Research Matters Blog
As part of the Canadian Mental Health Association 65th Mental Health Week running from May 2nd-8th, this blog covers some of the latest findings about the connection between mental health and homelessness. The theme for this year’s Mental Health Week is “GET LOUD”, encouraging people to speak up against mental illness discrimination and stigma, reflect on the advances in mental health, and share stories to promote public awareness, mobilization and action.
The relationship between mental health and homelessness is well documented. Considerable studies show that people experiencing homelessness are more susceptible to poorer mental health than the general population. The stressful environmental conditions and the difficult situations that homeless people experience daily can trigger mental illnesses or aggravate existing conditions. However, for some, compromised mental health can also precede the onset of homelessness. It is important to note that not all homeless people have a mental illness or concurrent disorders, and not all people who experience mental health issues are homeless or ever at-risk of homelessness.
The connections between mental health and homelessness are complex and further research into the subject is critical. Research provides information on the types of resources, programs, services and public education campaigns needed for policy development. With this in mind, below are some of the known statistics supporting the links between mental health and homelessness and some proposed recommendations for national policy to address some of the systemic problems.
- The Mental Health Commission of Canada reported between 25-50% of the homeless population in Canada suffer from a mental illness(es). More critically, the National Learning Community on Youth Homelessness found that well over 50% of the 1054 youth experiencing homelessness in their 2014 National Needs Assessment reported a mental health issue of some kind.
- The 2007 report by the City of Victoria Mayor’s Task Force reported that out of 162 homeless individuals with a substance or mental health condition recorded, 75% had disorders due to psychoactive substance use, 23% had personality disorders, 23% had schizophrenia, 22% had mood disorders and 9% had neurotic/stress related disorders.
- The Canadian Institute for Health Information suggested that mental health and behavioral disorders are the top reasons for people experiencing homelessness to end up in Emergency Departments or inpatient hospitalization.
- In 2005, Canada Mortgage and Housing Corporation estimated that 27% or 140,000 people with mental illness live in inadequate housing increasing their risk of homelessness due to employment and educational barriers along with the lack of personal and professional support systems in place.
- According to leading researcher on transitions from psychiatric wards into homelessness, Cheryl Forchuk found that in London, Ontario, 10.5% of individuals were discharged into homelessness from psychiatric wards in a single year.
These figures provide just a quick overview of the links between homelessness and mental health. Further research is required to better understand the needs of diverse people such as population specific studies that focus on the intersecting social identities of women, men, youth, newcomers, racialized people, those who identify as LGBTQ2S, people with disabilities, Indigenous Peoples, and those living in urban or rural settings.
Most importantly, Cheryl Forchuk emphasizes the need of the health, housing, and homelessness sectors to connect with each other to support homeless individuals with mental illness. This is an essential step in uncovering the system gaps while addressing the systemic issues, rather than solely focusing on individual-based problems and solutions. Below are a few federal policy recommendations commonly discussed among stakeholders:
Federal Policy Recommendations:
1. National Mental Health Supportive Housing Strategy
The creation of a National Mental Health Supportive Housing Strategy in partnership with The Mental Health Commission of Canada, provinces/territories, the federal government, First Nations, municipalities and service providers to ensure optimal health outcomes for people experiencing homelessness and mental health issues.
2. National Youth Homeless Strategy
The need for a national youth homelessness strategy to support youth-focused programs and services via a $16.5 million proposed annual financial investment through the Government of Canada’s Homelessness Partnering Strategy that would include mental health and addictions supports.
3. Housing First
Investments in Housing First approaches have demonstrated to reduce costs of serving individuals with mental health conditions. Housing First in Canada: Supporting Communities to End Homelessness explores Housing First as an effective and realistic response in serving the homeless population including those with acute and chronic mental health needs.
By “getting loud”, mental health and homelessness advocates are increasing public awareness on the links between mental health and homelessness. However, more work is required and this year’s Mental Health Week “GET LOUD” is one step towards the collective efforts required to best serve people experiencing homelessness and mental health.
