Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed action
Objectives Indigenous people in Canada are not only over-represented among the homeless population but their pathways to homelessness may differ from those of non-Indigenous people. This study investigated the history and current status of Indigenous and non-Indigenous people experiencing homelessne...
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BMJ Publishing Group
2019-04-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/4/e024748.full |
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| author | Brittany Bingham Akm Moniruzzaman Michelle Patterson Jino Distasio Jitender Sareen John O’Neil Julian M Somers |
| author_facet | Brittany Bingham Akm Moniruzzaman Michelle Patterson Jino Distasio Jitender Sareen John O’Neil Julian M Somers |
| author_sort | Brittany Bingham |
| collection | DOAJ |
| description | Objectives Indigenous people in Canada are not only over-represented among the homeless population but their pathways to homelessness may differ from those of non-Indigenous people. This study investigated the history and current status of Indigenous and non-Indigenous people experiencing homelessness and mental illness. We hypothesised that compared with non-Indigenous people, those who are Indigenous would demonstrate histories of displacement earlier in life, higher rates of trauma and self-medication with alcohol and other substances.Design and setting Retrospective data were collected from a sample recruited through referral from diverse social and health agencies in Winnipeg and Vancouver.Participants Eligibility included being 19 years or older, current mental disorder and homelessness.Measures Data were collected via interviews, using questionnaires, on sociodemographics (eg, age, ethnicity, education), mental illness, substance use, physical health, service use and quality of life. Univariate and multivariable models were used to model the association between Indigenous ethnicity and dependent variables.Results A total of 1010 people met the inclusion criteria, of whom 439 self-identified as Indigenous. In adjusted models, Indigenous ethnicity was independently associated with being homeless at a younger age, having a lifetime duration of homelessness longer than 3 years, post-traumatic stress disorder, less severe mental disorder, alcohol dependence, more severe substance use in the past month and infectious disease. Indigenous participants were also nearly twice as likely as others (47% vs 25%) to have children younger than 18 years.Conclusions Among Canadians who are homeless and mentally ill, those who are Indigenous have distinct histories and current needs that are consistent with the legacy of colonisation. Responses to Indigenous homelessness must be developed within the context of reconciliation between Indigenous and non-Indigenous Canadians, addressing trauma, substance use and family separations.Trial registration number ISRCTN42520374, ISRCTN57595077, ISRCTN66721740. |
| format | Article |
| id | doaj-art-86417f5a989f43e3bd87e5bb9b70b7ea |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-86417f5a989f43e3bd87e5bb9b70b7ea2025-02-04T02:05:13ZengBMJ Publishing GroupBMJ Open2044-60552019-04-019410.1136/bmjopen-2018-024748Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed actionBrittany Bingham0Akm Moniruzzaman1Michelle Patterson2Jino Distasio3Jitender Sareen4John O’Neil5Julian M Somers6Faculty of Medicine, Division of Social Medicine, University of British Columbia, Vancouver, British Columbia, Canada1 Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, CanadaProvincial Population and Public Health, Alberta Health Services, Calgary, Alberta, Canada2 Geography, University of Winnipeg, Winnipeg, Manitoba, Canada4 Departments of Psychiatry, Psychology and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada1 Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada1 Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, CanadaObjectives Indigenous people in Canada are not only over-represented among the homeless population but their pathways to homelessness may differ from those of non-Indigenous people. This study investigated the history and current status of Indigenous and non-Indigenous people experiencing homelessness and mental illness. We hypothesised that compared with non-Indigenous people, those who are Indigenous would demonstrate histories of displacement earlier in life, higher rates of trauma and self-medication with alcohol and other substances.Design and setting Retrospective data were collected from a sample recruited through referral from diverse social and health agencies in Winnipeg and Vancouver.Participants Eligibility included being 19 years or older, current mental disorder and homelessness.Measures Data were collected via interviews, using questionnaires, on sociodemographics (eg, age, ethnicity, education), mental illness, substance use, physical health, service use and quality of life. Univariate and multivariable models were used to model the association between Indigenous ethnicity and dependent variables.Results A total of 1010 people met the inclusion criteria, of whom 439 self-identified as Indigenous. In adjusted models, Indigenous ethnicity was independently associated with being homeless at a younger age, having a lifetime duration of homelessness longer than 3 years, post-traumatic stress disorder, less severe mental disorder, alcohol dependence, more severe substance use in the past month and infectious disease. Indigenous participants were also nearly twice as likely as others (47% vs 25%) to have children younger than 18 years.Conclusions Among Canadians who are homeless and mentally ill, those who are Indigenous have distinct histories and current needs that are consistent with the legacy of colonisation. Responses to Indigenous homelessness must be developed within the context of reconciliation between Indigenous and non-Indigenous Canadians, addressing trauma, substance use and family separations.Trial registration number ISRCTN42520374, ISRCTN57595077, ISRCTN66721740.https://bmjopen.bmj.com/content/9/4/e024748.full |
| spellingShingle | Brittany Bingham Akm Moniruzzaman Michelle Patterson Jino Distasio Jitender Sareen John O’Neil Julian M Somers Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed action BMJ Open |
| title | Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed action |
| title_full | Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed action |
| title_fullStr | Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed action |
| title_full_unstemmed | Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed action |
| title_short | Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed action |
| title_sort | indigenous and non indigenous people experiencing homelessness and mental illness in two canadian cities a retrospective analysis and implications for culturally informed action |
| url | https://bmjopen.bmj.com/content/9/4/e024748.full |
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