Homelessness in Toronto (1999)

• Hostel users: 71% male, 29% female• 26,000 people used Toronto hostels in 1996• 3,200 people use hostels on any given night

(the number is higher in the winter)• 170,000 used shelters between 1988-1996• Fastest growing group of hostel users are

youth under the age of 18 and families with children

• 1988: 24% of households in hostel system were headed by women

• 1996: 37% of households in hostel system were head by women

• 5,300 children were homeless in 1996 (that constitutes 19% of the homeless population)

• Between 30-35% of homeless are mentally ill• An estimated 754% of homeless, single

women are mentally ill

Homelessness in Toronto

Homelessness in Toronto

• 4,400 people in 1996 (17% of hostel users) stayed in the hostel system one or more years

• This chronic group occupies 46% of the hostel beds• 47% of hostel users come from outside of Toronto• >100,000 people are on the waiting list for social

housing in Toronto• >31,000 children are on the waiting list—at current

placement rate, families would have to wait 17 years to obtain housing

• Poverty is increasing for those on the waiting list> 1/3 have incomes <$800/month

Child Poverty in Toronto

• Incidence of child poverty in Toronto is double that of the rest of Ontario

• More than one in three children in Toronto are poor (37.7% of children under 12 yrs.)

• 15,000 children are waiting for subsidized child care spaces, 21,500 more spaces are needed for the Ontario Works programme

• The number of children in need of food relief in Toronto has almost doubled from 32,000 in 1989 to more than 60,000 in 1998

Causes of Homelessness

• Increased poverty• Lack of affordable housing• Deinstitutionalization and lack of discharge

planning• Social factors (e.g., domestic violence,

physical & sexual abuse, alienation of individuals from families & friends)

Prevention Strategies

• Shelter allowances for the working poor• Rent banks for short-term loans• Databases of affordable housing• Legal assistance• Enforce anti-discrimination legislation• Welfare recipients need funding for first & last

month’s rent.• Individual support & counselling• Community economic development

Homelessness in Toronto (1999)

• Hostel users: 71% male, 29% female• 26,000 people used Toronto hostels in 1996• 3,200 people use hostels on any given night

(the number is higher in the winter)• 170,000 used shelters between 1988-1996• Fastest growing group of hostel users are

youth under the age of 18 and families with children

• 1988: 24% of households in hostel system were headed by women

• 1996: 37% of households in hostel system were head by women

• 5,300 children were homeless in 1996 (that constitutes 19% of the homeless population)

• Between 30-35% of homeless are mentally ill• An estimated 754% of homeless, single

women are mentally ill

Homelessness in Toronto

Homelessness in Toronto

• 4,400 people in 1996 (17% of hostel users) stayed in the hostel system one or more years

• This chronic group occupies 46% of the hostel beds• 47% of hostel users come from outside of Toronto• >100,000 people are on the waiting list for social

housing in Toronto• >31,000 children are on the waiting list—at current

placement rate, families would have to wait 17 years to obtain housing

• Poverty is increasing for those on the waiting list> 1/3 have incomes <$800/month

Child Poverty in Toronto

• Incidence of child poverty in Toronto is double that of the rest of Ontario

• More than one in three children in Toronto are poor (37.7% of children under 12 yrs.)

• 15,000 children are waiting for subsidized child care spaces, 21,500 more spaces are needed for the Ontario Works programme

• The number of children in need of food relief in Toronto has almost doubled from 32,000 in 1989 to more than 60,000 in 1998

Causes of Homelessness

• Increased poverty• Lack of affordable housing• Deinstitutionalization and lack of discharge

planning• Social factors (e.g., domestic violence,

physical & sexual abuse, alienation of individuals from families & friends)

Prevention Strategies

• Shelter allowances for the working poor• Rent banks for short-term loans• Databases of affordable housing• Legal assistance• Enforce anti-discrimination legislation• Welfare recipients need funding for first & last

month’s rent.• Individual support & counselling• Community economic development

Homelessness in Girls & Young Women(data from Novac, Serge, Eberle & Brown, 2002)

• Among a sample of Ottawa shelter users, more young women than men cited parental abuse as the reason for homelessness (25% vs. 11%) or had been abused (31% vs. 14%)

• 2,150 single women (out of a total of 6,310 youth) used Toronto shelters in 1999. The total number of shelter beds increased by almost 600 beds from December 2000 to February 2001, totaling 3,075 beds (plus another 169 places available through the Out of the Cold Program and another 90 during cold weather alerts.

