When homelessness became increasingly visible in the early 1980s, most Americans were reluctant to admit that the homeless people they encountered were chronically disabled by alcoholism, drug addiction, and mental illness. The media, policymakers, and the American public, persuaded by advocates for the homeless, came to believe that the homeless were simply victims of the hardships of poverty and the lack of affordable housing, both of which were exacerbated by economic recession and unresponsive government. Policies were created in the belief that emergency shelters, soup kitchens, job training, and transitional housing would help the homeless regain their independence.

A Nation in Denial challenges these accepted notions. It presents a comprehensive and readable review of the scientific evidence that up to 85 percent of all homeless adults suffer the ravages of substance abuse and mental illness, resulting in serious social isolation. The authors provide new insights into the causes of increased homelessness in the early 1980s, linking the population explosion of the baby boom to increases in the numbers of Americans at risk for substance abuse problems, mental illness, and homelessness; assessing the relationship between the inner-city drug epidemic and increases in family homelessness; and reviewing the failed policies of deinstitutionalization, decriminalization of alcoholism, and the gentrification of skid row neighborhoods and substance abuse treatment centers.

Combining solid demographic and epidemiological research with personal accounts of homeless individuals, this unique study not only provides a new understanding of homelessness and prompts a serious reexamination of current policies but also proposes more honest and effective ways for helping America's most disabled and destitute citizens.