Introduction

As per the Universal Declaration of Human Rights, article 25, par. 1 “housing is reported as a basic right”, but several people are unfortunately homeless.

There is no standard universal definition of homelessness. In India, “Homelessness” is the condition and social category of people who lack housing, because they cannot afford, or are otherwise unable to maintain, a regular, safe, and adequate shelter. These people either live on the streets, in jail, in an institution, or in other places not meant to be sufficient night-time residences.

As per census data, homeless individuals living in India have increased from 1.77 million counted in 2011(0.15% of the total population) to an estimated record of more than 4 million people currently. Uttar Pradesh, Maharashtra, Rajasthan, and Andhra Pradesh have a greater homeless population in comparison to other states. (The Borgen Project 2020; Sanjukta S., 2014).

Source: Data from OECD, (Maisonneuve C., D., l., & Dek m., 2020)

The homeless persons with mental illness

The presence of mental illness among homeless people has long been recognized internationally. Social and economic factors such as crime, violence, and homelessness are all associated with mental illnesses. However, homelessness has often been linked to mental illness. People are most likely to suffer from mental disorders due to homelessness that further causes substantial disability (Frank, R. G., & McGuire, T. G., 2000).

Poverty, drug addiction, changes in the industrial economy leading to unemployment, inadequate income support and lack of family and social support, natural disasters and wars are some of the causes of this phenomenon called homelessness.

A causal connection was found between mental illness, income, and other labour market outcomes, is complex.

The symptoms of this illness may be aggravated by economic stress, such as involuntary unemployment. There is a direct correlation between homelessness and mental illness, and in turn, homelessness can lead to mental illness (Kumar P., 2014).

Several research has revealed that Australia, the United States and Germany have clear evidence that around 20-40% of homeless people suffer from mental disorders such as physical problems, psychiatric illness and intellectual disabilities. Other than that, the prevalence of depression, schizophrenia, posttraumatic stress disorder (PTSD), conversion disorder, mental retardation and panic disorders.

India has no such statistics on homeless people with mental illness, however, some small studies has revealed that the majority of the homeless population had at least one mental health condition (Hassan F., 20)

The dual perspective

Tripathi A., Das A., and Kumar S., 2021 talked about the duality, there exists a duality that shows the homeless population and mental illness act as risk factors for each other. It means, “Mental illness is a cause or effect of homelessness or homelessness due to a mental disorder, which has not been treated adequately”.

For example, a hospital-based study conducted in northern India found that around 84% of all homeless population in the sample were mentally ill before becoming homeless and half of them left home themselves because of the illness (Tripathi, A., et al, 2013).

“The apparent “disturbed” nature of the homeless population created an expectation that the public mental health system would assume responsibility for this vulnerable group”.

150 million people in India are estimated to live with mental health issues and only 17% get the care they need. There are various non-governmental organizations (NGOs) serving and supporting the vulnerable group of the population. The National Mental Health Policy, 2014 and Mental health Act, 2017 laid down an objective to increase access to mental health services for vulnerable groups, including the homeless (Gupta S., & Sagar R., 2021).   Mental health Act, 2017 Section 18 that the homeless, shall be entitled to mental health treatment and services free of any charge and at no financial cost at any government institution. In India, the Government of India's “Pradhan Mantri Awas Yojana” provide affordable housing for vulnerable population or people with disabilities and lower income and the “Swadhar Greh Scheme” provides accommodation; maintenance and rehabilitative services to women in distress. Still, the homeless mentally ill population have gained more attention from Non-Governmental Organizations.

The Banyan Approach

The Banyan a non-government organization founded on August 27, 1993, provides comprehensive mental health services to some states of Tamil Nadu, Kerala and Maharashtra. It provides safe spaces for homeless women, clinical and social care services, after-care services through home visits, and an open shelter for homeless men with mental illness and spreading awareness through educational courses. The Banyan has changed the lives of 5000 people, they have engaged 30-40 per cent of people in employment, and 3/4th of the homeless people with mental health condition/s got back to their families.

Conclusion

Nevertheless, there is still a large homeless population that needs an urgent need of care. The program could be expanded to PAN India, or government should collaborate to work with them for other states. Nevertheless, social stigma, financial obstacles, lack of knowledge about state entitlements, healthcare system barriers, the competing priorities of homeless persons themselves and lack of community care restrict their adequate access and availability to mental healthcare services (Singh, N., Koiri, P., & Shukla, S. K., 2018).