If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 or your local RCMP detachment. 911 and the RCMP can send immediate help. The Canadian Association for Suicide Prevention, Depression Hurts and Kids Help Phone all offer ways for getting help.
The daily lives of people experiencing homelessness are stressful, dangerous, traumatic, and often take a toll on their mental health. Access to adequate housing that meets a certain standard of living is a social determinant of mental health status. People can go without many things but going without a safe and comfortable space to live can be catastrophic for one’s general well-being. Homelessness itself can trigger a mental illness or worsen an existing condition, without even considering other factors such as poverty, personal conflicts, death of a loved one, serious medical condition, social isolation and other personal issues.
Studies confirm that people experiencing homelessness tend to have poorer mental health and have higher prevalence of mental illnesses than the general population. However, it’s important to note that not all people experiencing homelessness have or will ever develop a mental health condition. Yet, for those who do, contrary to the stereotype of the person experiencing homelessness suffering with psychosis, depression and suicidal behaviours are more commonly reported.
Mental Health Commission of Canada estimates that up to 50% of people experiencing homelessness have a mental illness. A Toronto study found that 66% of people experiencing homelessness experienced serious depression sometime in their lifetime, and 56% did so in the past year. Because mood disorders such as depression usually first appear in adolescence or young adulthood, youth tend to have the highest prevalence of depression than any other group.
Rates of depression are alarmingly high among youth experiencing homelessness. Considering the social factors that impact mental health, this population is clearly a population at higher risk. Negative impact on mental health often begins well before a young person experiences homelessness. Unhealthy family relationships, family breakdown, poverty, physical, emotional and sexual abuse, histories of domestic violence and neglect are known factors that impact this population. Given the extent of adversity that youth face even before experiencing homelessness, it is no surprise that nearly one in three youth experiencing homelessness suffers from depression.
Homelessness is often described as a process of repeated exposures of stressful circumstances and being immersed in unsafe or dangerous environments. These reoccurring and ongoing negative experiences can have devastating outcomes for those with depression thinking of suicide.
Not all individuals with depression will commit suicide, however 60% of those who died from suicide suffered from depression. While depression may not be 100% preventable, suicidal behaviour including completed suicide, suicide attempts and suicidal ideation are a preventable public health challenge in Canada. Suicide is the 9th leading cause of death in the country, with men three times more at risk than women.
A number of studies have reported higher rates of suicidal behaviour among youth experiencing homelessness in comparison to other youth. In Ottawa, 43% of youth experiencing homelessness reported suicidal thoughts, and 46% in Toronto and Vancouver reported a past suicide attempt. Of those at greater risk of suicide include youth with co-occurring substance use and mental health conditions.
Recently, suicide among First Nations and Inuit Peoples has been described as national epidemic and public health crisis, with Inuit having suicide rates 25 times higher than the national average. This issue has been linked to the legacy of residential schools including the social and economic inequities Indigenous Peoples face such as inadequate housing and poverty. As part of the solution, The National Inuit Suicide Prevention Strategy calls for addressing the inequalities experienced by Inuit in the areas of housing, education and healthcare while validating Inuit culture, language and identity. Health Canada has also developed the National Aboriginal Youth Suicide Prevention Strategy Program Framework in 2010, however further financial resources are required to prevent and reduced the risk factors associated with suicide.
There is no single-handed solution to reduce the rates of suicide and depression among those experiencing homelessness. Yet, it is essential to strengthen systems that support youth, families and communities including clinical, outreach and community programs, along with coordinating policies targeting mental health, housing, income, and employment. In addition, addressing the historical determinants such as the legacy of residential schools that are believed to have shaped the mental health of Indigenous Peoples is critical in fostering and promoting healthy communities while paving Canada’s way towards reconciliation.