Abstract Research Paper Homelessness In Canada

Abstract

Individuals who have mental health issues and are homeless or in housing crisis have been found to access emergency departments more frequently than individuals with stable housing. While emergency departments primarily focus on medical issues, homeless individuals may require psychosocial support as well. This study examined issues around housing crises and emergency department use for individuals with mental illness in Canada. Collecting baseline data about these issues is important to inform subsequent interventions. Administrative data from a hospital emergency department and psychiatric crisis service were collected, and five individuals accessing the emergency department for psychiatric reasons were interviewed. Results indicated that individuals with an identified housing crisis accessed the emergency department 930 times in 6 months. None of the interview participants identified housing as the primary reason for accessing the emergency department, but all noted that housing was a contributing stressor. Future research is needed to examine ways in which discharge to homelessness from emergency departments can be avoided and identify alternative services to address housing concerns, particularly for individuals with mental illness. Crisis service and emergency department staff, especially nurses, can play an important role in screening for housing issues and connecting individuals to outside services.

This study was designed to provide a representative description of the mental health of youth accessing homelessness services in Canada. It is the most extensive survey in this area to date and is intended to inform the development of mental health and addiction service and policy for this marginalized population.

This study reports mental health–related data from the 2015 “Leaving Home” national youth homelessness survey, which was administered through 57 agencies serving homeless youth in 42 communities across the country. This self-reported, point-in-time survey assessed a broad range of demographic information, pre-homelessness and homelessness variables, and mental health indicators.

Survey data were obtained from 1103 youth accessing Canadian homelessness services in the Nunavut territory and all Canadian provinces except for Prince Edward Island. Forty-two per cent of participants reported 1 or more suicide attempts, 85.4% fell in a high range of psychological distress, and key indicators of risk included an earlier age of the first episode of homelessness, female gender, and identifying as a sexual and/or gender minority (lesbian, gay, bisexual, transgender, queer, and 2 spirit [LGBTQ2S]).

This study provides clear and compelling evidence of a need for mental health support for these youth, particularly LGBTQ2S youth and female youth. The mental health concerns observed here, however, must be considered in the light of the tremendous adversity in all social determinants faced by these youth, with population-level interventions best leveraged in prevention and rapid response.

Cette étude visait à offrir une description représentative de la santé mentale des jeunes utilisant les services aux sans-abri au Canada. Il s’agit de l’enquête la plus poussée dans ce domaine jusqu’ici, et elle tend à informer l’élaboration des services et des politiques de santé mentale et de toxicomanie pour cette population marginalisée.

Cette étude présente les données liées à la santé mentale de Sans domicile: un sondage national sur l’itinérance chez les jeunes de 2015 qui a été administré par 57 organismes offrant des services aux jeunes itinérants de 42 collectivités du pays. Ce sondage auto-déclaré, ponctuel évaluait une vaste gamme de données démographiques, des variables avant et après l’itinérance, ainsi que des indicateurs de la santé mentale.

Les données du sondage ont été obtenues auprès de 1 103 jeunes utilisant les services canadiens aux sans-abri dans le territoire du Nunavut et dans toutes les provinces canadiennes sauf l’Île-du-Prince-Édouard. Quarante-deux pour cent des participants ont déclaré une ou plusieurs tentatives de suicide, 85,4% se classaient dans une échelle élevée de détresse psychologique, et les indicateurs de risque clés étaient notamment l’âge précoce du premier épisode d’itinérance, le sexe féminin, et le fait de s’identifier à une minorité sexuelle ou de genre (LGBTQ2S).

Cette étude présente des preuves nettes et convaincantes du besoin de soutiens de santé mentale pour ces jeunes, en particulier pour les jeunes hommes et femmes de la communauté LGBTQ2S. Les problèmes de santé mentale observés ici, cependant, doivent être considérés à la lumière de l’adversité extraordinaire de tous les déterminants sociaux à laquelle font face ces jeunes, et les interventions au niveau de la population devraient miser sur la prévention et la réponse rapide.

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