By ANNE-MARIE TOBIN
August 30, 2007
TORONTO — More than half of hospital stays by homeless Canadians are a direct result of mental disorders, suggests a study of mental health and homelessness released Thursday.
The report by the Canadian Institute for Health Information describes homelessness as a "harsh reality" for more than 10,000 people staying in shelters on any given night in Canada, and provides an overview of research and interventions for people living on the street and in shelters.
In particular, it pulls together hospital data on admissions in 2005-06, and the reasons behind them.
"This is the first time we're tracking this kind of information," Elizabeth Votta, an author of the report, said from Ottawa.
* CIHI report: Homeless and hospitalization Popup
The Globe and Mail
"It's data that's collected from Vancouver, Calgary and Toronto — primarily Toronto because that's the way the database is set up — but what it's telling us is that 52 per cent of homeless persons that are being hospitalized are being done so for mental disorders ... and that's much higher than the general population, which is coming in at five per cent."
A portion of the report looked at selected emergency rooms, mostly in Ontario, and found that 35 per cent of visits by the homeless were related to a mental disorder. Substance abuse accounted for 54 per cent of those mental disorders, followed by psychotic disorders, such as schizophrenia, at 20 per cent.
The report notes Aboriginal Peoples are over-represented among the homeless in cities across Canada, and men comprise three-quarters of the hospital visits by the homeless.
"One of the things from a stigma point of view that we want to get across is that not everyone who's mentally ill is going to become homeless, and not everyone who's homeless has a mental illness," said Ms. Votta.
"But we do have to recognize that there is that higher prevalence of mental illness and compromised mental health among the homeless."
Bill Wilkerson, co-founder of the Global Business and Economic Roundtable on Addiction and Mental Health, expressed impatience with the report, which noted homelessness is linked to stress, low levels of self-esteem and suicide.
"We have known for 25 years what this report is telling us yet again," he said. "So it's time for action, not time for more study."
Mr. Wilkerson was involved in a task force that scrambled to find housing for mentally ill people who were deinstitutionalized in Ontario in the early 1980s.
"The only difference, I think, is the problem then was new. Now it's old," he said from his home in Port Hope, Ont.
"I think we have studied this problem into the ground ... I think the city of Toronto, the city of Vancouver should both say, as a matter of public policy, living on the street is unacceptable," he added.
"We need a combination of tough love and community support, housing and drug treatment support measures, and a whole ton of compassion to resolve this issue."
Beric German of Street Health, an organization in Toronto that provides health care at shelters and on the streets, said one in five people in Canada will have a mental-health issue in their lifetime.
He noted that many people who are homeless develop mental-health problems after landing on the streets.
"In reality, the extreme stress of being homeless can cause mental-health issues, certainly can lead to depression," he said.
"You don't get enough food. You don't get enough sleep. You're in a worse situation in regard to being possibly assaulted. If you're very, very stressed out, it's very common in this country to reach for a bottle or to reach for some drug to kill the pain. And people do that. And sometimes they kill the pain too much and they end up in an emergency ward."
Homelessness can often be traced to the lack of a job and affordable housing — and German said this is something that any Canadian could face.
"There's a tremendous prejudice out there around mental health. ... They see people sometimes who are in terrible shape, and they think that somehow that person can be dismissed."
He called for a comprehensive health-care system that would provide housing, support, income and nutritious food for those who need it.
Ms. Votta said it's hoped the CIHI report will increase awareness and discussion about homelessness and foster a broader look at interventions, such as providing housing.
Friday, August 31, 2007
By ANNE-MARIE TOBIN
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