Mental illness is an important factor to look at in homelessness because it can contribute to both becoming homeless and/or to the experience of homelessness itself. While it is important to note that not everyone experiencing homelessness has a serious mental illness, and not everyone with a serious mental illness will experience homelessness, mental illness does have a significant impact on homelessness. According to the Mental Health Commission of Canada 25-50% of Canada’s homeless population also report having mental illness(es) (1). Those experiencing both homelessness and mental illness remain homeless for longer periods of time than those without mental illness (2), and the homeless population in Canada has been observed to have increased levels of stress, lower self-esteem, higher rates of suicide and suicidal thoughts, etc, than their non-homeless counterparts (3). Additionally, Canadian studies and reports from Canadian homeless shelters report that those experiencing homelessness have higher rates of depression/mood disorders, schizophrenia, and personality disorders (3).
Why is it that Canada’s homeless population might experience mental health issues and/or mental illness(es) at such a high rate in comparison to the non-homeless population? Unfortunately there are multiple factors that could contribute to this. For one, some individuals' mental illness predates them becoming homeless. Mental illness can disrupt an individual’s executive functioning and can lead to other behavioural or cognitive problems that make it difficult to earn a steady income (4). Another reason mental illness is so high among the homeless population is because homelessness can be a traumatic and stressful situation and can lead to symptoms of mental illness(es) (ex. post-traumatic stress disorder) as well as substance abuse. People experiencing homelessness and mental illness may also demonstrate behaviours that distance themselves from friends and families and other avenues of support, which further alienates them and makes it even more difficult to get help (3).
So what should be done to help those who are mentally ill and homeless? Do we treat the mental illness first so that they can more easily help themselves, or do we house them first? Despite the stereotypes against the homeless population that may lead one to believe that giving them housing and resources will be ineffective longterm, a Toronto study conducted by the Centre for Addiction and Mental Health shows the opposite. The study aimed to uncover the efficacy of a “housing first” approach in helping adults struggling with both mental illness and homelessness. Adults in the program were provided two thirds of the rent for a one bedroom apartment, followed by support for mental health issues any of them were experiencing. What the study found was that those in the program had 42% greater housing stability than those using the usual services provided to the homeless, and it saw a drop in adults returning to the streets after receiving housing support from the program. According to the chief executive officer of Homes First in Toronto, Patricia Mueller, housing is the “key to mental health”(5). This idea is echoed by organizations like the Canadian Mental Health Association (2) and the Brain & Behaviour Research Foundation (3), both of which have found stable housing to be an effective intervention.
While there may be some time until a housing first approach is picked up across all of Canada, the concept is important to think about, especially in order to re-evaluate the negative perceptions society has for those experiencing homelessness and mental illness. Before judging someone through stereotypes and stigmas, remember that housing and adequate support is all people need sometimes, and these are things everyone is deserving of.
1. Aleman, A., (2016, May 4). Mental health and homelessness in Canada. Homeless Hub. https://www.homelesshub.ca/blog/mental-health-and-homelessness-canada
2. Canadian Mental Health Association. (n.d.). Homelessness. (https://cmha.ca/public-policy/subject/homelessness
3. Canadian Population Health Initiative of the Canadian Institute for Health Information. (n.d.). Mental health, mental illness, and homelessness in Canada.
4. Homelessness and mental illness: A challenge to our society. (2018, November 19). Brain & Behaviour Research Foundation. https://www.bbrfoundation.org/blog/homelessness-and-mental-illness-challenge-our-society
5. Favaro, A., & JOnes, A.M., (2019, October 7). For homeless people struggling with mental illness, housing can make a world of difference: Canadian study. CTV News. https://www.ctvnews.ca/health/for-homeless-people-struggling-with-mental-illness-housing-can-make-a-world-of-difference-canadian-study-1.4627905