The X-Podcast: Real Conversations About Mental Health
A Conversation About: Unhoused Women and Mental Health
January 15, 2026
The X-Podcast: Real Conversations About Mental Health
A Conversation About: Unhoused Women and Mental Health
Episode #61: Unhoused Women and Mental Health
In this episode, The X-Team discusses some issues related to unhoused women and mental health. The team explains why they use the term “unhoused” instead of the term “homeless”. Xiomara talks about her passion project in the community, providing free mental health services to the unhoused community members in her community through her nonprofit organization, and encourages other healers and helpers to create their own passion project to provide these much-needed services in their communities. After the lively and impactful conversation, they provide ways that everyone can give support to this population, even in small ways.
The term unhoused vs. homeless
While both "unhoused" and "homeless" are used to describe people without stable housing, "unhoused" is increasingly preferred as a more respectful and person-first alternative to "homeless." "Unhoused" emphasizes the lack of housing as a temporary condition, rather than defining a person by their lack of housing.
- "Homeless" has been the more common term for a long time, but it can carry negative connotations and may be seen as dehumanizing by some.
- "Unhoused” is gaining traction as a way to focus on the lack of housing as a circumstance, rather than a defining characteristic of a person.
- "Houseless" is another alternative term that highlights the absence of a house or dwelling, and is preferred by some organizations and individuals who work with people experiencing homelessness.
- "People experiencing homelessness" is another phrase gaining popularity, as it emphasizes the temporary nature of the situation and avoids defining individuals solely by their lack of housing.
Ultimately, the best term to use may depend on context and personal preference. However, "unhoused" or "people experiencing homelessness" are often seen as more respectful and inclusive alternatives to "homeless," according to multiple news and advocacy organizations.
The X-Community Service Project
Summerville Women’s Mental Health Services (SWMHS) launched The X-Community Service Project, which provides Summerville's unhoused women’s shelter guests and past guests with pro bono mental health services.
This community service project provides professional mental health services at no cost to the shelter’s past and current guests.
This is in partnership with Keys to Change - The Light House - Women’s Shelter, formerly Dorchester County Community Outreach- DCCO - Centers for the Unhoused.
The Light House is a women’s shelter that is a haven for women in need. It provides a sanctuary to cater to the diverse needs of unhoused women facing various challenges.
The community service project partnership launched in May 2025.
Individual Counseling
We provide mental health counseling for issues such as stress, anxiety, depression, navigating difficult relationships, life transitions, and other challenges, to support individuals in increasing coping skills and managing symptoms.
Individual counseling sessions require an initial intake and evaluation session by the SWMHS center. This intake and evaluation session is free, and all follow-up counseling sessions are also free.
This counseling program is open to all current and past guests of The Light House.
They are offered in person and by telehealth by appointment and drop-in options.
A one-on-one session with a mental health counselor in person or via telehealth.
Offers immediate, short-term assistance, typically including:
- Emotional support
- Self-care planning
- Referral support
- Eligibility screenings for individual counseling
This program is not designed for crisis intervention or therapy.
The leadership of both organizations, Xiomara A. Sosa and Ginny Vicini, is excited about this partnership, which will provide much-needed professional mental health services to these women in our community.
Both organizations stand together in the fight against homelessness and the vital importance of access to professional mental health services for disenfranchised and marginalized women in our community.
Both organizations believe that all people deserve the necessities of life, and as part of the community we live in, we serve this purpose.
Both organizations are community-focused and run.
They believe that volunteers play a vital role in delivering health and hope across all aspects of their organizations.
They are dedicated to fostering a culturally sensitive environment that embodies compassion toward our community.
Unhoused women
Unhoused women in the United States experience significantly higher rates of mental health problems compared to their housed counterparts and the general population.
Women also face sexual assault, physical, and domestic violence as unhoused people, and they are often forced to take up prostitution, or they end up trading themselves.
Increased mental health problems
Studies consistently show that unhoused/homeless women are more likely to experience mental health disorders like depression, anxiety, post-traumatic stress disorder, and substance use disorders compared to women who are not homeless. More serious diagnoses, such as schizophrenia, are often exacerbated by the challenges of homelessness itself, including trauma and lack of stable housing. (Bassuk et al., 1998; Folsom et al., 2005; Robertson & Winkleby, 1996).
Prevalence and severity
The lifetime prevalence of mental health disorders among people experiencing homelessness is high (77%). While there's debate on the precise percentage of homeless individuals with serious mental illness (SMI), studies suggest a substantial portion, with rates higher for unsheltered individuals.
Trauma and abuse
A significant number of unsheltered women report experiences of trauma or abuse, which can be a contributing factor to their homelessness and mental health issues.
