Determinants of Unmet Mental Healthcare Needs of Single Adults Who Are Homeless or Vulnerably Housed

Abstract

Persons who are homeless experience higher levels of mental illness, unmet mental healthcare needs, and physical healthcare needs than the general population. This study aimed (1) to determine the reasons contributing to having unmet mental healthcare needs (UMHCN) and (2) to examine the determinants of UMHCN among a representative sample of adults who are homeless or vulnerably housed in three Canadian cities (N=1190). Almost a quarter (23.3%) of the sample reported UMHCN in the past year. The reported reasons for having UMHCN pertained especially to the availability (31.5%), accommodation (22.1%), and acceptability (21.3%) of services. Age, city, and need-for-care variables were associated with UMHCN in multivariate analysis. Implications of the findings for policy and program planning are discussed. Les personnes sans-abri présentent des niveaux plus élevés de maladie mentale, de besoins de soins de santé et de besoins non comblés de soins de santé mentale que la population générale. Cette étude visait (1) à déterminer les raisons des besoins non comblés des soins de santé mentale (BNCSM) et (2) à examiner les déterminants des BNCSM auprès d›un échantillon représentatif d›adultes sans-abri ou logés de façon précaire dans trois villes canadiennes (N = 1190). Près d›un quart (23,3%) de l›échantillon a rapporté des BNCSM lors de l›année passée. Les raisons principales des BNCSM portaient sur la disponibilité (31,5%), l’accommodement (22,1%), et l›acceptabilité (21,3%) des services. L’âge, la ville et les besoins de soins étaient les variables associées aux BNCSM en analyse multivariée. Les implications des résultats pour la planification des services et le développement des politiques sont discutées.

Perceived unmet substance use and mental health care needs of acute care patients who use drugs: A cross‐sectional analysis using the Behavioral Model for Vulnerable Populations

“…Predisposing factors are non-modifiable sociostructural indicators related to service seeking and satisfaction [15]. We included age [7,24], identifying as a woman [25] and identifying as Indigenous (First Nations, Métis, Inuit) [7]. We also included recent involvement in criminal activity [26] and adverse childhood experiences (ACE) [27].…”

“…Need factors included health conditions of particular relevance to service seeking and satisfaction for PWUD compared to the general population [15]. This included self‐reported past 6‐month injection drug use, injection and/or non‐injection opioid or stimulant use [31], positive depression screening [24], and self‐reported HIV and/or hepatitis C (HCV) seropositivity [31]. HIV and HCV were combined as HIV's cell size was small and nested.…”

Homelessness and Vulnerably-Housed Defined: A Synthesis of the Literature

“…Additionally, those at risk of losing their current housing accommodations were an inclusion criterion in one study (Purkey & MacKenzie, 2019), which aligns with the extrapersonal stressor of recent housing history from the definition of VH. Argintaru et al, 2013;Duhoux et al, 2017;Ecker & Aubry, 2016;Gadermann et al, 2020;Harris et al, 2019;Hunter et al, 2015;Hwang et al, 2011a;Jaworsky et al, 2016;Magee et al, 2019;Nikoo et al, 2017;Palepu et al, 2013;To et al, 2015;To et al, 2016a;To et al, 2016b;Walsh et al, 2019;Zhang et al, HHiT study Argintaru et al, 2013;Duhoux et al, 2017;Ecker & Aubry, 2016;Gadermann et al, 2020;Harris et al, 2019;…”

Improving the Response to People Experiencing Homelessness and Psychoactive Substance Use in Montreal: A Systemic and Intersectoral Perspective

“…The chronicity of homelessness is also exacerbated among people experiencing homelessness who use psychoactive substances (Cheng et al, 2016;Latimer & Bordeleau, 2019;. In addition, PSU often leads to additional stigma and barriers to accessing the various services available to them, including those in homelessness (Alunni-Menichini et al, 2020;Argintaru et al, 2013;Brener et al, 2010;Duhoux et al, 2017;Moore et al, 2011;Raven et al, 2010). For example, the requirement of abstinence as a criterion for admission is a significant barrier to access faced by these individuals (Alunni- Duhoux et al, 2017).…”

“…In addition, PSU often leads to additional stigma and barriers to accessing the various services available to them, including those in homelessness (Alunni-Menichini et al, 2020;Argintaru et al, 2013;Brener et al, 2010;Duhoux et al, 2017;Moore et al, 2011;Raven et al, 2010). For example, the requirement of abstinence as a criterion for admission is a significant barrier to access faced by these individuals (Alunni- Duhoux et al, 2017). One of the consequences is that they do not perceive their needs as being met (Argintaru et al, 2013;Baggett et al, 2010;Duhoux et al, 2017;Lebrun-Harris et al, 2013).…”