1. In this meta-ethnography, basic human needs, psycho-emotional factors, and external social determinants demonstrated a role in the unmet mental health needs of homeless individuals.

2. Furthermore, stable housing was found to be foundational in improving all domains of mental health needs.

Evidence Rating Level: 2 (Good)

Over 200,000 individuals experience homelessness in Canada – many of which face significant barriers to basic human needs, as well as mental health needs. Currently, meta-ethnography studies have not focused specifically on the mental health needs of this population. As a result, the objective of the present meta-ethnography study was to elucidate the ways in which mental health needs are unmet for homeless individuals across a variety of settings.

Of 913 screened records across 2011 to 2021, 35 studies (n=1511) were included in the final analysis. Studies were included if they were conducted in Canada, used qualitative methods, and reported the subjective mental health needs of homeless individuals. Studies were excluded if they focused on service providers’ perspectives. Studies were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist and followed PRISMA guidelines. The thematic analysis framework was followed. Themes were interpreted by comparing and contrasting findings across a variety of settings.

Results demonstrated six themes that characterized the mental health needs of the homeless population: autonomy, ontological security, hope and purpose, social connection and belonging, empowerment, and access to services. Unmet health needs were revealed through personal narratives of trauma, stigmatization, victimization, and a lack of necessities. Stable housing was identified as a potential avenue to improve all domains of health needs; however, it did not always create a sense of home and community, or improve a sense of mental well-being. Despite these results, the study was limited by the restrictive search strategy which may have excluded additional articles, as well as generalizing findings from a subpopulation. Nonetheless, this study was significant in providing important implications for the development of social programs and on-site mental health support for people in Canada who are homeless or recently housed.

Click to read the study in Health and Social Care in the Community

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