Mental disorders account for more than half of hospital stays among the homeless in Canada



    New CIHI report offers overview of links between mental health, mental
    illness and homelessness

    OTTAWA, Aug. 30 /CNW Telbec/ - Mental disorders accounted for 52% of
acute care hospitalizations among the homeless in 2005-2006 (outside Quebec),
according to a new report released today by the Canadian Institute for Health
Information (CIHI). In addition, the report shows that 35% of visits to
selected emergency departments (EDs)-mostly in Ontario-by homeless people were
related to mental and behavioural disorders, a proportion that is higher than
that for other patients (3%).
    The Improving the Health of Canadians: Mental Health and Homelessness
report provides an overview of the latest research, surveys and policy
initiatives related to mental health and homelessness and, for the first time,
presents data on hospital use by homeless Canadians.
    "Mental illness affects a broad range of Canadians; most people with
compromised mental health are not homeless, and many people who are homeless
have never been diagnosed with a mental illness," says Dr. Jennifer Zelmer,
Vice President, Research and Analysis at CIHI. "However, studies show that
people who are homeless are more likely to suffer from a mental illness or
compromised mental health than the general population."
    For example, the leading reasons for hospital use were different for
homeless patients and others. Mental disorders were the most common diagnoses
among homeless patients admitted to an acute care hospital in 2005-2006 (52%
of admissions). The most frequent reasons for hospitalization among other
patients were pregnancy and childbirth (13%). Likewise, 35% of visits by
homeless persons to selected EDs (mostly in Ontario) were related to mental
disorders; injury and poisonings were the most common reasons for ED visits
among other patients (25%). Among ED patients recorded as homeless, the most
common type of mental disorder was substance abuse, which accounted for 54% of
visits (62% for homeless men and 30% for homeless women), followed by other
psychotic disorders (20% of visits), such as schizophrenia.

    Homelessness linked with stress, coping, low self-esteem, low levels of
    social support and suicide

    The report notes many factors both at the individual and broader social
level-such as housing, income and the ability to cope-that have been shown to
contribute to the onset or duration of homelessness. Many of these same
factors are also linked to compromised mental health.
    "This report explores the complex relationship between mental health and
homelessness," says Dr. Elizabeth Votta, Program Lead at the Canadian
Population Health Initiative, a program of CIHI. "People with severe mental
illness may experience limited housing, employment and income options. On the
other hand, people who are homeless tend to report higher stress, lower
self-worth, less social support and different coping strategies, factors that
are associated with depressive symptoms, substance abuse, suicidal behaviours
and poor self-rated health."
    Research cited in the report indicates that the homeless often experience
more difficulty coping with stress, experience lower self-esteem and have less
social support than people who are not homeless. For example:

    
    - A study in Ottawa revealed that homeless male youth reported stress
      levels more than twice as high as levels reported by a group of
      non-homeless youth.
    - A study in Kitchener-Waterloo showed that street youth were more likely
      to engage in substance abuse and self-harm as a means of coping.
      Non-homeless youth were more likely to cope by talking to someone they
      trusted or through productive problem-solving.
    - A national survey found that 2% of males and 6% of females aged 15 to
      24 reported having attempted suicide in Canada. Studies report higher
      rates among homeless youth. For example, a 2006 British Columbia survey
      indicates that 15% of males and 30% of females who were street-involved
      and marginalized reported having attempted suicide at least once in the
      previous 12 months.

    The report also cites many examples of research linking mental illness and
homelessness. These studies, conducted across Canada with different methods
and over different periods of time, tended to show higher levels of diagnosed
mental illness among people who were homeless than among the population as a
whole. Several studies also indicate that rates of substance abuse are higher
among the homeless than among other Canadians. Research suggests that homeless
individuals with both a substance abuse disorder and a mental illness
diagnosis are likely to remain homeless longer than others.

    Canadian Population Health Initiative

    The Canadian Population Health Initiative (CPHI) is part of the Canadian
Institute for Health Information (CIHI). CPHI supports research to advance
knowledge on the determinants of health in Canada and to develop policy
options to improve population health and reduce health inequalities.

    About CIHI

    The Canadian Institute for Health Information (CIHI) collects and analyzes
information on health and health care in Canada and makes it publicly
available. Canada's federal, provincial and territorial governments created
CIHI as a not-for-profit, independent organization dedicated to forging a
common approach to Canadian health information. CIHI's goal: to provide
timely, accurate and comparable information. CIHI's data and reports inform
health policies, support the effective delivery of health services and raise
awareness among Canadians of the factors that contribute to good health.

    The report and the following figures and tables are available from CIHI's
website at www.cihi.ca.

    Table 1. Top Five Reasons for Emergency Department Visits by the Homeless
             and Others, 2005-2006 (based on Table 4 in the report)

    Table 2. Top Five Reasons for Inpatient Hospitalization Among the
             Homeless and Others, 2005-2006 (based on Table 5 in the report)

    Table 3. Reported Mental Illness Among Canada's Homeless in a Sample of
             Canadian Cities: Results From Selected Studies (based on Table 2
             in the report)
    




For further information:

For further information: Christina Lawand, (613) 241-7860 ext. 4310,
Cell: (613) 299-5695, clawand@cihi.ca; Leona Hollingsworth, (613) 241-7860
ext. 4140, Cell: (613) 612-3914, lhollingsworth@cihi.ca


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