Research demonstrates the devastating health impacts of homelessness, for individuals and all society.

Homelessness is a medical emergency, as we’ve long known from work on the ground.

Increasingly, research is reinforcing the knowledge from lived experience.

Most recently, this report, Association of Homelessness and psychiatric hospital readmission—a retrospective cohort study 2016–2020, from Vancouver, shows the connections between mental illness, homelessness and hospital admission.

Here is the bottom line.

“Homelessness was significantly associated with increased 30-day and 90-day readmission rates in a large comprehensive sample of adults with mental illness and substance use disorders. Interventions to reduce homelessness are urgently needed.”

And here are some of the critically important findings.

Hospital readmissions cost Canada $2.3 billion per year. Homeless patients have been found to be nearly four times more likely to be readmitted, and their subsequent care is more complicated and expensive.

The study involved 3,907 people admitted to hospital with an acute psychiatric admission.  The folks in the study were mostly male (62 per cent), with a severe mental illness (71 per cent), and 20 per cent had a substance use disorder with 19 per cent experiencing homelessness at the time of their admission.

The study shows there are a series of inter-related factors at play:

  • People with psychiatric conditions are more likely to experience homelessness.
  • Those experiencing homelessness experience far worse health and require more health and social services care.
  • People being discharged from hospital to the shelters and the streets are much more likely than other patients to be readmitted within a couple of months.
  • Their care is time consuming and expensive.
  • Housing is healthcare. (And collectively, reduces the strain on the healthcare system.)

The authors show that providing suitable housing for people experiencing homelessness and mental health and/or substance use diagnosis is both better for the health of the individual and saves money.

“Housing is considered a crucial social determinant of health and being homeless or unstably housed not only impacts the individual experiencing inequities, but also has substantial economic impacts.

“Latimer and colleagues conducted an economic analysis of public services received by people experiencing homelessness, addiction, and mental illness in Canada, concluding that costs ranged between $53,000 to $58,000 per person/per year in Canada’s three largest cities (Vancouver, Toronto and Montreal).

“Additionally, in Vancouver, 12–30 per cent of annual per person costs were directly related to psychiatric hospitalizations while less than 5 per cent of annual per-person costs went to supportive housing.”

Canada is facing a complex emergency of poverty, homelessness, drug use and an overburdened healthcare system. Providing supportive housing for people experiencing homelessness is the essential foundation for all these related harms and critical to reducing strain on the healthcare system.

We need to recognize how integral housing is to health.  And act urgently to address this crisis.