not all school districts reported data to the U.S. Department of Education, and because the data collected represents only those children identified and enrolled in school. Finally, the number does not include all preschool-age children, or any infants and toddlers. Students may also indirectly indicate that they are homeless through changes in their habits and appearance, such as increased sleepiness; wearing the same clothes frequently or other personal care issues; a decreasing quality of school work; and most often, and absences from school. Homeless students are of every race and cultural background. Ninety percent of homeless families are single-parent families that are typically headed by the mother. The characteristics of homeless students are similar to other students living in poverty, the difference being that they do not have consistent housing.
Homeless students are often on their own by the time they reach secondary school age. Administrators frequently refer to these older homeless students as unaccompanied youth or, more informally, as “couch surfers” or “couch hoppers.” Homeless students sometimes do not get enough to eat and therefore come to school hungry. Homeless students may not get enough sleep at night or are afraid to sleep. Many homeless students do not receive adequate medical or dental care and are more likely to have health problems. Homeless students have higher rates of upper respiratory and ear infections, skin diseases, and common cold symptoms than their peers.
About 12% of homeless children are not enrolled in school and up to 45% do not attend school regularly.
The relationships that homeless students have with school staff members may be the only associations they have with people who are living in a productive and positive manner and who can serve as guides for how to live constructive lives.
The number of Americans who are homeless at some point during a year changes constantly as people move in and out of homelessness, sometimes for days at a time, sometimes weeks or months.
Poor health can contribute to being homeless, and being homeless can lead to poor health. Limited access to health care can make it worse. That’s why the health of homeless people in the United States is worse than that of the general population. Common health problems include
• Mental health problems
• Substance abuse problems
• Bronchitis and pneumonia
• Problems caused by being outdoors
• Wound and skin infections
Many homeless women are victims of domestic or sexual abuse. Homeless children have high rates of emotional and behavioral problems, often from having witnessed abuse. One study found that 28 percent of homeless people with previous psychiatric hospitalizations obtained some food from garbage cans and 8 percent used garbage cans as a primary food source. 
More than 124,000 – or one-fifth – of the 610,000 homeless people across the USA suffer from a severe mental illness, according to the U.S. Department of Housing and Urban Development. They’re gripped by schizophrenia, bipolar disorder or severe depression — all manageable with the right medication and counseling but debilitating if left untreated. The number of mentally ill homeless surged in the 1970s and ’80s as the second half of the Baby Boom generation reached the age of onset for schizophrenia, which typically begins when a person reaches their 20s, and psychiatric hospitals and group homes struggled to keep up with demand.
In many cities such as New York, homeless people with severe mental illnesses are now an accepted part of the urban landscape and make up a significant percentage of the homeless who ride subways all night, sleep on sidewalks, or hang out in the parks. These ill individuals drift into the train and bus stations, and even the airports.
Many other homeless people hide from the eyes of most citizens. They shuffle quietly through the streets by day, talking to their voices only when they think nobody is looking, and they live in shelters or abandoned buildings at night. Some shelters become known as havens for these ill wanderers and take on the appearance of a hospital psychiatric ward. Others who are psychiatrically ill live in the woods on the outskirts of cities, under bridges, and even in the tunnels that carry subway trains beneath cities.
There is evidence that those who are homeless and suffering from a psychiatric illness have a markedly elevated death rate from a variety of causes. This is not surprising since the homeless in general have a three times higher risk of death than the general population and severely ill individuals have a 2.4 times higher risk of death during any year. 
One approach to understanding mental illness and homelessness in this country is go back to the JFK-era.
In 1963, President John F. Kennedy delivered an historic speech on mental illness and retardation. He described sweeping new programs to replace “the shabby treatment of the many millions of the mentally disabled in custodial institutions” with treatment in community mental health centers. This movement, later referred to as “deinstitutionalization,” continues to impact mental health care. Though he never publicly acknowledged it, the program was a tribute to Kennedy’s sister Rosemary, who was born mildly retarded and developed a schizophrenia-like illness. Terrified she’d become pregnant, Joseph Kennedy arranged for his daughter to receive a lobotomy, which was a disaster and left her severely retarded.
While 6 percent of the general population is severely mentally ill, one-third of homeless people have untreated mental illnesses.
Between 2009 and 2012, states cut a total of $4.35 billion in public mental-health spending from their budgets. By cutting their budgets for mental health services, states are not saving themselves money. It costs less to treat people appropriately, including providing housing, than it does to pay for the emergency room services, shelters and prisons they wind up in instead.
Even if homeless individuals with mental illnesses are provided with housing, they are unlikely to achieve residential stability and remain off the streets unless they have access to continued treatment and services. Research has shown that supported housing is effective for people with mental illnesses. In addition to housing, supported housing programs offer services such as mental health treatment, physical health care, education and employment opportunities, peer support, and daily living and money management skills training. Successful supported housing programs include outreach and engagement workers, a variety of flexible treatment options to choose from, and services to help people reintegrate into their communities. Homeless people with mental illnesses are more likely to recover and achieve residential stability if they have access to supported housing programs.
Helping homeless people with mental health problems isn’t a question of finding and spending more money. We already are spending that money, to fund prisons, shelters, emergency rooms, and other safety-net institutions. The question is directing the money to the right place: supported housing programs, where people get both housing and help with their mental illness and with day-to-day life. All it takes is the political will at the state level. Sadly, political will is in very short supply these days.
