By Howard Dichter, M.D., and Rajesh Mehta, M.D.

Mr. T is in his late 20s and is grappling with schizophrenia as well as abusing methamphetamine. He suffers from paranoid delusions that his family is seeking to control and harm him. He occasionally exhibits violent behavior towards his mother.

Mr. T’s mother immigrated legally from China when Mr. T was 6 years old. Recognizing her child’s emotional difficulties, she felt a cultural obligation to care for him within the home. She also faced language barriers that created additional challenges in accessing social resources for her son.

Because Mr. T was unable to work or support himself, the family allocated the garage to Mr. T, which provided him with some independence. However, he still had to use his mother’s bathroom and kitchen, forcing regular, close proximity between mother and son.

Unfortunately, unstable housing arrangements like these can often deteriorate, resulting in the family member with a serious mental illness (SMI) being unhoused.

Contrary to common assumptions, single, unhoused adults often do have family members. Unfortunately, relationships with families are often fraught with difficulties, especially when the unhoused individual has an SMI. In such situations, usually, all family members suffer.

It is extremely challenging to maintain family connections when one member of the family is an unhoused individual with an SMI. When this problem was studied in one community treatment center, 73% of those unhoused single individuals who were being treated for an SMI had significant contact with their families.

In light of the findings, it is important to recognize that unhoused individuals can have families in their lives. Understanding the dynamics and difficulties faced by families dealing with a mentally ill, chronically unhoused individual will facilitate developing strategies to........

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