The older adult population is rapidly growing in the United States and across the globe. The Institute of Medicine estimates that the number of older adults with mental health or substance use disorders will reach 10.1 million to 14.4 million people by 2030. A particularly vulnerable subgroup within this aging population is the subset experiencing homelessness. According to a 2017 report by the U.S. Department of Housing and Urban Development, homeless adults >50 years old increased from 22.9% to 33.8% between 2007-2017. Moreover, the number of people >62 years old living in shelters or transitional housing increased during the same time period to 76,000, a growth of 69%. This challenge is likely to worsen in the next decade as adults >65 years old experiencing homelessness is expected to triple between 2017-2030. Amongst the general population of adults experiencing homelessness, there is a higher prevalence of mental health and substance use disorders compared to the general population. Mental health care of older homeless adults can be negatively affected by systemic issues associated with homelessness. Such factors include victimization while being homeless, involvement in the criminal justice system, medication nonadherence, and complex case management issues. Homeless individuals, especially women, with mental illnesses experience higher levels of victimization compared to their housed counterparts. A systematic review found that the on-year prevalence of criminal victimization among adults with major mental disorders was up 35% for violent victimization and 28% for nonviolent victimization. Additionally, the lifetime victimization rate ranged between 74% and 87%. Data also show that 63% to 90% of homeless individuals with severe mental illness have been arrested at least once, 28% to 80% have been convicted of a crime, and 48% to 67% have been incarcerated. These issues may affect rapport building by the treatment team and disposition planning. Furthermore, not attending an outpatient mental health appointment after a psychiatric hospitalization is associated with an increased risk for rehospitalization. A 2007 study determined that patients who attended a follow-up appointment had a 1 in 10 chance of being rehospitalized, whereas patients who did not attend (or were not offered) an appointment had a 1 in 4 chance of rehospitalization. At San Francisco General Hospital, a chart review during a 4-week period between February and April 2020 revealed that 83% of unhoused patients did not show up for their outpatient mental health appointment following discharge from a psychiatric unit. Proposed solutions to help older adults who first experience homelessness late in life include developing more affordable housing, boosting rental assistance (Housing Choice Vouchers), increasing wages, Supplemental Security Income, Social Security Disability Insurance, and state supplemental income. Another proposal is Permanent Supportive Housing (PSH), a program that provides housing paired with supportive services such as case-management, individual and group therapy, and peer support. Veteran-specific PSH has been used to reduce homelessness in chronically homeless veterans (United States Interagency Council on Homelessness, 2018). PSH is also less restrictive and less expensive than nursing home placement of chronically homeless individuals. The At Home/Chez Soi randomized controlled trial from Canada, showed that rent supplements and mental health support services improved housing stability for homeless adults with mental illness.