November 19, 2019

Homelessness continues to be an ongoing epidemic throughout Ontario. This creates more cause for concern than just the lack of affordable housing and people living on the streets. Rather, this vulnerability increases the risk of poor health outcomes and increased mental illness symptoms. The homeless population can be comprised of people of any gender, age, race or ethnicity. This vulnerable group faces significant health challenges every day in their fight to survive life on the streets. Homelessness can be understood as a process of repeated exposures of stressful circumstances and being immersed in unsafe or dangerous environments (Homeless Hub, 2019). With that understanding and the knowledge we have as mental health clinicians, it comes as no surprise that there is an increase in suicidality among the homeless. We know that people experiencing homelessness have poorer mental health have a higher prevalence of a mental illness than that of the general population and those who do suffer from a mental illness and homelessness more commonly report suicidal behaviours and tendencies (Homeless Hub, 2019). Coping skills are often taught to clients working through depressive episodes with thoughts of suicide but it creates a whole new level of difficulty when trying to implement healthy coping strategies while not having access to housing or constantly feeling guarded or unsafe. When faced with a crisis, youth who live at home are more likely to use productive problem solving, confide in a trusted support person, and avoid relying on substances whereas homeless youth are more likely to repress, engage in self-harming behaviours or turn to drugs or alcohol (Gauvin et al., 2019). So, if sharing healthy coping skills aren’t working and community based resources have long waitlists, then how can we limit the risk and support this vulnerable group?

My ideas for supporting the homeless population rely on outreach services, meeting the clients where they are and not having an expectation that this population will attend appointments in a clinic. Sinyor et al. (2017) suggests that greater efforts at engagement and targeted prevention in these groups, including access to mental health services and programs focuses on social connectedness, and suicide risk assessment. I agree with the concept of focusing on social connectedness. Below is an attached video that reflects the same thought of the homeless population missing human connection and relationship. This is one possible protective factor that could be implemented within this population. In my experience working with the homeless, it is much more effective to eliminate as many barriers as possible. When arranging communication or appointments certain aspects need to be considered such as available transportation, shelter timing rules (do they need to vacate the shelter during certain hours), operating hours of public spaces ie. the library where someone can use the internet.