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prevent people from forming and maintaining stable relationships or cause people to misinter- pret others guidance and react irrationally. This often results in pushing away caregivers family and friends who may be the force keeping that person from becoming homeless. As a result of these factors and the stresses of living with a mental disorder people with mental illnesses are much more likely to become homeless than the general population. People with schizophrenia or bipolar disorder are particularly vulnerable. Poor mental health also affects physical health especially for people who are homeless. Those with mental illness might not take normal precautions against disease. Combine that with inadequate hygiene and its easy to see how mental illness makes homeless people vulnerable to physical problems such as respiratory infec- tions skin diseases or exposure to tuberculosis or HIV. Its a vicious cycle spiraling out of control. NCH breaks it down Some mentally ill people self-medicate using street drugs which can lead not only to addictions but also to disease trans- mission from injection drug use. This combina- tion of mental illness substance abuse and poor physical health makes it very difficult for people to obtain employment and residential stability. One homeless woman Deborah Zelinsky spent more than 20 years homeless before being diagnosed with bipolar disorder. There are so many people out there who are mentally ill that need to be treated she says. On the streets you 10 WWW.AGRM.ORG MARCHAPRIL 2016 There are so many people out there who are mentally ill that need to be treated. On the streets you dont have time to get treated. You are trying to survive. Continued on page 14