Substance use
Substance use disorders often co-occur with mental health conditions among homeless women, and can both be a cause and a result of homelessness.
Intersectionality
The experiences of homeless women are complex and shaped by factors like race, ethnicity, gender, and other marginalized identities.
Barriers to care
Homeless women often face barriers to accessing mental health services, including a lack of transportation, insurance, and trust in the system.
Unhoused women experience disproportionately high rates of mental health issues compared to the general population. This is linked to factors like trauma, violence, substance abuse, and the lack of access to adequate housing and resources. Additionally, the stress of homelessness can exacerbate existing mental health conditions or even trigger new ones.
Factors contributing to poor mental health among unhoused women
Trauma and violence
Experiences of domestic violence, physical and sexual abuse, and other forms of trauma are prevalent among this population, leading to high rates of PTSD and depression.
Substance abuse can be both a cause and a consequence of homelessness and mental health issues.
Lack of access to resources
Limited access to affordable housing, healthcare, mental health services, and other essential supports can exacerbate mental health challenges.
Social isolation
The isolation and lack of social support often experienced by unhoused women can further contribute to mental health problems.
Lack of culturally-sensitive, trauma-informed, and anti-oppressive mental health services can create additional barriers to accessing care.
Child welfare Involvement
Fear of child apprehension by mothers who are homeless can deter women from seeking support and services, further contributing to mental health challenges.
Gender-specific needs
Women experiencing homelessness may face unique challenges related to their gender, such as domestic violence, reproductive health concerns, and the impact of motherhood.
Increased risk of substance abuse and addiction.
- Difficulty accessing and maintaining stable housing.
- Reduced ability to engage in employment and seek social support.
- Higher rates of chronic physical illnesses.
- Increased risk of suicide.
Addressing mental health needs
Housing first
This approach provides individuals with stable housing and access to supportive services, which can significantly improve mental health outcomes.
Mental health services
Access to culturally-sensitive, trauma-informed, and anti-oppressive mental health services is crucial.
Supportive services
Providing access to food, showers, laundry, and other basic needs can improve overall well-being.
Prevention and early intervention
Addressing mental health concerns early on can prevent the development of more severe problems.
Advocacy and awareness
Raising awareness about the unique challenges faced by unhoused women and advocating for policies that address their needs is essential.
The stress and trauma of homelessness make it a known risk factor for creating the conditions for mental illness and substance abuse disorders, and people who experience chronic homelessness have a far higher risk of mental illness, disability, or substance abuse disorder.
The demographic profile of homelessness in the United States has shifted dramatically in recent decades (Baker, 1994; Rossi, 1990), with women and racial/ethnic minorities comprising an increasing proportion of individuals without stable housing. Limited research has explored women’s experiences of homelessness, and even less has focused on racial/ethnic differences in the correlates and health consequences of homelessness among women (North & Smith, 1994).
The social correlates of mental health outcomes in the general population have been thoroughly explored, with a report to the U.S. Surgeon General on the mental health of Americans finding that racial/ethnic minorities in the United States experience serious mental health disorders at rates similar to White Americans (U.S. Department of Health and Human Services, 2001).
The interrelationship between race/ethnicity, socioeconomic status, and mental distress has received particular research attention, though findings are far from consistent (Takeuchi & Williams, 2003). Some studies find that race-based differences in perceived mental distress are explained by socioeconomic status, while others find persistent racial differences in distress even after controlling for socioeconomic status (George & Lynch, 2003; Lincoln et al., 2003).
Regardless of racial/ethnic background, however, evidence suggests that individuals in impoverished neighborhoods tend to experience heightened depression and anxiety as a consequence of their surroundings (Hill et al., 2005).
Because the homeless population is transient by definition, many studies of homeless populations are based on small convenience samples. Studies often sample individuals who have been identified by social service agencies or the courts as needing care for mental health or substance abuse problems, potentially overestimating the prevalence of mental distress in this population.
Studies show
Many predisposing characteristics vary by race/ethnicity.
White women had been homeless longer on average and experienced more lifetime episodes of homelessness, while African American women were older on average when they first became homeless.
Hispanics were much more likely to have stayed at a shelter or institution and less likely to have spent time on the streets over the past 30 days. White women had less access to showers/baths over the past 30 days.
African American women were the oldest on average, while almost half of the Hispanics were under age 30. Hispanics had the lowest average educational attainment, significantly lower than both African Americans and Whites. Few of the women had worked in the past month, regardless of ethnicity.
While approximately half of the African American and White women had spent time in jail or prison, a significantly smaller percentage of Hispanics had done so. African American women reported more close friends or relatives in the Los Angeles area compared to White women, though there were no ethnic differences in the reported frequency of social contact. There were marked differences in women’s experiences of physical and sexual assault, with nearly twice as many White women reporting childhood or recent assault. Substance use also varied by ethnicity, with Hispanics being much less likely to report alcohol or drug abuse; Hispanics were also less likely to have been hospitalized for psychiatric care.
