Photo: Getty Images | Design: Genevieve Pizzale
When we talk about stigma facing Canada’s homeless population, there’s no question that the big one is our perception of the role mental health plays in displacing people. The thing is, there are plenty of misconceptions about the connection between these illnesses and the country’s poor.
More than 35,000 people across Canada are homeless tonight, and about a quarter of a million Canadians will experience homelessness this year. And yes, the truth is that about a third of them live with mental illness.
If you’re surprised by that stat and assumed the number would be much higher, you’ve already stumbled onto one of the more common misconceptions out there. The connection between mental health problems and homelessness isn’t new, but it’s definitely misunderstood, says Dr. Stephen Hwang, a physician and researcher at Toronto’s St. Michael’s Hospital who has studied homelessness and health (and has been a physician for homeless patients) for 25 years. “While people who are homeless have a higher prevalence of mental illness than the general population, it doesn’t mean most homeless people have mental illness.” And while it’s true that homelessness is generally more severe when it affects those with mental health problems (these people tend to stay homeless for longer and don’t have as much support) and substance abuse issues can be linked to some who suffer (alcohol and drugs may be used to cope), most of us are more familiar with the myths than the facts.
Misconception: “Mental illness precipitates homelessness.”
Sometimes, yes, but this one’s a bit chicken-versus-egg (and it’s obviously a rather contentious topic). It’s true that mental health disorders can precede homelessness. In some cases, for example, folks who suffer from mental illness may be less likely to work, and as a result, less likely to make rent or mortgage payments, says Dr. Hwang. That said, it’s been well-documented (and has been found in Dr. Hwang’s studies) that the stress homeless people experience can trigger or exacerbate mental illness.
Misconception: “Most homeless people who have a mental illness are schizophrenic.”
“It’s an incorrect assumption that homeless people with mental health issues are often schizophrenic and psychotic,” says Dr. Hwang. “These people are often the ones who are more likely to be chronically homeless (for at least six months or longer), and they’re more visible on the street—hallucinating and talking to themselves. But this is atypical. These are a relatively small percentage of people who experience homelessness.” In fact, the most common type of mental illness found in homeless people is depression, as well as anxiety and post-traumatic stress disorder. Psychotic disorders are way down the list.
Misconception: “Homeless people need to get their mental illnesses under control before being placed in housing.”
Experts and research say otherwise. “One of the most striking things we take for granted is our homes—these places play an essential role in wellness, refuge, rest, where we can recuperate, recover. Our homes are safe places,” Dr. Hwang says. “Imagine how hard it must be for people with mental illness to start the road to recovery when they’re homeless.” The Housing First model is considered best practice by many (and has been tested in cities across Canada and the United States). Its approach is to end homelessness by moving people into permanent housing first, then providing healthcare and other supports and services. “It’s impossible to get well or stay well without a home and the support we receive from our communities and neighbourhood.”
How you can help
Dr. Hwang says there’s a need for more healthcare providers to get involved, but for the rest of us, donating to social services in your community is a great start. And he says there’s something all of us can do that will ultimately make a huge difference—support friends and family who have mental illness. “That’s where it starts. If you know people who are struggling, help them. If they’re at risk of losing their housing, step in. Don’t underestimate the ability to help when someone close to you is going through a tough time. This really does help prevent homelessness from spiralling.”