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Many times mental problems are at the core of why someone is homeless, particularly long term homeless. They can't keep it together long enough to work within the usual framework of job, pay bills, get along with people -- and for the same reasons can't stick with medical/psychological routines required to get better, like taking the correct medicines, going to therapy etc. They do self-medicate tho, just with the wrong stuff, like alcohol and various street drugs.

For the same reasons they won't and can't stay in the homeless shelters or the housing solutions that every big city Dem government wants to build -- they won't/can't obey the rules and get thrown out or they leave on their own because of the stress of the minimal conformity required. But because you cannot forcibly require someone to accept mental health treatment until they do something really seriously illegal, they just kind of float around in limbo, cycling through jail periodically for relatively minor league stuff, until they die or they do something so bad they go to prison for years.