Behavioral health challenges both contribute to and are exacerbated by homelessness. To better understand behavioral health and homelessness, we examined data from the California Statewide Study of People Experiencing Homelessness. Our latest report examines the relationship between homelessness, substance use, and mental health, providing critical insights for policymakers, program leaders, Continuum of Care leaders, and healthcare systems.
Key Findings
- Nearly half (48%) of people experiencing homelessness in California have complex behavioral health needs—regular drug use, heavy drinking, hallucinations, or recent psychiatric hospitalization.
- About one-third (35%) report regular drug use; 42% reported that they began to use regularly after the first time they experienced homelessness.
- Methamphetamine (32%) is the most common drug used, followed by opioids (11%) and cocaine (3%).
- More than one in four (28%) people with regular drug use or heavy alcohol use sought treatment during their current episode of homelessness but couldn’t access it.
We thank the California Health Care Foundation (CHCF) for supporting this work.

Resources
Related Resources
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Press Release
New UCSF BHHI Report Examines the Relationship Between Homelessness and Drug Use
March 19, 2025
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Press Release
New UCSF BHHI Report Examines the Relationship Between Homelessness and Drug Use
March 19, 2025
The University of California, San Francisco Benioff Homelessness and Housing Initiative (BHHI) today released a report that examines the issues of homelessness and behavioral health (substance use and mental health) and makes recommendations for policymakers and practitioners.
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Videos
Webinar: Behavioral Health & Homelessness: Findings from CASPEH
March 20, 2025
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Homelessness and behavioral health issues (mental health and substance use) are intertwined. The UCSF Benioff Homelessness & Housing Initiative held a webinar about this complex bidirectional relationship, along with solutions to this crisis. Margot Kushel, MD, Claudine Sipili, Darrell Steinberg, JD, and Stephanie Welch, MSW, discussed findings from the California Statewide Study of People Experiencing Homelessness (CASPEH), highlighted key policy recommendations, and answered audience questions. Marc Dones moderated the webinar.
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Reports
Toward a New Understanding: The California Statewide Study of People Experiencing Homelessness
June 20, 2023
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Conducted by the UCSF Benioff Homelessness and Housing Initiative, the California Statewide Study of People Experiencing Homelessness (CASPEH) is the largest representative study of homelessness in the United States since the mid-1990s. The study provides a comprehensive look at the causes and consequences of homelessness in California and recommends policy changes to shape programs in response.
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