How Homelessness Happens: Health Challenges

Oct 2021 | Homelessness Housing Resources

Imagine how much your life could change if you were diagnosed with a serious ailment or injury, especially one that requires regular care, expensive medications and/or treatment that leaves you unable to function.

Now imagine that you don’t have any family to call on for support, and you’re living paycheque to paycheque without any savings. You can no longer go to work; you can’t afford the bills associated with your care and you have to choose between eating or paying your rent. Just like that, you could be facing homelessness.

Short-term illnesses, long-term disabilities, mental health challenges and substance use are all common paths into homelessness. When you’re already struggling to get by and you’re facing a health challenge, it doesn’t take a lot to lose your home.


Any Canadian at any moment in their life can find themselves facing a physical, mental or behavioural disability through chronic illness, injury or disease. A disability can impact mobility, dexterity and stamina, interrupting your ability to work and function in society.

According to Statistics Canada, persons with disabilities make up 41% of the low-income population. The Institute for Research and Development on Inclusion and Society (IRIS) reported that people living with disabilities are twice as likely to live below the poverty line.

There is no disputing that having a disability increases the risk of being poor; solidifying a strong connection between disabilities and homelessness. Every Canadian Counts reports that:

“Programs to assist with disability-related needs are underfunded, difficult to access, provide inadequate support, and do not transfer between provinces. This fragmented system makes entire households, including caregivers and dependents, vulnerable to poverty.”

This statement is supported by the 2020 Nanaimo Point-in-Time Count where 57% of respondents indicated they were receiving social assistance and a further 30% disability benefits, but they also reported that these supports were entirely inadequate to meet rent in Nanaimo and basic necessities like food and transportation.  

Traumatic Brain Injury

In 2020, the Nanaimo Point-in-Time Count asked a new question regarding Traumatic Brain Injury (TBI). TBI is a sudden trauma, like a blow to the head, that disrupts the normal function of the brain. Falls, assaults and car crashes are common culprits.

People who have TBI’s can experience seizures, mental health problems and weakened physical health. Some may not realize they are experiencing a brain injury and thus don’t seek out the proper treatment, resulting in delayed healing and an inability to work.

According to the 2020 Nanaimo Point-in-Time Count, 24% of people facing homelessness in Nanaimo have reported having an acquired brain injury.

We are seeing more and more evidence of a high percentage of people facing homelessness having high incidents of traumatic brain injury. Recent studies have suggested that up to 50% of people experiencing homelessness have an acquired brain injury. This study also suggested that acquired traumatic brain injury is consistently associated with poorer self-reported physical and mental health, suicidality and suicide.

Mental Health

When Nanaimo residents facing homelessness were asked about the cause of losing their housing as part of the 2020 Nanaimo Point-in-Time Count, mental health was listed in the top five reasons.

The Mental Health Commission of Canada reported that between 25% to 50% of Canada’s homeless population suffer from a mental illness. Their study determined that as many as 520,700 people living with mental illness are inadequately housed in Canada and among them, as many as 119,800 are homeless, with only 25,000 supporting housing units available that are dedicated to people living with mental illness.

People with conditions as common as depression and anxiety as well as bipolar and schizophrenia may struggle to maintain full-time employment, may experience compromised judgement and may have withdrawn from their community, leading to increased rates of homelessness.  

Housing instability and the loss of your home are usually caused by a number of factors culminating at once. When you combine mental health issues with other challenges, like low-income and substance use, it will most certainly increase your chances of falling into homelessness.

For those with mental health challenges that do access housing, the rates of remaining housed long-term are low. A well-cited Canadian study by Lancet Psychiatry recruited 575 people facing homelessness between 2009 and 2011 to track their progress over six years. This study was one of the largest and longest-running studies into mental health and homelessness. The study found that the Housing First model, which provides immediate access to rent supplements and mental health support services for people with a mental illness, showed a significant increase in the rate of housing stability. After six years, the group that accessed Housing First supports achieved stable housing an average of 85% of the time, compared to 60% for the treatment as usual groups.

Substance Use

The connection between substance use and homelessness is well known and probably the most prevalent stereotype about homelessness.

The 2020 Point-in-Time Count reported that substance use was the fourth most common reason for people losing their home in Nanaimo, after not enough income, conflict with a landlord, and conflict with a partner or spouse.

Canada is facing an opioid crisis with a record number of overdose deaths; 22,828 opioid toxicity deaths between January 2016 and March 2021. That’s 20 deaths per day.  

Since the start of the COVID-19 pandemic, there was an 88% increase in opioid toxicity deaths between April 2020 and March 2021, as compared to the same time period the previous year. There are a number of factors worsening the overdose crisis, including the toxicity of the drug supply, feelings of loneliness, depression and stress brought on by COVID-19 isolation and job loss, and lack of access to resources and reduced services throughout the pandemic.

In 2016, B.C. declared a state of emergency in response to the increased number of people dying from opioid poisoning. In the Island Health region alone, 1075 people died between 2016 and 2020.

Substance use supports in Nanaimo

Health and housing loss are complex

There is usually no single cause for homelessness, but instead a complex intersection of life challenges that lead to the loss of housing.

Physical health issues can lead to depression, while depression can lead to substance use, while substance use can lead to job loss and so on. Our security in life is fragile and it can take just one accident, one loss or even one pandemic to lose that security, leading you on the path to homelessness.

Resources in Nanaimo

Haven Society – Located in Nanaimo, Haven Society is guided by feminist ideals and offers a range of services, public education, and campaigning to advance the integrity and safety of women, children, youth and families.

Cedar Woman House – a purpose-built institution in Nanaimo for Indigenous women and children who have undergone or are in danger of facing violence. It is staffed 24 hours a day. This facility was built with Indigenous values, cultural interests, and programming in mind.

Nanaimo Youth Services Association – a non-profit that provides support to young people between the ages of 15 and 24 who are living independently of parents and/or caregivers. Their services range from providing housing, mental, physical and emotional support, life skills training and employment assistance.

Tillicum Lelum Aboriginal Friendship Centre – Strives to improve the quality of life for Aboriginal people living in an urban environment by promoting justice, fairness and equality through a holistic approach to programming and services.

Nanaimo Aboriginal Centre – Offers a variety of educational and cultural opportunities for toddlers to youths, as well as housing and outreach programs. 

HelpSeeker – Register your organization on the HelpSeeker app so that people in need can find support and information right when they need it.

Resources to help you

Do You Need Help?

If you’re looking for mental health support, shelter, addictions treatment, food banks and more, BC 211 can help.

Or search HelpSeeker for access to over 770 services, programs and resources in Nanaimo.