Homelessness and Mental Health: Why Understanding Executive Function is Important

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Mental health and homelessness


Mental healthcare can be extremely difficult to access and maintain for people with unstable housing. There are many barriers such as cost, transportation, and lack of resources. While 25-30% of homeless individuals have severe mental illness, there is another population that is often overlooked, those with executive dysfunction.


What is executive function?

According to the Cleveland Clinic, executive function is made up of 3 parts: working memory, cognitive flexibility, and inhibition control. Working memory is your ability to retain and process information. Cognitive flexibility is the ability to adapt to change and multi-task. Inhibition control is the ability to control and maintain your thoughts, emotions, and focus. With executive dysfunction, any, or all, of these parts may not work properly. 
Photo from Authentically Emily


Ellie Atkins, a manager and safeguarding lead for a social work team in Manchester, noticed many people she was working with had hidden disabilities and differences that impacted their executive functioning. Executive dysfunction isn’t limited to one condition and can be caused by complex post-traumatic stress disorder (C-PTSD), acquired brain injury, fetal alcohol syndrome, ADHD, and autism. 

Executive function in the homeless population 


Homelessness is an inherently traumatic experience. Many of the conditions that cause executive dysfunction are often overlooked in marginalized communities, sometimes  leading to a misdiagnosis or simply just remaining undiagnosed. These people aren’t having their needs met. 


Atkins says, “Executive functioning can be stabilized and optimized when we meet the non-negotiable human need to feel safe: safe in body, safe in where we live, safe in who is around us and safe in the way that people work with us.” 


Instead of blaming or questioning those who are housing-insecure of creating their situation, we need to lead with empathy. 


Click here to learn more about executive function.

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