To join the conversation on social media, use the hashtags #GETLOUD and #MHW2016. You can also follow the Canadian Mental Health Association on Twitter (@CMHA_NTL) or visit their website (www.mentalhealthweek.cmha.ca) for updates and further information on the campaign.
Photo credit: Canadian Mental Health Association
Crossing Canada for a charitable cause is as much a part of our Canadian culture as hockey and maple syrup. So why not do it to raise awareness for homelessness?
That was the question Dr. Sean Richardson and I pondered four years ago. How could we raise awareness and support a national conversation on what is needed to prevent, reduce and end youth homelessness?
I had just returned from a corporate social responsibility event in Montreal, where I shared my personal experience with youth homelessness. During the event we led a team of 350 leaders through immersion exercise, where they experienced different aspects of homelessness. The impact was incredible and I left that event asking how we could leverage that shared experience, across Canada.
Youth homelessness is an issue that hits close for me. In 1989 I was a homeless person pushing a shopping cart around Vancouver’s downtown East Side. I was addicted to drugs and lived under a bridge. For years I struggled and could not seem to break the cycle of addiction, poverty and homelessness by myself. Fortunately for me I had supports, I had a mother and a police officer that assisted my transition off the streets. I subsequently went on to graduate college and became a successful entrepreneur.
When I look back at my story I am most grateful I had those supports: my mother, access to treatment and access to education that lead to fulltime employment. In my case, the system to exit homelessness worked. It wasn’t until much later in my life when I began to dig deeper and ask questions about what didn’t work. Where were the systemic breakdowns that could have prevented my street involvement? Here I discovered big gaps, gaps that, if filled, could have changed the trajectory of my life.
The first opportunity to assist me was in school. There were a number of measurable things that began to change: attendance, discipline issues and grades dropping. Any teacher, counsellor of coach I was in contact with would have known something was not working.
The next area that went unaddressed was when I left home at 15. There were no attempts to reconnect me with a suitable environment. I was left to try and mange as an adult, with the life experience of a 15 year old.
The third area where a successful intervention could have occurred was through the justice system. I had frequent contact with probation and courts. Yet again nothing was initiated to prevent the train wreck that was about to become my life.
When I look back today I was an average young person dealing with challenges that I could not mange on my own and once I became entrenched in street involved living, all the other poor choices followed.
What if the system was a little different? What if we support young people better at those crucial crossroads of their lives and prevented them from entering homelessness? These questions caused me to begin Push for Change.
The idea to cross the country was good but adding a symbol of chronic homeless - a shopping cart - was brilliant. We checked and learned that in fact, nobody has cross Canada with a shopping cart. So, we began to build. In 2012, to get fit and prepare for the cross-country walk, we did a “trial” walk from Calgary to Vancouver - a distance of 1071km.
From here, we began building national partnerships and seeking sponsors. One of the first conversations we had was with Dr. Stephen Gaetz, to better understand the state of youth homelessness in Canada and what could be done. I also spoke with Mike Lethby from the RAFT to understand the successes they were having helping youth through Niagara Region. Next we met Melanie Redman from Eva’s and we were introduced to the National Learning Community. It was at this time that A Way Home, a national coalition to end youth homelessness, was beginning to take shape. The timing was perfect. Next we met with Carolann Barr from Raising the Roof to form a charitable partnership.
Our goal as a campaign is to do two things, raise dollars to support youth homelessness and to engage the public in conversations about what we need to do, as a country, to move towards a systemic change. Along the way we want very much to engage with frontline service providers and invite them to push for change with us.
Since 2011, a mountain of ground has been covered and we launched just yesterday. As you read this we will have already left St John’s, Newfoundland and Labrador to commence a 9000km walk across Canada. It will take us 17 months; we will walk through all 10 provinces and engage in the 3 northern territories. We have over 400 community and school events planned. Our team consists of a fulltime road manager, a public relations support person and our dedicated campaign director whose tireless work built the dream I had over four years ago. The person I speak of is my best friend, extremely competent leader and lovely wife Marie who is as committed to the project as I am.
When I was in Vancouver at my lowest point in life I made a promise that if I ever escaped the streets I would do something to “pay it forward”. This is my opportunity to give back to a country I love very much.
