Chronic Mental Illness: Recovery while (Still) Homeless?

Did you know that among the large population we in the United States have of homeless people, approximately 30% are people with serious mental illness! Yes, at least 30%. Fifty percent, if you count those that also have substance abuse disorder. These homeless, along with those individuals with mental illness in prison and jails, are the forgotten of our world … even at times, forgotten by the advocates of mental health policy and care. They are out of view and out of mind.

Do we assume we can’t do much or shouldn’t do much for these forgotten?
Or do we realize we can end homelessness?

“Providing someone who is chronically homeless with a home first gives them the stability that they need to begin the process of recovery.” – Sam Tsemberis, Pathways to Housing

I couldn’t agree more … recovery is hard enough when you have a stable home!

One of the unique features of Pathways’ Housing First model is that participation in treatment or sobriety as a precondition is not required for housing. [More here]

Real Depression; Real Men: “Because you have to deal with it. It doesn’t just go away.”

This post’s title is taken from a video clip “Real Men, Real Depression” featuring Patrick McCathern, 1st Sergeant, US Air Force, Retired, and available here on The National Institute of Mental Health’s website.

Depression in Men often manifests itself differently. What ails men may not be recognized by them or their family or friends as depression. It may be mistaken as a sleeping problem or a digestive problem … or a character flaw. When a man has depression he has trouble with everyday life and loses interest in anything for weeks at a time.) He may be irritable, feel very tired, and lose interest in his work, family, or hobbies.

The tricky part of depression in men: They may not want to recognize, talk about, or acknowledge “it” or how they are feeling. (Please see my entry on Male Depression under These Illnesses in the menu section of my website for life experiences with my father’s depression.)

The quiet truth about depression is that it is very, very painful, and unending. And although women with depression more often attempt suicide, men are more likely to die by suicide.

HOW CAN I HELP A MAN WHO IS DEPRESSED? (Recommendations from The National Institute of Mental Health):

  • Offer him support, understanding and encouragement. Be patient.
  • Talk to him, but be sure to listen carefully.
  • Never ignore comments about suicide, and report them to his therapist or doctor.
  • Invite him out for walks, outings and other activities. If he says no, keep trying, but don’t push.
  • Encourage him to report any concerns about medications to his health care provider.
  • Ensure that he get to his doctor’s appointments.
  • Remind him that with time and treatment, the depression will lift.


Call your doctor or 911 for emergency services.

Call the toll-free, 24-hour lifeline, National Suicide Prevention Lifeline

1-800-273-TALK (1-800-273-8255)                  TTY: 1-800-799-4TTY (1-800-799-4889

More “First Things First” – Half the cigarettes in America

AODA/mental health patients smoke half the cigarettes in America. They’re dying from it. Most want to quit. Many have tried. For example: My story is available here, on my website, and I’ll be writing more about the Center for Tobacco Research and the problems associated with smoking and mental illness shortly. . .

The facts are startling: 50% of people with persistent mental illness smoke compared to 18% of the general population; they consume 40% of all cigarettes smoked. The result is 200,000 deaths of  individuals with mental illness in the US  per year from smoking. The average lost years of life spans 20 -24 years! That is right, people with mental illness who smoke, as a group, live 20 – 24 fewer years than the general non-smoking population.  You can view this and more great information at the Center for Tobacco Research & Intervention, University of Wisconsin School of Medicine and Public Health, Madison.

Smoking: Serious and Plentiful Challenges

As the smoking statistics imply, there are many additional challenges for people with mental illness who wish to quit. For one thing, they smoke “harder” than their counterparts (e.g., smoke more of the cigarette) and they begin smoking  earlier.  They lack of confidence about their life and about their chance of quitting.  And are more likely to make unaided quit attempts without benefit of evidence-based treatment.

The above are serious and plentiful challenges – did I mention high stress and lack of support? But there are more…..some people with mental illness receive an “unhelpful” response from their health care providers. The professional can say “it’s not in the scope of my job” (to help someone stop smoking). Few professionals identify and document smoking status,  and some say…”I don’t know how important ths is for the health of my patient”……,  Many conclude/assume their patients don’t want to quit (UW-CTRI reported on a study where 83% of smokers have tried to quit.)

In addition, some providers feel that trying to quit will harm the patient (for example, de-stabilize the person, or “now is not the time – we’ll do it later”) or don’t know how important smoking cessation is. Then there is also the belief or thought that …smoking is one of the few pleasures my patient has…. And lastl,” I don’t know how to help”, “I don’t have time” and “I don’t know how to bill for tobacco dependence treatment”.(Poor things!)

Dr Bruce Christiansen PhD, Lead Researcher at the University of Wisconsin’s Center for Tobacco Research and Intervention states “Those with significant mental illness who smoke need treatment of greater intensity than the typical smoker while currently they are getting far less, resulting in a considerable treatment gap.”

The Quit Line

How is tobacco dependence treated? Counseling, support, and medication for starters.  How about free?: Free coaching, free materials, and, if you need it, free medication? If you’re even thinking of quitting, call:


Hours:  7 am to 11 pm daily

Click the link above, or call 1-800-QUIT-NOW (784-8669)

1-877-2NO-FUME (Spanish)

1-877-777-6534 (TTY)

This free service is offered by the Center for Tobacco Research & Intervention at the University of Wisconsin School of Medicine and Public Health. Its website is excellent. Easy to use and full of great information for the smoker or the family and friends of smokers. The main menu has sections anyone can access for Researchers, Health Care Providers, Smoker, Insurer and Employer. They have information on E-cigarettes! Topics include: What happens when you quit smoking (from 20 minutes to 15 years out), helping someone else quit, cost savings, time savings, etc.  Plus There’s a list of services to help you quit and videos with quit tips, various publications, a glossary, Quit Smoking apps, and more.

Just a great resource.