The 2020 Point-in-Time Count reported that 61% of those experiencing homelessness in Nanaimo are also struggling with mental health. People with mental ill-health are more susceptible to factors that can lead to homelessness.

– They may not have the capacity for sustained, full-time employment;
– They may withdraw from family and friends;
– They may struggle with resiliency and resourcefulness;
– They may experience impaired judgement.

A common statement we hear is “I don’t understand why some people struggling with mental health don’t take their medications.” The idea being that, once well, the person would be able to find employment, a home and get off of the streets. Here are some common reasons people suffering from mental ill-health may not take their medications:

Fear and shame
There’s stigma around mental health struggles and taking medication means acknowledging a shaming disorder. Taking medication can seem like an admission of defeat, admitting they couldn’t handle it on their own and they need help.  

Unawareness
Many people are unaware that they’re experiencing mental health struggles. Life events such as grief, trauma, or feeling stuck can feel very similar to depression, bi-polar, personality disorder or Post-Traumatic Stress Disorder (PTSD). They may not know that their experience is more than just a really hard time.  

As we learn more about mental health and how it evolves throughout our lives, we’re understanding more about how significant life events can cause changes in the brain. These changes can lead to life-long PTSD, depression or other mental ill-health. Many people still believe the myth that you’re either born with mental ill-health or not.

Lack of access
Many people experiencing homelessness don’t have access to medication and/or health care. For example, they may not have a cell phone to call for help or make an appointment with a doctor. They may not have reliable transportation or aren’t able to pay for bus fare. People experiencing homelessness are fighting to address their most basic needs; staying warm and finding a meal. Making and attending a doctor’s appointment is often a luxury they don’t have.

Side effects
Side effects of some antidepressants, anti-anxiety medicine and psychotropic drugs can include sedation, insomnia, drowsiness, dry mouth, weight gain and sexual issues. If someone is already hesitant about taking medication, these side effects can be a powerful deterrent.

They feel better
Many people take medication until they feel better and the symptoms disappear. However, with many mental health disorders, once patients stop taking the medication the symptoms may return. Life events such as the death of a loved one or stress at work could also cause symptoms to re-appear.  

Misunderstanding
It’s difficult to talk about personal details with a doctor or counsellor, particularly one that a person doesn’t have a relationship with.  Patients also may not understand the potential benefits of the medicine, the nature of the side effects or the time it will take to see results. Physicians and counsellors may may not see their patients regularly enough to make an accurate diagnoses.

More challenges
Not only does homelessness have a direct impact on health, it makes it difficult or impossible to obtain medication and to adhere to medical treatment. The stress of experiencing homelessness may amplify mental illness disorders. People struggling with mental illness while facing homelessness encounter more barriers to employment and tend to be in poorer health than other people experiencing homelessness. [1]

To make it even more difficult, many services have long waitlists and limited availability. This can be a major barrier to getting the consistent support that recovery from mental ill-health requires.

[1] Homeless Hub

Youth between the ages of 13-25 make up 20% of the homeless population in Canada [1]. In Nanaimo, we’re seeing increasing numbers of vulnerable youth experiencing homelessness. Of the people facing homelessness surveyed in the 2020 Nanaimo Point-In-Time Count, 10.7% of respondents were under the age of 25. An estimated 60 to 65 youth are living on the street. There are many reasons that lead young people into homelessness.

FAMILY CONFLICT

Family and relationship breakdowns are one of the main reasons young people become homeless. Many youths leave home after years of physical, sexual and/or emotional abuse, strained relationships, addiction issues in the family and parental neglect. Young people often become homeless because it’s safer to leave home than to stay.

Conflict with parents or caregivers was a major cause of homelessness for 74% of youth, and was a contributing factor for 92% of youth, according to the 2014 Leaving Home report. [2]

RESIDENTIAL INSTABILITY

Aging out of the child welfare system is another cause of youth homelessness. When they reach the age of 19, youth are no longer supported.  Without adequate planning, housing and income support, some youth living in residential or institutional placements become homeless when they’re discharged.

The 2020 Nanaimo Point-in-Time Count confirmed that foster care is a precipitating factor leading youth into homelessness. In Nanaimo, of those who indicated they had been in foster care, 39% were homeless within five years or less of leaving.

LIVING IN POVERTY

Many young people who become homeless come from families living in poverty. The families may indeed be supportive and caring, but may simply not have the means to take care of the young person and they may be forced to leave the home.

Some youth become homeless with their families, after the family suffers financial crises resulting from lack of affordable housing, limited employment opportunities or insufficient wages. These youth may be separated from their family by shelter, transitional housing or child welfare policies.

MENTAL HEALTH AND ADDICTION CHALLENGES

Youth may be pushed into homelessness because of their own undiagnosed or untreated mental health or addictions challenges or because of their parents’ mental health and addictions challenges.  This is concerning because the sufferings of being homeless only exacerbate these challenges.

LGBTQ2S+ YOUTH

LGBTQ2S+ youth experience higher levels of homelessness than their peers. It’s estimated that between 25-40% of homeless youth in Canada identify as LGBTQ2S+ compared to 10% of non-homeless youth.

Many sexual and gender diverse youth grow up in homes with family members that are not accepting, supportive or affirming. Often, coming out to family leads to homelessness. Some youth may run away from home because of abuse or discrimination from their family members. Others may be thrown out of their family home.

DISCRIMINATION

When young people experience discrimination of any kind, it impacts their options and access to employment, educational opportunities, and their ability to access the services they need. This contributes to an increased risk of falling into homelessness, particularly when combined with other challenges the young person may be experiencing in the home.

Challenges for youth

Youth homelessness is complex and is usually the result of a combination of factors.

Experiencing homelessness at any age is extremely difficult. Homeless youth are especially vulnerable to physical and mental health issues, overdoses, abuse and exploitation without a stable support system.

[1] https://awayhome.ca/youth-homelessness/
[2] https://ighhub.org/leavinghome