At the Push for Change we believe that inspired action can change the world; we believe every young person deserves to grow up and transition safely into adulthood. We believe that ending youth homelessness is possible.
Ending youth homelessness is not a silly altruistic bumper sticker response to a serious social issue. It’s a plan with measured results that will impact taxpayers and save a whole lot of personal and family trauma.
My daughter asked me what I want to accomplish and it’s simple. By creating collaborative relationships, nationwide, maybe in my lifetime, maybe in hers, we can visit youth homelessness in a museum where it belongs.
This question was asked anonymously via our latest website survey: What are some ways that affordable housing has been built, even in these very austere times?
On this website, my peers and I have written extensively about the lack of affordable housing in Canada and how it’s a key contributor to homelessness. Housing is considered affordable by the Canada Mortgage and Housing Company (CMHC) if a household spends less than 30% of its pre-tax income on adequate shelter – but what a household’s income is varies wildly.
Right now, Canada relies heavily on the private market for its housing supply. Plenty of new units have been developed across the country and real estate is booming in cities like Toronto and Vancouver, but the majority of those options simply are not available to many people in medium to low income levels. Decades ago, the federal government pledged funding for affordable social housing, but such funding has been rapidly declining since 1993.
In the State of Homelessness in Canada 2014 report, Gaetz, Gulliver-Garcia and Richter highlighted the fact that decades of disinvestment in new affordable housing projects has resulted in 100,000 units not being built. There have been some successes, however, that were also discussed in the report:
As of March 31st 2014, the federal government reports that 183,642 households were no longer in “housing need” (CMHC, 2014)…The majority of these households were in Quebec (137,481 units). It is important to look at what this means. Approximately 110,000 of the households assisted in 2010-2011 in Quebec were helped by the province’s small although laudable housing benefit, Allocation Logement. The maximum amount per household is currently $80 per month, but the average in 2010-2011 was just $56 (Société D’Habitation Du Québec, 2011; 2014).
These numbers also include units that were funded under renovations programs and therefore are not new units of housing (although improvement of poor housing conditions is certainly an important and admirable goal, which may lead to the prevention of homelessness).
Similarly in British Columbia, 813 households were assisted under the same program between 2012 and 2013. Of those, 165 were new builds and 609 were units that were “renovated, rehabilitated or repaired.” So while this is necessary assistance, it doesn’t lead to the development of lots of new housing.
Today, most affordable housing funding comes from the Investment in Affordable Housing (IAH), and most of that money goes to improving and modifying existing housing (as shown on the right). Given the declining quality of much of Canada’s social housing, these are crucial investments, but they only maintain what we already have. The CMHC lists a number of country-wide agreements by province and territory.
Affordable housing can and is being built
Through the development of affordable housing strategies and partnerships between government and developers, affordable housing is being built.
In many areas, affordable housing is often built on property owned (or previously owned) by municipalities. In Toronto, the municipal government website lists affordable housing developments currently under construction. Much of the affordable housing in the city is repurposed – the most well-known example is the Pan-Am Games Athletes’ Village buildings. In 2011, two non-profit agencies, Wigwamen and March of Dimes, purchased one building and will be offering the units well below market pricing. Other partnerships are in the works throughout the province, including Barrie, Niagara region and Kingston.
As Catherine McIntyre wrote for Torontoist, the rate at which housing is being built simply isn’t keeping up with demand:
Since 2010, fewer than 3,700 new affordable units have been built in Toronto, while about 94,000 individuals and families are waiting for subsidized housing. Of the affordable units that do exist, 400 are currently uninhabitable and another 7,500 are on pace to be boarded up in the next decade.
In any area, the ability to build new housing requires cooperation between levels of government. Back in March, the Ontario government announced its long-term affordable housing strategy, which proposes inclusionary zoning: requiring developments of certain sizes to include a percentage of affordable units. Development companies are currently opposing this inclusion, and it remains to be seen if the province will enforce it or not. Toronto, Montreal and Vancouver municipal governments have adopted inclusionary housing policies, but higher level government support is needed to truly make them effective. Hopefully between provincial and territorial commitments to affordable housing and the increase in federal support and funding, we will see much more built in the coming years.
