67% to 75% of unhoused people have a mental health condition: University of Calgary

A new study published by a team of researchers at the University of Calgary found that the majority of people who are experiencing homelessness have an underlying mental health condition.

According to a meta-analysis published on Wednesday, the team found that around 67 per cent of people experiencing homelessness had a current mental health disorder, while 75 per cent have had a mental health disorder at some point in life.

The prevalence of lifetime mental health disorders was higher among men (86 per cent) than women (69 per cent).

North America also has the highest prevalence of mental health disorders among people experiencing homelessness, influenced by factors such as health care access, cultural differences, social support, housing affordability and working conditions.

The researchers said the most common mental health disorders include substance use disorders, anti-social personality disorders, major depression and general mood disorders.

Dr. Dallas Seitz, a psychiatrist and one of the researchers involved in the study, said the team searched published studies from 1980 to 2021 and narrowed them down to those that clearly identified the population was experiencing homelessness.

The studies also had to measure mental health conditions in some sort of standardized way. The team then combined the studies to get a more accurate measurement of how common mental health conditions are.

“I think most people understand that there is some sort of relationship between mental health disorders and homelessness,” Seitz told Global News.

“One of the goals of our study was to try and get a better sense of actually how common mental health disorders are amongst people who are experiencing homelessness and then start to understand a little bit more deeply some of the characteristics or factors associated with mental health disorders amongst people experiencing homelessness.”

Seitz said the study is cross-sectional, meaning the team was looking at homelessness and mental health disorders at the same point in time. He said it’s hard to know whether mental health or homelessness issues came first, adding there are a lot of factors that have contributed to these peoples’ circumstances.

Common risk factors for both homelessness and mental health problems are early traumatic life experiences and poverty, he said. Mental health conditions can also be debilitating for a lot of people and make it hard for many to sustain employment.

“There are people who have stressful life events, who maybe didn’t have a mental health condition before … But because they’ve lost a job or had a relationship breakup, they wind up being homeless. You can understand how that could lead to mental health problems as well,” Seitz said.

However, he said he isn’t able to directly find a reason why men would have higher rates of mental health disorders compared with women. Seitz speculates that some of the common mental health conditions, such as substance use disorders, tend to be more common in men.

“That might be part of why mental health conditions are higher in men than women,” the psychiatrist said.

“Women may be more likely to experience homelessness because they might be getting away from an unsafe home environment, or they may be more economically vulnerable in some situations. There are reasons for experiencing homelessness. It may be different than the reasons that men may be experiencing homelessness, but we can’t, why that is.”

The study also looked at research from low to middle-income countries because homelessness is a common issue around the world. According to Seitz, it’s difficult to study homelessness, especially in those parts of the world.

“There are so few studies that have been published in low and middle-income countries. There’s a call for there to be more research done in those countries as well to better understand those problems because homelessness may be a bigger issue, and the contribution of mental health may be different in those countries as well,” he said.

Seitz said he wants politicians and policymakers to fund resources and supports for those who are experiencing homelessness, and the study gives them a better idea of how many resources and the type of resources that are required.

The study said it is crucial to have strategies to address the mental health needs of people experiencing homelessness and effectively support people with mental health disorders to prevent them from experiencing homelessness. Housing-first strategies, which provide housing supports without requiring specific treatments, are effective at improving housing retention but “demonstrate mixed results” for reducing substance use and improving mental health.

“It’s an extremely complex problem. That’s the case everywhere,” Seitz said.

“We need everyone in all levels of government, everyone involved with mental health and social services to work together to try and find solutions for this complex problem. I’m not sure if all these parties are always collaborating as strongly as they could be for this complex problem.

“Although there’s been so much talk about housing affordability and much-needed supports to make housing more affordable for this population, we also need to be talking about mental health supports and making sure that we have the mental health resources to go along with those housing supports.”

Seitz wants regular Calgarians to know that nobody chooses to become mentally ill or homeless, and most people probably had their own struggles or know someone who’s suffered from a mental illness.

“In some ways, mental health problems affect everyone, and some people are just more lucky in terms of support that they have around them than others,” he said.

The psychiatrist and researcher said he wants more academics to look at ways to better use data on mental illnesses and homelessness to understand the issue in more detail. Right now, the data is in different sectors and it’s hard to look at both issues together.

Another limitation is those experiencing homelessness may be hesitant to talk to researchers and may be reluctant to seek professional treatment for their mental health issues.

“I hope this type of research might also spur us to find innovative ways of working together and to better collaborate between mental health services and housing services. I think there’s tons of great work going on, but the fact is that both systems don’t have enough resources,” Seitz said.

“Hopefully our governments will also increase funding and support for both of these sectors because it’s desperately needed. But in the meantime, there might be ways to explore different models or ways of working together that could be effective.”

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