Mental homelessness: Locked within, locked without

The concept of Mental Homelessness is presented and developed. This paper will provide a historical review of the connection between mental illness and housing and the changing approaches toward institutionalization and de-institutionalization over several centuries. Case illustrations from practice in Israel will be presented to highlight the theme of home, or rather the theme of lacking a home as an element which may be inherent to a mental illness. More specifically, the paper argues that homelessness is a state of mind of which the actual, physical homelessness may be a manifested reflection of. If so, even if a mental patient does initially own a home, he or she is at high risk to lose it somehow. This work is a primary attempt at developing a new idea, stemming originally from the field of mental health, with an attempt to widen its theoretical scope to populations not usually defined as mentally ill. Clinical characteristics are presented, as well as an attempt at a theoretical formulation of this concept permitting the development of therapeutic implications. These are presented in relation to existing psychodynamic concepts and therapeutic approaches related to the phenomenon of homelessness.