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St. Louis Study Captures the Changing Face of Homelessness

New research is measuring significant changes in America's homeless population, now estimated at between 700,000 and two million people. During the Great Depression of the 1930s, many of the homeless were victims of bad luck and an even worse economy. But, after an investigation of the homeless in the midwestern city of St. Louis, Missouri, researchers at Washington University say the problem has become more complex.

The new study notes that most homeless people used to be men. Those men also tended to be white and abuse alcohol. But the research uncovered an increasing diversity during the 1980s, including more members of minority groups joining the homeless population.

"The other thing that changed in the 1980s and thereafter is that there were more women and children joining the ranks," says Washington University psychiatry researcher Carol North. She and social work researcher David Pollio have taken a demographic snapshot of the homeless of St. Louis - first at the start of the 1980s, again at the start of the 1990s, and most recently at the beginning of the 21st century.

Carol North says it has been a persistent myth that the majority of homeless people are seriously mentally ill and ended up in the streets when mental patients were deinstitutionalized during the 1980s. Ms. North says that some homeless people are psychotic or suffer from schizophrenia or bipolar disorder…but not nearly as many as is commonly believed. "The rates of schizophrenia were not anywhere near 100%," she says. "They were more like on the order of 5 to 10%, which is overrepresented in that population The rates of schizophrenia in the general population are 1 to 2%…that's one out of every 50 or 100 people."

So how many of the homeless are mentally ill? Carol North says the answer depends on how you define psychiatric illness. If alcohol and drug abuse are included, then, she says, most are psychiatrically ill. "The drug of choice is clearly cocaine," she says, "but not just any form of cocaine, but almost unanimously crack cocaine."

Carol North says it is just as much of an oversimplification to say that all homeless people use crack as it is incorrect to say that most homeless people are psychotic. According to the new report, there are many reasons why people become homeless, and it is difficult to identify a typical homeless person.

"Homeless is disproportionately a condition that befalls ethnic minority groups," says the Washington University researcher. "Caucasian subgroups have higher proportions of people with mental illness. So, there are many different groups that appear quite different. But if you were just to take our dataset and average everything out, the average person who is homeless is in their 30s, has been homeless for maybe a year on average and has a much better-than-even chance of having some kind of substance abuse problem."

Ms. North says the prevalence of substance abuse among the homeless means that it is probably not a good idea to give cash to a homeless person. She prefers donating money to organizations that provide assistance to the homeless. That way, she says, the chances are higher that the money will be used to assist the homeless rather than spent in ways that could worsen the problems of a particular homeless person.