A majority of Hispanic women (62%) were currently caring for children, while only 33% of White women and 42% of African American women were doing so. Hispanic women reported a significantly lower number of competing needs over the past 30 days compared to African Americans and Whites.
A variety of other predisposing variables were associated with mental distress, and these factors varied considerably by race/ethnicity. Being partnered or married was significantly associated with greater mental distress among both African American and White women.
The history of incarceration was significantly associated with lower levels of mental distress among African Americans (and was marginally significant for Whites). Recent physical assault resulted in higher levels of mental distress for African Americans, while recent sexual assault resulted in higher levels of mental distress for Whites.
Childhood physical assault was predictive of mental distress among Hispanics, even once enabling characteristics were considered, and recent physical assault became a significant predictor of mental distress among Whites once enabling characteristics were controlled. Only among Whites was psychiatric hospitalization significantly associated with greater mental distress.
None of the enabling characteristics were associated with mental distress among Whites, though the challenge of dealing with competing needs (e.g., for food, shelter) was associated with increased mental distress among both African Americans and Hispanics. For Hispanics, being on a general health relief program was associated with lower mental distress, while having a regular source of care was associated with greater mental distress.
Overall, the proportion of explained variance resulting from the inclusion of all predisposing and enabling factors – both traditional predictors and those specific to vulnerable populations – was moderate and varied by ethnicity, with just under a quarter of the variance in mental distress explained by the Behavioral Model for Vulnerable Populations among African Americans and Hispanics and nearly 35 percent of variance in mental distress explained for Whites.
In considering the impact of homelessness on mental distress, a key distinction is whether individuals are currently solitary or whether they are partnered and/or caring for children (Buckner et al., 1993; Smith & North, 1994).
Additional analyses were conducted to explore whether this aspect of the homeless experience resulted in different degrees of mental distress across ethnic categories; specifically, we tested whether the correlates of mental distress varied for women in current partnerships versus single women and for women who were currently caring for children versus those who were not by further stratifying the full models by partnership and parenting status (results not shown).
While the predisposing and enabling factors that comprise the Behavioral Model for Vulnerable Populations do not appear to operate differently for partnered and single women, the experience of caring for children while homeless had a clear impact on mental distress. Distress scores were higher among non-mothers within each ethnic group, though only among Hispanic women was there a significant difference in mental distress scores between women currently caring for children (mean = 33.74, SD = 21.59) and those who were not (mean = 41.68, SD = 25.82).
Being currently partnered was associated with higher distress scores only among African American women without children; among African American mothers, being partnered had no relationship to distress, pointing to the buffering effect that caring for children may have for African American women.
Among White women caring for children, having close relatives in the area reduced mental distress, while there was no association between the number of close relatives and distress for White non-mothers. Having a regular source of medical care dramatically reduced mental distress among White non-mothers but not among White mothers.
For Hispanic women without children, more frequent social contact was associated with reduced distress. However, Hispanic mothers living on the street were predicted to have dramatically higher mental distress scores, while living on the street was not significantly associated with distress for Hispanic women without children. Working was also correlated with distress for Hispanic mothers but not for non-Hispanic mothers, suggesting that Hispanic women may be particularly susceptible to stress resulting from the difficulties associated with raising children without the benefit of stable housing.
#TheXPodcast #MentalHealth #Counseling #Therapy #Unhoused #Women #UnhousedWomen #Unsheltered #UnshelteredWomen #Homeless #HomelessWomen
Listen to this episode here
Listen to all episodes at https://blubrry.com/studio_talk_mental_health/
Donate https://www.studiotalkpodcast.net/donate
The X-Podcast on social media
YouTube https://www.youtube.com/@thexpodcastmentalhealth
Website https://www.studiotalkpodcast.net/
Substack: https://substack.com/@counselorxiomaraasosa
Bluesky https://bsky.app/profile/counselorxasosa.bsky.social
Facebook https://www.facebook.com/profile.php?id=61563518781923
Instagram https://www.instagram.com/counselorxiomaraasosa/
Resources
https://www.thex-studio.org/resources
https://www.swmhs.net/the-x-community-service-project
If you are experiencing a mental health emergency, please call 911, go to your nearest emergency room, or contact one of the crisis hotlines listed below:
988 Suicide & Crisis Lifeline: Call or text 988 or chat 988lifeline.org, available 24/7.
Region Ten Emergency Services: 434.972.1800, available 24/7
References
https://endhomelessness.org/overview/
Visit Podcast Website
RSS Podcast Feed
Subscribe
Share
Add to MyCast