Homelessness in Girls & Young Women

• A Montreal study found:– More females than males stayed with

relatives/friends. Fewer females than males were on the street—they used personal networks to avoid visible homelessness

– More females than males engaged in prostitution– Most of the younger females had prior involvement

with the child welfare system– Early school leaving was common (half the

females 18-25 had not finished high school

Homelessness in Girls & Young Women

• Montreal study:– Family poverty only moderately associated with

homelessness (the majority reported that their families did not have financial problems)

– Over-representation of aboriginal youth– Illicit activities were common (e.g. drug dealing, shoplifting,

etc.)– More young women than men had no source of income

(44% vs. 5%). They were less likely than men to have received financial assistance from relatives (3% vs. 23%) or received social assistance (36% vs. 48%)

Health Issues

• Homeless youth are more likely to have problems with:– Respiratory tract infections– STDs– Skin infections– Substance abuse– Trauma– Hepatitis B infections– HIV/AIDS– Dental disease– Pregnancy

Health Issues

• A Toronto study found that more than half of female street youth had attempted suicide and suffered from clinical depression.

• A Montreal study found 35% of homeless youth had attempted suicide, 63% reported suicidal thoughts, and 9% reported severe depression.

• Alcohol and drug use were higher in a Toronto sample of homeless youth than in a nonhomeless group.

• A Calgary study found that 71% of homeless youth were involved in delinquency (stealing, burglary, shoplifting).

Homelessness in Toronto (1999)

• Hostel users: 71% male, 29% female• 26,000 people used Toronto hostels in 1996• 3,200 people use hostels on any given night

(the number is higher in the winter)• 170,000 used shelters between 1988-1996• Fastest growing group of hostel users are

youth under the age of 18 and families with children

• 1988: 24% of households in hostel system were headed by women

• 1996: 37% of households in hostel system were head by women

• 5,300 children were homeless in 1996 (that constitutes 19% of the homeless population)

• Between 30-35% of homeless are mentally ill• An estimated 754% of homeless, single

women are mentally ill

Homelessness in Toronto

Homelessness in Toronto

• 4,400 people in 1996 (17% of hostel users) stayed in the hostel system one or more years

• This chronic group occupies 46% of the hostel beds• 47% of hostel users come from outside of Toronto• >100,000 people are on the waiting list for social

housing in Toronto• >31,000 children are on the waiting list—at current

placement rate, families would have to wait 17 years to obtain housing

• Poverty is increasing for those on the waiting list> 1/3 have incomes <$800/month

Child Poverty in Toronto

• Incidence of child poverty in Toronto is double that of the rest of Ontario

• More than one in three children in Toronto are poor (37.7% of children under 12 yrs.)

• 15,000 children are waiting for subsidized child care spaces, 21,500 more spaces are needed for the Ontario Works programme

• The number of children in need of food relief in Toronto has almost doubled from 32,000 in 1989 to more than 60,000 in 1998

Causes of Homelessness

• Increased poverty• Lack of affordable housing• Deinstitutionalization and lack of discharge

planning• Social factors (e.g., domestic violence,

physical & sexual abuse, alienation of individuals from families & friends)

Prevention Strategies

• Shelter allowances for the working poor• Rent banks for short-term loans• Databases of affordable housing• Legal assistance• Enforce anti-discrimination legislation• Welfare recipients need funding for first & last

month’s rent.• Individual support & counselling• Community economic development

Homelessness in Girls & Young Women(data from Novac, Serge, Eberle & Brown, 2002)

• Among a sample of Ottawa shelter users, more young women than men cited parental abuse as the reason for homelessness (25% vs. 11%) or had been abused (31% vs. 14%)

• 2,150 single women (out of a total of 6,310 youth) used Toronto shelters in 1999. The total number of shelter beds increased by almost 600 beds from December 2000 to February 2001, totaling 3,075 beds (plus another 169 places available through the Out of the Cold Program and another 90 during cold weather alerts.

Homelessness in Girls & Young Women

• A Montreal study found:– More females than males stayed with

relatives/friends. Fewer females than males were on the street—they used personal networks to avoid visible homelessness

– More females than males engaged in prostitution– Most of the younger females had prior involvement

with the child welfare system– Early school leaving was common (half the

females 18-25 had not finished high school

Homelessness in Girls & Young Women

• Montreal study:– Family poverty only moderately associated with

homelessness (the majority reported that their families did not have financial problems)

– Over-representation of aboriginal youth– Illicit activities were common (e.g. drug dealing, shoplifting,

etc.)– More young women than men had no source of income

(44% vs. 5%). They were less likely than men to have received financial assistance from relatives (3% vs. 23%) or received social assistance (36% vs. 48%)

Health Issues

• Homeless youth are more likely to have problems with:– Respiratory tract infections– STDs– Skin infections– Substance abuse– Trauma– Hepatitis B infections– HIV/AIDS– Dental disease– Pregnancy

Health Issues

• A Toronto study found that more than half of female street youth had attempted suicide and suffered from clinical depression.

