Two of the biggest problems in first world countries go hand in hand; homelessness and mental illness, and a lot of people don’t understand how bad it is.
This issue impacts many people in a plethora of ways. But there are supports in places. Statistics Canada estimates that more than 10,000 people in Canada are homeless on any given night. There is a great diversity within the 10,000, varying in age, ethnicity, sex, mental health status, and use of health services.
This is especially a problem in regards to mental health. A 1997 Toronto study of 300 shelter users found that while two-thirds of respondents reported a lifetime diagnosis of mental illness, another study shows that 33% of a sample of Ottawa’s adult street population self-reported mental health difficulties; of these, 20% reported depression. Yet another survey suggests that 25% of people experiencing homelessness suffer from concurrent disorders such as severe mental illness and addictions.These show that people with serious mental illness are disproportionately affected by homelessness, and sadly, people with mental illnesses remain homeless for longer periods of time.How does mental health play a part in homelessness? Mental illness was the least reported reason for becoming homeless at 4%; loss of a job or insufficient income to pay rent was the main reason at 34%, however, 30-35% of those experiencing homelessness, and up to 75% of women experiencing homelessness, have mental illnesses.
But the lack of a diagnosed mental illness doesn’t mean that they have good mental health, as almost all homeless people have compromised mental health. These patterns of mental health are influenced by a number of factors, including personal coping skills; perceived self-worth; one’s social environment; physical, cultural and socio-economic characteristics. Its found that 29% of shelter users met criteria for antisocial personality disorder by Toronto’s Pathways into Homelessness Project. These may cause delusional thinking that may lead them to withdraw from friends, family and other people, leaving fewer and fewer coping resources. The ability to be resilient and resourceful may be impaired by compromised mental health and it can cloud thinking and impede judgment. This exacerbates the problem leaving those suffering more susceptible to three main factors that can lead to homelessness: poverty, disaffiliation, and personal vulnerability.
Homelessness, in turn, amplifies poor mental health continuing the cycle. The stress of experiencing homelessness may worsen previous mental illness and thus encourage anxiety, depression, fear, sleeplessness and substance use and abuse. So no matter whether mental illness or homelessness comes first the other can follow. For those who are experiencing homelessness there are two main types of support for this issue that is being used; these are Housing First programs and Treatment First programs. Research shows maintaining and improving the housing of those with mental illness contributes to a reduction in psychiatric symptoms which in turn decreases the need for treatment and emergency services. Research on these programs seems to be showing that Housing First seems to work better than Treatment First. A study from New York City found that after a five-year period 88% of participants in the Housing First programs remained housed compared to 47% of participants in Treatment First.
Those who were enrolled in Housing First programs also spent more time in stable housing and less time in hospitals than those in Treatment First programs. Housing First does not usually require participants to meet certain behavioural or treatment expectations. Housing First is of the philosophy that housing is a human right. With support from these programs people can generate positive outcomes, including enhanced life skills, improved health status, an increased sense of empowerment and involvement in the community. Although there are programs like these there are also some barriers that can hinder homeless people trying to getting help.
These barriers are things like the administrative processes, timeline constraints, and a lack of ID or personal address. There is a push to cut those down as much as possible so more people can access help needed. Therefore it is essential to create a non-threatening and supportive atmosphere that provides basic needs like food and shelter that is accessible for everyone.