Introduction

In this paper I want to examine how mental illness is a factor in chronic homelessness in Canada. This paper will draw on academic sources, both sociological and otherwise, in order to synthesize an understanding of the relationship between the concepts of mental health and homelessness. I will begin with an explanation of the history of the issue, followed by an in depth analysis which seeks to explain the correlation from a sociological perspective.

For the purpose of this paper, I define chronic homelessness in accordance with the government of Canada’s use of the term where chronic homelessness refers to “individuals who are currently experiencing homelessness AND who meet at least 1 of the following criteria: they have a total of at least 6 months (180 days) of homelessness over the past year [or] they have recurrent experiences of homelessness over the past 3 years, with a cumulative duration of at least 18 months (546 days)” (Government of Canada, n.d.). This is in contrast to episodic and transitional homelessness which refer to periodic and isolated periods of homelessness respectively. I will define “mental illness” in accordance with the American Psychiatric Association (not to be confused with the American Psychological Association) as “health conditions involving changes in emotion, thinking or behaviour (or a combination of these) [which are] associated with distress and/or problems functioning in social, work or family activities.” (American Psychiatric Association, n.d.). Note that addiction is included in this definition by nature of its symptoms.

It is also important to mention that mental illness is not the only correlative factor to homelessness. There is always a broad range of factors and circumstances for any homeless individual. This intersectionality is worth acknowledging as it would be incorrect to attribute the entirety of an individual’s situation to a single attribute. Many of the studies I will be referencing take this into account so it should be noted that while I am conscious of this while drawing on sources.

As a final note, one of the issues with homelessness is that it’s not always visible. Although chronic homelessness is easier to count than transitional homelessness, the scale of the issue makes tracking it a monumental task nonetheless. Roger Nooe (2010) explains that tracking rates of mental illness among chronic homeless populations is even more challenging as small adjustments in methodology tend to lead to wild varions in results. As such, it is often difficult to find data which is as up to date as is ideal for tracking an issue which is as quickly changing as this one. This is a widely acknowledged fact among homelessness advocacy and research groups. As a result, the norm in the field seems to be to construct general trends from the data that is available. This is a task which I will refrain from partaking in myself as I am not equipped to handle such data responsibly. In lieu, I will rely on organizations which are known for their efforts on the issue. I have discovered that even scholarly papers are forced to rely on non academic sources for their figures regarding these issues (Piat et al., 2015).

HISTORY

There have been two significant historical events which have led to widespread homelessness in Canada today. These are the abolition of the housing policy in the 1980s and 1990s and the deinstitutionalization of individuals with mental illness around the same time.

The Homeless Hub’s 2014 State of Homelessness report provides a summary of Canadian social-housing policy through the 1980s and 90s (Gaetz et al., 2014). Gaetz and his colleagues recall significant cuts to welfare, housing and the Canadian social safety net as a whole through the 1980s and 90s. Less affordable housing meant more people who were unable to afford homes. This was the first step in Canada’s homelessness epidemic.

For reasons which will be further discussed later, individuals with mental illness are significantly more susceptible to homelessness than the average Canadian. With the previously mentioned policy, many of the people who were ending up on the streets were suffering from some sort of mental illness. This disproportionate effect was compounded by deinstitutionalization policies of the 1980s and 90s (Sealy, 2012). For decades, the Canadian government had locked up individuals with mental illnesses in total institutions until it was determined to be inhumane in the 80s. Sealy explains that deinstitutionalization was a province-by-province process. However, very few provinces set up propper contingency plans for the released patients. The unfortunate fact was that by this point, many of those who had previously been housed in these institutions were unable to thrive in the outside world. Sealy also discusses the state of mental institutions of the time. Many of them were total institutions. The individuals in the facilities were given very limited autonomy and lacked much contact to the outside world. The facility was dedicated to resocializing them but for many of the long-term patients it did the opposite. It reduced the patients’ ability to thrive outside.

This leads us to today. According to more recent data courtesy of the homeless hub, as of 2013, there have been roughly eight thousand people experiencing chronic homelessness in Canada at a given time (Gaetz et al., 2016). With this, the correlation to mental health is ever present (Calsyn et al., 1991), (Calvo, 2020). It could be argued that this correlation is due to the remnants of the deinstitutionalization mentioned earlier. However, this correlation seems to be present even in countries with different histories of mental health treatments. For example, a Spanish study determined that mental illness is the number one risk factor that differentiates episodic and transitional homelessness from chronic homelessness, where chronically homeless individuals were much more likely to suffer from a mental health condition. The most common issues were found to be addictions such as alcohol (Calvo, 2020). This proves that mental illness is a major factor in chronic homelessness outside of Canada too.

DISCUSSION

In this section, I will establish several facts about the relationship between mental health and homelessness. The following section will attempt to define several sociological factors that are present in this relationship. It is my hope that with a better understanding of the mechanisms through which these concepts are interconnected, it will be possible to make more informed decisions to address the issue in the future.

There are three points I will be focusing on. First, I will go over the meritocratic argument which seeks to justify the correlation economically. Second, I will discuss the socialization factor, which represents an understanding of the two-way nature of the relationship. Finally, I will shine light on the cultural element. In this section, I will outline concrete solutions to the issue as well as aspects of Canadian culture that contribute to the perpetuation of these issues.