This post is part of our Friday "Ask the Hub" blog series. Have a homeless-related question you want answered? E-mail us at email@example.com and we will provide a research-based answer.
This week’s infographic comes to us from the True Colors Fund, an organization aiming to raise awareness about and help bring an end to gay, lesbian, bisexual and transgender youth homelessness. Today, Wednesday 27th April 2016, is 40 to None Day, a day to raise public awareness about LGBT* youth homelessness. Approximately 40% of youth experiencing homelessness identify as lesbian, gay, bisexual, or transgender (LGBT), yet LGBT young people make up less than 7% of the general youth population. The goal of 40 to None day is to ultimately reduce this disproportionate percentage from 40% to none.*”LGBT” is the acronym used by the True Colors Fund. In Canada, the acronym “LGBTQ2S” is more commonly used to refer collectively to lesbian, gay, bisexual, transgender, queer, questioning, and 2-Spirit identified youth.
The figures in this Infographic come from a report funded by the True Colors Fund, the Palette Fund and Williams Institute, three organizations dedicated to the advancement of LGBT equality.
Serving Our Youth presents data from The Lesbian, Gay, Bisexual, and Transgender (LGBT) Homeless Youth Provider Survey, a web-based survey that sampled over 350 youth living in critical housing conditions that were receiving services from local agencies. Approximately 40% of the survey respondents identified as LGBT. The report also made note that “youth may not be willing to self-identify as being LGBT when initially presenting for services” and as such, this data may underestimate the proportion of LGBT youth served by homeless youth providers.
Family rejection based on sexual orientation and gender identity was the most frequently cited factor in the report contributing to LGBT homelessness. Many youth experience homophobia and transphobia at home and in school, and due to gaps in knowledge and a lack of reported incidents, discrimination against queer and trans youth remains largely invisible to shelter workers. Funding, to meet the unmet needs of underserved homeless populations and to continue to provide services to currently funded groups, is largely dependent on community support and committed advocacy.
Although this study was conducted in the US, LGBTQ2s youth are also overrepresented among Canadian homeless populations. 20% of youth in Toronto's shelter system identify as being LGBTQ2s, meanwhile only approximately 5-10% of the general population identify as members of the community. Research has shown that LGBTQ2s youth are at higher risk for victimization and associated negative health and mental health outcomes. Further, many youth do not access support services due to issues regarding homophobia and transphobia in the shelter system and drop-in programs.
Surveys of LGBTQ2s youth highlight the need for specialized services for this subpopulation. Failure to account for the unique needs of homeless LGBTQ2s youth is likely to perpetuate and further exacerbate existing problems. 40 to None Day aims to shed light on the issues faced by LGBT youth experiencing homelessness on social media through the hashtag #40toNone. To find out more about the campaign, visit the True Colors Fund website.
Do you have any questions about LGBTQ2S youth homelessness? We’re hosting an Ask Me Anything on the Community Workspace on Homelessness. We encourage you to post your questions in advance of the AMA. Log in and post your questions on the LGBTQ2S thread. Experts David French and Dr. Alex Abramovich will answer your questions on Monday, May 9th at 1PM.
This question came from Bill T. via our latest website survey.
Homelessness in Canada’s remote and northern communities is unique and worthy of attention. There is an ongoing need for more data and research focused on Yukon and other territories.
That said, we do have some great data about homelessness in Yukon. The majority of existing studies focus on Whitehorse, Yukon’s capital and only city, where about 75% of people live.
As is the case in other locations, homelessness is impossible to quantify with 100% certainty, so what we do know about homelessness in Yukon is estimated from multiple data sources. Statistics Canada has some data on Yukon, but does not track rates of homelessness – this is a difficult task anywhere. More recent data on employment, population, income and more in the territory can be found through the Yukon Bureau of Statistics. Many recent reports have used data from (or in collaboration with) the YBS to publish findings about poverty and housing in Yukon, including:
- Dimensions of Social Inclusion and Exclusion in Yukon, 2010 – which used the Yukon Social Inclusion Household Survey (2010)
- Bridges and Barriers 2010: Yukon experiences with poverty, social exclusion and inclusion
- 2010 Whitehorse Housing Adequacy Study
Together, these reports showed that health and wellbeing in Yukon is poor. A CBC News article succinctly summarizes some of the findings:
On average, Yukon has high average income and education levels, though segments of the population still struggle in those areas.