• A Montreal study found 35% of homeless youth had attempted suicide, 63% reported suicidal thoughts, and 9% reported severe depression.

• Alcohol and drug use were higher in a Toronto sample of homeless youth than in a nonhomeless group.

• A Calgary study found that 71% of homeless youth were involved in delinquency (stealing, burglary, shoplifting).

Homelessness in Canada

• Statistics Canada estimates that more than 10,000 people are homeless in Canada

• A Toronot survey (1997) of 300 shelter users found that 2/3 reported a lifetime diagnosis of mental illness (4% was the least reported factor for becoming homeless)

• Loss of job or insufficient funds to pay rent was the main reason given for homelessness (34%)

Measuring Homelessness

• No widely accepted definition of homeless exists

• Differing sampling methods in different cities can result in over- or underestimating the number of homeless

• The homeless may be difficult to reach (e.g., youth)

• Data are collected at different times of the year, but seasonal variation exists

• Homeless is more common in certain groups (e.g., aboriginal peoples)

Aboriginal Peoples and Homelessness

• Hamilton: Aboriginals comprise 1.3% of Hamilton’s population, but represent 20% of its homeless

• Vancouver: Aboriginals comprise 2% of the population, but represent 30% of the homeless

Pathways to Homelessness

• Housing costs• Decline in new rental

housing, low vacancy rates

• Long waiting lists for subsidized housing

• Poverty• Loss of employment• Mental health &

addictions

Mental Health & Homelessness

• Reported stress levels are higher in the homeless

• Coping and substance abuse

• Social support• Self-esteem• Suicidal behaviours• Schizophrenia &

personality disorder• Substance abuse• Depression

Richmond Street, Toronto

Mental Health & Homelessness

• Toronto: 2/3 of homeless reported having received a diagnosis of mental illness at some point during their lifetime; 25% reported receiving psychiatric outpatient services in past year

• New York City: homeless schizophrenic men were less likely to receive discharge planning, aftercare & finances than nonhomeless men

Mental Health & HomelessnessSchizophrenia & Personality Disorder

• Less than 1% of adults in the general population reported being diagnosed as schizophrenic

• Toronto: 6% of shelter users reported a psychiatric disorder (usually schizophrenia)

• Vancouver: 19% of shelter users were diagnosed with psychiatric condition; about a quarter of those were schizophrenic

• 29% of shelter users met criteria for anti-social personality (often with another condition—depression, PTSD

• Homeless youth: 24% met criteria for PT

Mental Health & HomelessnessSchizophrenia & Personality Disorder

• Less than 1% of adults in the general population reported being diagnosed as schizophrenic

• Toronto: 6% of shelter users reported a psychiatric disorder (usually schizophrenia)

• Vancouver: 19% of shelter users were diagnosed with psychiatric condition; about a quarter of those were schizophrenic

• 29% of shelter users met criteria for anti-social personality (often with another condition—depression, PTSD

• Homeless youth: 24% met criteria for PTSD;

Mental Health & HomelessnessSubstance Abuse & Concurrent Disorders

• Toronto: 68% of shelter users reported a lifetime diagnosis of substance abuse or dependence

• Vancouver: 44% of homeless reported marijuana & cocaine use within past month

• Edmonton: 40% & 55% of homeless youth reported drinking alcohol and using marijuana at least 2 or 3 times a week. 55% reported using either cocaine, heroin, amphetamines or tranquilizers in past year

Mental Health & HomelessnessDepressive Symptoms & Major Depressive

Disorder• Ottawa: homeless youth were more likely (39%) to

report depressive symptoms than nonhomeless youth (20%). 33% of adult homeless reported mental health problems (20% were depression)

• Kitchener-Waterloo: 48% of street youth reported a decrease in their depression level since leaving home; 28% reported an increase

• Northeast US city: 12% of homeless youth reported depression; rates were higher for females (20% vs. 7% for males). 73% reported they experienced their 1st depressive episode before leaving home

Mental health & behavioural disorders were the most common reason for ER/ED visits by the homeless, but were not in the top 5 for the nonhomeless. These conditions accounted for 35% of the visits by the homeless.

Reasons for Hospital Admission in the Homeless

• Psychoactive substance use (54%)

• Psychoactive substance use predominated for men (62%), but was only 32% for women

• Schizophrenia & delusional disorders (20%)

• Schizophrenia & delusional disorders were 28% for homeless women, 18% for homeless men