What are the major factors that contribute to Kevin’s frequent homelessness?


Case Study, Mohr

CHAPTER 38, Homeless Clients

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In completing the case study, students will be addressing the following learning objectives:

Discuss factors that contribute to homelessness in people with mental illness.

Discuss barriers that prevent homeless people with mental illness from receiving care measures to promote access.

  • Kevin, a 39-year-old unemployed homeless male who has paranoid schizophrenia, was brought to the psychiatric hospital by the police.  Citizens called the police because Kevin was in the street directing pedestrians and traffic in opposition to the traffic lights and verbally abusing everyone who did not follow his directions.  Kevin is known to the police since he is often homeless, and states that his family does not want him.  Kevin also has a history of poly substance abuse with alcohol, heroin, and crack cocaine, and he has been jailed for public intoxication several times.  The nursing assessment reveals that Kevin has not been taking his prescribed psychotropic medications for 3 weeks.  Kevin states that he does not have any money, and he does not remember where to go for mental health care (Learning Objectives: 2)

a. What are the major factors that contribute to Kevin’s frequent homelessness?

b. What barriers does Kevin face in the receiving treatment? How can these barriers be addressed?


Factors Contributing to Homelessness in Individuals with Mental Illness: A Case Study of Kevin


 This case study explores the factors contributing to the frequent homelessness of Kevin, a 39-year-old male with paranoid schizophrenia. It also addresses the barriers he faces in receiving treatment for his mental illness and proposes potential solutions to overcome these barriers. By examining Kevin’s situation, we can gain insight into the complex interplay between mental health and homelessness.

 Factors contributing to Kevin’s frequent homelessness: Several factors can contribute to Kevin’s recurrent experiences of homelessness, including:

Mental Illness: Kevin’s paranoid schizophrenia is a significant factor in his homelessness. Symptoms such as delusions, hallucinations, and impaired judgment can make it challenging for individuals with mental illness to maintain stable housing.

Lack of Family Support: Kevin states that his family does not want him, indicating a strained or nonexistent support system. Family rejection or strained relationships can leave individuals without a safety net and contribute to their homelessness.

Substance Abuse: Kevin has a history of poly substance abuse, including alcohol, heroin, and crack cocaine (Thompson & Hasin, 2011). Substance abuse can exacerbate mental health symptoms, disrupt social relationships, and increase the risk of homelessness due to financial instability and impaired decision-making.

Unemployment: Kevin is unemployed, which adds to the financial strain he faces. Limited income and lack of employment opportunities can make it difficult to secure stable housing and access essential resources.

 Barriers to treatment for Kevin and potential solutions:

Lack of Financial Resources: Kevin states that he does not have any money, which can hinder his access to mental health care (Kutash et al., 1994). To address this barrier, community-based organizations and government agencies could provide financial assistance programs specifically tailored to individuals experiencing homelessness and mental illness. These programs could cover the cost of medications, therapy sessions, and other essential mental health services.

Lack of Awareness and Information: Kevin mentions that he does not remember where to go for mental health care. Lack of awareness about available resources and services is a common barrier among homeless individuals with mental illness. To address this, community outreach initiatives can be implemented to raise awareness about mental health services and establish dedicated helplines or websites that provide information on nearby mental health clinics, support groups, and social services.

Medication Non-Adherence: The nursing assessment reveals that Kevin has not been taking his prescribed psychotropic medications for three weeks. Medication non-adherence is a significant barrier to effective treatment. Solutions could include implementing mobile psychiatric services that visit homeless shelters or outreach centers regularly, providing medication reminders, and simplifying medication regimens to improve compliance.

Coordinated Care: Kevin’s case highlights the need for an integrated approach to care. Collaboration between mental health providers, substance abuse treatment centers, homeless shelters, and social service agencies can ensure comprehensive and continuous support for individuals like Kevin (National Academies Press (US), 2006). Coordinated care models, such as assertive community treatment (ACT) teams, can be established to provide intensive, wraparound services addressing mental health, substance abuse, housing, and employment needs.


 Kevin’s case exemplifies the complex challenges faced by individuals with mental illness experiencing homelessness. Factors such as mental illness, lack of family support, substance abuse, and unemployment contribute to the recurrent nature of homelessness in such individuals. Addressing the barriers to treatment, including financial limitations, lack of awareness, medication non-adherence, and fragmented care, requires a multi-faceted approach involving community-based organizations, government agencies, and integrated care models. By understanding the factors contributing to homelessness in people with mental illness, we can strive to develop effective strategies that promote access to care and support the recovery of individuals like Kevin.


Kutash, K., Rivera, V. R., Hall, K. R., & Friedman, R. H. (1994). Public sector financing of communitybased services for children with serious emotional disabilities and their families: Results of a national survey. Journal of Mental Health Administration, 21(3), 262–270. https://doi.org/10.1007/bf02521333 

National Academies Press (US). (2006). Coordinating Care for Better Mental, Substance-Use, and General Health. Improving the Quality of Health Care for Mental and Substance-Use Conditions – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK19833/ 

Thompson, R. W., & Hasin, D. S. (2011). Cigarette, marijuana, and alcohol use and prior drug treatment among newly homeless young adults in New York City: Relationship to a history of foster care. Drug and Alcohol Dependence, 117(1), 66–69. https://doi.org/10.1016/j.drugalcdep.2010.12.020 

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