The people most likely to be homeless were not raising children, were aboriginal, were younger than 25, or were living on a household income of less than $20,000 in the past year.
For those with homes, the housing study found that young people, low-income people and single parents were most likely to suffer from excessive shelter costs, though rent subsidies helped single parents. Senior citizens were significantly more likely to be living in overcrowded housing.
By capturing data on poverty and social exclusion, these reports encouraged further evidence development to make the case for investments in not only social infrastructure in Yukon, but housing as well.
Developing a homelessness research base in Yukon
In 2011, The Yukon Anti-Poverty Coalition published A Home for Everyone: A Housing Plan for Whitehorse. The report was based on a year of interviews with service providers and organizations to determine how four levels of government and over 80 social service agencies can work together to end homelessness. Its writers emphasized the importance of partnerships and collaboration, concluding that: “Our city needs a coordinated approach to housing—one that recognizes the many players and their responsibilities and opportunities to make a difference; one that demonstrates the benefits of working collaboratively; and one that includes the community.”
Regarding women’s homelessness in Yukon, the Yukon Status of Women Council produced a report in 2007. Through interviews with women in Dawson City, Whitehorse, and Teslin, the study used a naturalistic research method to outline 13 determinants of women’s homelessness. Its authors made a number of recommendations to territorial and federal governments, including: ending clawbacks of national child benefit and other forms of social assistance, building more and varied affordable housing, and including women in decision-making.
Another important report was Nick Falvo’s Poverty Amongst Plenty: Waiting for the Yukon Government to Adopt a Poverty Reduction Strategy (May 2012, key housing indicators pictured right). Falvo combined data about food insecurity; child apprehensions; income, social assistance and unemployment; housing development, cost, quality and availability; and more to paint a more accurate portrait of poverty in Yukon and what it costs. Falvo also encouraged the government to implement a poverty reduction strategy, which happened six months later.
Finally, Kate Mechan’s 2013 report on homelessness in Whitehorse used information from existing sources and from voluntary interviews with some local service providers. Her findings spoke to the affordability and housing problems experienced by many people in Whitehorse, and included:
- The Salvation Army shelters over 350 unique clients every year.
- FASSY found that 17% of their clients identified as homeless inSeptember 2013.
- In November 2013, the Whitehorse Food Bank database indicated that of 612 households in their registry: 58 were ‘staying with family and friends’; 5 were on the street’; 87 in ‘social housing’; 83 in ‘Band owned’ housing; and 282 in ‘private rental.’
Despite the overwhelming evidence that Yukon needs affordable and varied housing (i.e. supported, transitional and permanent), the territorial governments have not acted as much as they could have. In 2014, the government rejected federal funding to for-profit developers that would have seen the development of 100 rental units.
Even so, positive moves are being made in Yukon to address homelessness and poverty. This month, the Council of Yukon First Nations, Yukon Planning Group on Homelessness, and various volunteers will lead the first Point-in-Time (PiT) Homeless Count in Whitehorse; contributing important data to help complete our understanding of homelessness in the area. And as Bill Thomas noted in Yukon News: “…on Feb. 11, we witnessed a piece of history during a press conference held at city hall, where three levels of government jointly announced that they will work together to end homelessness.” Hopefully, the combination of even more data and a public declaration will lead to a more defined strategy on reducing poverty and homelessness in Yukon.
This post is part of our Friday "Ask the Hub" blog series. Have a homeless-related question you want answered? E-mail us at firstname.lastname@example.org and we will provide a research-based answer.
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The analysis and interpretations contained in the blog posts are those of the individual contributors and do not necessarily represent the views of the Canadian Observatory on Homelessness.