{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:09:35Z","timestamp":1791518975206,"version":"4.3.4"},"reference-count":20,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T00:00:00Z","timestamp":1664064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Health Care for the Homeless Council"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The United States is experiencing a syndemic of homelessness, substance use disorder, and mental health conditions, which has been further exacerbated by the COVID-19 pandemic. Although it is expected that mitigation strategies will curb community transmission of COVID-19, the unintended consequences of social isolation on mental health and substance use are a growing public health concern. Awareness of changing mental health and substance use treatment needs due to the pandemic is critical to understanding what additional services and support are needed during and post-pandemic, particularly among people experiencing homelessness who have pre-existing serious mental illness or substance use disorder. To evaluate these effects and support our understanding of mental health and substance use outcomes of the COVID-19 pandemic, we conducted a qualitative study where behavioral health providers serving people experiencing homelessness described the impact of COVID-19 among their clients throughout the United States. Behavioral health providers shared that experiencing social isolation worsened mental health conditions and caused some people to return to substance use and fatally overdose. However, some changes initiated during the pandemic resulted in positive outcomes, such as increased client willingness to discuss mental health topics. Our findings provide additional evidence that the social isolation experienced during the pandemic has been detrimental to mental health and substance use outcomes, especially for people experiencing homelessness.<\/jats:p>","DOI":"10.3390\/ijerph191912120","type":"journal-article","created":{"date-parts":[[2022,9,25]],"date-time":"2022-09-25T23:13:27Z","timestamp":1664147607000},"page":"12120","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Impact of Social Isolation during the COVID-19 Pandemic on Mental Health, Substance Use, and Homelessness: Qualitative Interviews with Behavioral Health Providers"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2936-8899","authenticated-orcid":false,"given":"Alexiss","family":"Jeffers","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1406-0886","authenticated-orcid":false,"given":"Ashley A.","family":"Meehan","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Barker","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"},{"name":"Oak Ridge Institute for Science and Education (ORISE) Fellow, Oak Ridge Associated Universities, 100 Orau Way, Oak Ridge, TN 37830, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Asher","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha P.","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Bautista","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen M.","family":"Ray","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca L.","family":"Laws","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria L.","family":"Fields","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Cha","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleta","family":"Christensen","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1637-9663","authenticated-orcid":false,"given":"Brandi","family":"Dupervil","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3112-018X","authenticated-orcid":false,"given":"Jorge V.","family":"Verlenden","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia H.","family":"Cassell","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention COVID-19 Emergency Response, 1600 Clifton Rd., Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaina","family":"Boyer","sequence":"additional","affiliation":[{"name":"National Healthcare for the Homeless Council, 604 Gallatin Ave, Nashville, TN 37206, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"DiPietro","sequence":"additional","affiliation":[{"name":"National Healthcare for the Homeless Council, 604 Gallatin Ave, Nashville, TN 37206, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Cary","sequence":"additional","affiliation":[{"name":"Oregon Health Authority, 500 Summer Street NE, Salem, OR 97301, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Yang","sequence":"additional","affiliation":[{"name":"Downtown Emergency Service Center, 515 3rd Ave, Seattle, WA 98114, 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