Protecting the mental health of people experiencing homelessness

Homelessness is frequently stressful and traumatic, and many people who experience it struggle with the impacts it has on their mental health. While providing housing stability must always be a priority, it is also important to provide people experiencing homelessness with tools and strategies to maintain their mental health. Resilience, defined as the ability to adapt to adversity, trauma, or significant stress, is an important tool for staying mentally healthy. In their recently published study, Dr. Anna Durbin and her co-authors set out to determine if having greater resilience levels helped improve mental health and, by extension, the quality of life of those experiencing homelessness

What motivated this research?

AD: Lead author Prof. Cilia Mejia‑Lancheros and I were motivated to conduct this study because individuals experiencing homelessness are generally exposed to stressful conditions, such as lack of safety or a private space and loss of social networks.  Additional traumatic and stressful experiences such as victimisation, physical and sexual abuse, exposure to crime, and discrimination further compound the severe psychological challenges associated with homelessness. Still, the full benefits of increasing resilience for homeless adults are not well known, and we did not know if improving resilience would in turn improve quality of life and well-being.

What was the most important finding of this study, in your opinion?

AD: We found that higher resilience levels were associated with higher quality of life for adults experiencing homelessness and mental illness

How does this change treatment among adults experiencing homelessness and mental illness?

AD: Our findings mean that finding ways to increase resilience may help minimize the harmful effects of stressful experiences on homeless individuals. Finding ways to help homeless people enhance their resilience may have positive, lasting impacts on their mental health, substance use, and quality of life.  For homeless people, supports to increase resilience should be delivered in parallel to efforts that increase housing stability. 

Any next steps?

AD: Our next step will be to examine if resilience protects against suicidal thoughts and behaviours for people experiencing homelessness. This is a major issue as suicide is disproportionally high among this group, with rates of suicide and suicidal thoughts estimated to be up to 19 times higher among homeless populations than among the general population. However, among homeless adults, there has been very little examination of the relationship between resilience and suicide.

What is the major take home message for the public?

AD: We need to fully understand the benefits of resilience for homeless adults and youth and develop interventions and services that incorporate resilience-building mechanisms to help them maintain mental health in the face of adversity. While this study was conducted prior to the COVID-19 pandemic, knowledge of resilience building mechanisms for these groups will be especially important during and in the aftermath of the pandemic.

Mejia-Lancheros C, Woodhall-Melnik J, Wang R, Hwang SW, Stergiopoulos V, Durbin A. Associations of resilience with quality of life levels in adults experiencing homelessness and mental illness: a longitudinal study. Health Qual Life Outcomes. 2021 Mar 4;19(1):74. doi: 10.1186/s12955-021-01713-z.