Do transitions in and out of homelessness relate to mental health episodes? A longitudinal analysis in an extremely disadvantaged population

This paper studies the association between homelessness and mental health episodes focusing on episodes of depression, anxiety and other conditions (bipolar affective disorder, schizophrenia, and post-traumatic stress disorder). Using panel data from the Australian Journeys Home survey, we investigate the extent to which this association is due to common determinants of homelessness and mental health episodes, or whether there is a causal link between them. The results indicate that episodes of depression increase the probability that a person becomes homeless. This is not the case for other mental health conditions. We find no evidence that becoming homeless causes a person to have a mental health episode. Instead, respondents are less likely to be diagnosed with depression in the 6 months after being precariously housed. Overall, our results indicate that, except for depression, the links between mental health episodes and homelessness are complex and are mostly unlikely to be causal. Using information on service usage, we find suggestive evidence that people use mental health services when they need to but that more coordination with housing services is required to protect them from becoming precariously housed.