Chronic homelessness in a nation as wealthy as Canada is an extreme example of social inequality. Social inequality is generally something that is accepted in Canadian society as it seems to be a necessary trait of a meritocracy (which I posit Canada aspires to be). Unfortunately, the merits by which society judges individuals are often wholly unaccommodating to those with mental health conditions. A paper by Myra Piat (2015) explains that the reason that there are high rates of mental illness among the homeless population is because mental illness makes it difficult to work and without a job, it is difficult to afford housing. This is likely one reason why so many of the homeless individuals suffer from mental health conditions. Furthermore, Piat shows that this meritocratic model stigmatises those with lower social status, leading to frequent victim blaming of homeless individuals. This is in turn internalized which increases the difficulty in improving the situations of the individuals as they constantly feel they are tied to a certain social class.

A qualitative study by Tammy Morrell-Bellai and her team into the experiences of chronically homeless individuals determined that mental illness isn’t just a predictor of homelessness (2000). It can also be caused by homelessness. Possible explanations for this include internalization of stereotypes or socialization to the new environment, both factors mentioned in Piat’s paper, although additional qualitative data will need to be gathered to be sure. Taking this into account with what we already know about mental illness being a predictive indicator of homelessness, it seems that this is an example of a vicious cycle. If an individual becomes homeless, they are at risk for mental illness which would increase their chances of further homelessness. This tells us that these factors are linked by more than just coincidental correlation. They are deeply and inextricably tied to each other.

It is sometimes assumed that because homelessness is tied to mental illnesses, some of which are thought to be incurable, homelessness is unstoppable. Several practical achievements have shown this to not be the case. For example, Annalisa Sannino (2020) describes how Finland was able to become one of the few places in the world where rates of homelessness are decreasing. Given what we know about mental illness and homelessness already, it is no surprise that Finland has accounted for these facts in their policy. By analysing the success of Finland’s policy with regards to mental health and homelessness, it is possible to both test the claims previously made in this paper as well as gleam new insight into the subject.

As previously mentioned, because homeless makes individuals susceptible to mental illness and mental illness is an indicator of homelessness, homelessness increases the risk for further homelessness in the future. The idea should be to stop this process before the initial experience with homelessness. This is the process that Finland has adopted. While most countries have a scaling system for dealing with homelessness, where individuals first stay on the streets, then shelters, then transitional housing before finally reestablishing themselves in permanent housing, Finland has reversed this concept. In Finland, fully housing people is the top priority. This reduces the risk of class internalization because it prevents individuals from reaching the low class altogether. Furthermore, it prevents the risk of long term mental illness which could be developed on the street.

Another policy Finland has adopted is with regards to mental health services. In Canada, the closest thing many homeless people get to intensive mental health services is prison. Recalling the shutdown of the mental hospitals, it would appear that Canada has replaced one ineffective total institution for an even less effective one. Naturally, the prison system is unequipped to deal with the mental health issues that are at the root of individual circumstance. Therefore, by reconstructing mental health supports, mental health systems may be able to tackle the issues that the justice system has been attempting and failing to tackle for so long.

It has now been established that homelessness is likely solvable. Therefore, the question becomes what does the fact that Canada allows chronic homelessness to persist say about Canadian culture? I posit that Canada remains a deeply classist and ableist society. Given the intersection between low class and disability, to ignore one would necessarily be to ignore the other. Although Canada claims to care about the mentally ill, it consistently ignores the homeless.

SUMMARY

Through this exploration into mental health’s relationship to chronic homelessness in Canada, we have discovered several important facts about the topics’ intersection. In the beginning, I seeked to establish an understanding of the mechanisms behind their relationship. Now, I’ve pinpointed three distinct revelations I’ve had regarding these subjects. First, the intersection of mental illness and homelessness is a deeply cyclical and self-referential structure. Mental illness leads to homelessness but homelessness also leads to mental illness through socialization and internalization. Second, the side-effects of a meritocratic system are damaging to those suffering from mental illness and often pushes them toward homelessness. In order to solve homelessness, a certain degree of meritocratic idealism must be abandoned lest it continue to widen the intersection of homeless and mentally ill individuals. Finally, effective methods of tackling homelessness are out there but there seems to be a general unwill to adopt them within Canadian society. This could be due to the meritocratic ideals mentioned earlier, or a deeper classist and ableist force hidden within the society as a whole.

Even before making this discovery, while researching this topic I reflected on my own biases and position within it. I have neither suffered from mental illness or been homeless so it is sometimes difficult to relate to those who are. I had hoped that this disconnect from the topic would allow me a higher level of objectivity that might not be available to someone closer to the issue. Although I have no way of judging my level of objectivity in this paper, it quickly became apparent to me that I hold certain negative connotations of both mental illness and homelessness in myself. Over time, while conducting research, certain stereotypes would present themselves and I would have to confront them before moving forward. The qualitative studies in particular provided valuable insight into the lived experiences of individuals who suffer from both these issues on a daily basis. With that, I was able to further my empathy with these individuals and pursue the topic in a more responsible way.

Works cited

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