The link between mental health and homelessness

Earlier this week, I had lunch with some friends and acquaintances at a local restaurant.  The subject of homelessness came up during a conversation about some of the issues facing the city of Toronto as the June 26th byelection for mayor draws closer.  Two of my lunch companions immediately slammed the homeless. They claimed that the homeless preferred to be without shelter, that they chose to live that way.  I begged to differ and I tried to point out to them that most are not homeless by choice, but by circumstance,  Unfortunately, my companions had bought into a false narrative about the homeless.

I do not dispute that many homeless people prefer living on the street rather than in a shelter.  They can't stomach the conditions in a shelter and the lack of privacy.  However, the majority do not wish to live in abject poverty.  Who really enjoys being hungry?  Who really enjoys freezing outside in cold winter weather or in a sweltering during a summer heat wave?  People become homeless for a variety of reasons.  Every homeless person has a different story.  So, why are they all lumped together.

The Mental Health Commission of Canada estimates that between 25 percent and 50 percent of homeless people in Canada suffer from mental illness.  Out of those with severe mental illness, up to 70 percent struggle with substance abuse. Sadly, those with mental illness experience homelessness for longer periods of time and have less contact with family and friends.  

With the ongoing effects of the Covid-19 pandemic, and the high cost of food and rent, is it any wonder that homelessness is so prevalent, especially among the mentally ill?  In the city of Toronto, where I live, there have been calls to declare homelessness a public health crisis.  The Ontario Human Rights Commission has expressed concern about the "significant lack of cold weather services in Toronto." 

South of the border, the U.S. Substance Abuse and Mental Health Services Administration estimates that 20 to 25 percent of homeless population of the United States suffer rom some form of severe mental illness.  The National Coalition for the Homeless has found that 38 percent of the homeless are dependent on alcohol and 26 percent are dependent on chemical substances.  Addiction is frequently the result of homelessness.  Mental illness, alcohol and drug addiction are not crimes or moral failings.  They are illnesses.  They are diseases.

Although little more than one percent of the U.S. population suffers from schizophrenia, the estimates go as high as high as 20 percent of the homeless population.  There is definitely a correlation between schizophrenia and homeless, especially since many, for a number of reasons, do not take anti-psychotic medication.

Dealing with mental illness is deeply personal for me as I have a close family member who suffers from mental illness.  He is unable to work and is often filled with anxiety.  If it weren't for the support of his family, he would probably be homeless and living on the street.  Not every mentally ill person is fortunate enough to have the support of a family.  Not every mentally ill person has access to medical care.  Many youths end up on the street to escape an abusive home life.

More and better services and safe, affordable housing are needed for the mentally ill.  A clearer  understanding of the nature and causes of homelessness is urgently required.  Our society must deal with the link between mental illness and homelessness.

- Joanne