Role of Social Disadvantage in Crime, Joblessness, and Homelessness Among Persons With Serious Mental Illness

TLDR

Research on mental illness and social problems such as crime, unemployment, and homelessness frequently neglects the broader social context, including poverty-related factors like lack of education, employment difficulties, substance abuse, and weak prosocial attachments, which complicates simple explanations. The study aims to show that incorporating the broader social context into policy, research, and practice will improve the effectiveness of interventions for persons with serious mental illness. The authors critically analyze and compare conventional psychiatric services literature with studies that validly account for social context to infer links between mental illness and social problems. The broader perspective shows that the impact of serious mental illness on crime, unemployment, and homelessness is much smaller than previously thought, and that poverty moderates this relationship.

Abstract

Research on mental illness in relation to social problems such as crime, unemployment, and homelessness often ignores the broader social context in which mental illness is embedded. Policy, research, and practice will be improved if greater attention is given to social context. The authors critically analyze the approach used in much of the psychiatric services literature to infer links between mental illness and social problems. They compare these studies with studies that have been more validly conceptualized to account for social context. With this broader perspective, the impact of mental illness on crime, unemployment, and homelessness appears to be much smaller than that implied by much of the psychiatric services literature. Poverty moderates the relationship between serious mental illness and social problems. Factors related to poverty include lack of education, problems with employment, substance abuse, and a low likelihood of prosocial attachments. This relationship is often complicated and is not amenable to simple explanations. Research and policy that take this complexity into account may lead to greater effectiveness in interventions for persons with serious mental illness.