Mental Health Care for Homeless Youth: A Proposal for Federal, Provincial, and Territorial Leadership, Coordination, and Targeted Investment

With the release of Without a Home: The National Youth Homelessness Survey (2016), we now have national data on youth homelessness for the first time in Canada. The mental health findings of this report are startling:

• 85.4% of homeless youth were experiencing a mental health crisis
• 42% of homeless youth reported at least one suicide attempt
• 35.2% of homeless youth reported having at least one drug overdose requiring hospitalization

Youth experiencing the most severe mental health challenges include LGBTQ2S youth, Indigenous youth, and young women. LGBTQ2S youth and Indigenous youth are also more likely to attempt suicide, become homeless at a young age, and have multiple experiences of homelessness.

Falling Short: Youth Homelessness as Systems Failure

Homeless youth in Canada often struggle to access appropriate services that are equipped to support the co-occurring mental health and addictions challenges they face. This is an issue of failed systems and poor coordination across systems. Barriers to appropriate supports include:

Variable quality and responsiveness of care, including long waitlists

• The segregation of different care systems (e.g., education, health, and social services), and lack of coordination and integration among existing services
• Lack of funding and funding disparities, resulting in organizations that are understaffed, lack clinical resources, and are overwhelmed
• A focus on emergency care and response, rather than prevention

The Need for Government Action to Address the Mental Health Needs of Homeless Youth

While mental health and housing status are intimately linked, our policies and programs have been insufficiently funded and coordinated to enable effective, timely, and appropriate care for some of the most marginalized young people in our country. In order to prevent and end youth homelessness in Canada and address the mental health needs of youth who are homeless, two key government actions must be taken:

• Federal implementation of a youth homelessness strategy embedded within the renewed federal investment in homelessness, with a special focus on mental health and wellness.
• Provincial and territorial implementation of provincial/territorial strategies to prevent and end youth homelessness, ensuring that the mental health needs of youth at a high risk of homelessness and experiencing homelessness are addressed both through these targeted strategies and the federal mental health transfer funds.

By employing a systems approach, these efforts can address the need for improved coordination and collaboration across services and sectors to best meet the needs of youth who are homeless. Government leadership and investment in this area will position Canada as an international leader on youth homelessness, youth mental health, and systems integration.

Why Now?

• Suicide and drug overdose are the leading causes of death for young Canadians who are homeless
• Improving a child’s mental health from moderate to high can lead to a lifetime savings of $140,000
• New federal health transfer funds provide provinces and territories the opportunity to invest in mental health services for marginalized youth
• Increasing numbers of communities across Canada are adopting youth homelessness strategies
• The federal government has declared youth a key priority
• The economic cost of mental health problems and illnesses to Canada is at least $50 billion per year in lost productivity
• The federal government’s re-investment in HPS provides a crucial opportunity to address youth homelessness

Recommendations for Government

Government of Canada

1. Federal leadership in the development and implementation of a National Youth Homelessness Strategy to prevent and end youth homelessness, supported by a targeted investment.
2. Federal prioritization and support for systems integration at the provincial, territorial, and community levels to address the mental health needs of youth experiencing homelessness.
3. Federal support for program models that focus on prevention and rapid exits from homelessness for youth, within which strategies for addressing the mental health needs of youth should be embedded.
4. Federal adoption of a youth-centered approach to addressing youth homelessness, grounded in human rights.
5. Federal commitment to addressing the unique needs of diverse youth experiencing homelessness, as reflected in both policy and funding.
6. Federal adoption of a national research strategy focused on youth homelessness in order to advance an integrated systems response, within which a mental health strategy is embedded in all elements.

Provincial and Territorial Governments

1. Provincial and territorial development and implementation of strategies to prevent and end youth homelessness, supported by a targeted investment.
2. Provincial and territorial prioritization and support for systems integration in all efforts to address the mental health needs of youth experiencing homelessness.
3. Provincial and territorial support for program models that focus on prevention and rapid exits from homelessness, within which strategies for addressing the mental health needs of youth should be embedded.
4. Provincial and territorial adoption of a youth-centered approach to addressing youth homelessness, grounded in human rights.
5. Provincial and territorial commitment to ensuring that all provincial, territorial, and community strategies and program responses address the unique needs of diverse youth experiencing homelessness.
6. Provincial and territorial knowledge development and data management specific to youth homelessness in order to advance an integrated systems response, with a special focus on youth’s mental health and wellness.