Monday, February 7, 2011

Youth Homelessness in the Greater Toronto Area

Dr Ruwan M Jayatunge

Canada is one of the few countries in the world without a national housing strategy (United Nations, 2009). Surveys and statistics over the past three decades have repeatedly shown that the numbers of homeless people in Canada have been steadily increasing. Toronto is one of the cities that is facing the acute problem of homelessness. Youth Homelessness in the GTA has become one of the worst nightmares.

The United Nations have defined homelessness in two categories –that is absolute and relative. Absolute homelessness” describes the condition of people without physical shelter who sleep outdoors, in vehicles, abandoned buildings or other places not intended for human habitation. The term “Relative homelessness” describes the condition of those who have a physical shelter, but one that does not meet basic standards of health and safety; these include protection from the elements, access to safe water and sanitation, security of tenure, personal safety and affordability.

Each night about 8000 homeless people are sleeping in shelters in Toronto. Some do not seek such services and choose to spend the night in the streets. The terms “homeless youth” and “street youth” are used interchangeably to refer to teenagers and young people below the age of 20–25 years. These young people first leave home at a mean age of 15 years. About 75% of homeless youth in Toronto do not use shelters.

Barbara Murphy’s 1999 book entitled The Ugly Canadian: The Rise and Fall of a Caring Society points out that annually a considerable number of desperate youth come to live in the streets of the GTA.

Psychological Aspects of being homeless youth

There are various psychological reasons associated with youth homelessness. The youth do not select to live in the streets. The circumstances force them to do so.

Major psychological reasons are

1) Psychological trauma followed by physical and psychological abuse in the households – domestic violence and such abuses leads to PTSD, Rape Trauma Syndrome

2) Poverty and oppressive living conditions, forced evictions make youth insecure and put them to streets.

3) Lack of parental care, disintegration of family systems, divorces, separations, broken family ties give them no sense of belongingness and they become the drifters of the streets.

4) Mental illnesses -conduct disorders, depression, schizophrenia, BPAD, ATPD, push them to streets . (the serves indicate that 6% in Toronto, of the homeless population suffers from schizophrenia).

5) Alcohol, drugs and substance abuse make them consumers as well as drug pushers in the streets.

Homeless youth are psychologically vulnerable group. The basic problem of homelessness is associated with need for personal shelter, warmth and safety, which are essential to human beings. Being in the streets their psychological wellbeing is shattered. They face numerous psychosocial problems such as alienation, and social withdrawal.

The problems of personal security, which is a primal human need and most of the times, they are over vigilant and become hyper arousal. Some are highly reactive to provocations. They can be victims of street violence, targeted by the police and other authorities.

While living in the streets these youth are unable to relax, rest and being with one’s self. Unable to enjoy nature, silence. Cannot have privacy, no place to keep their possessions safe. The streets become their universe.

Being a street youth they are constantly moving and have no sense of attachment to one place. No permanent location or mailing addresses make them absolute drifters. They are unable to form appropriate human relationships with others. They can be victims of street violence. There have been many violent crimes committed against the homeless. A 2007 study found that the rate of such crimes is increasing. These youth can get sexually abused, can become the victims of forced prostitution and compelled to sell their bodies to avoid starvation.

Streets youth have severe hygiene problems and often avoided by the decent citizens who walk by. They are being rejected and feared by the society. Deterioration of physical health (TB risk / HIV risk/ STD risk / skin infections like scabies /chronic malnutrition) directly affect their physical as well as mental health parameters. In addition, extreme weather conditions -severe cold of Canadian winters, and heat waves in summers can deteriorate their overall health.

They begin to lose sense identity and self worth. Low self-esteem trouble them to a greater degree. Gradually they detach from the human touch. Basic trust becomes minimal. Hopelessness and despair sometimes lead them to commit self-harm or suicide.

The health care system may not adequately meet the needs of homeless people. Homeless people are at increased risk of dying prematurely and suffer from a wide range of health problems, including seizures, chronic obstructive pulmonary disease, musculoskeletal disorders, tuberculosis, and skin and foot problems. Homeless people also face significant barriers that impair their access to health care. Homeless people have high levels of morbidity and mortality and may experience significant barriers to accessing health care. (Homelessness and health -Stephen W. Hwang – Assistant Professor of Medicine, Division of General Internal Medicine, University of Toronto).

The incidence of active TB among homeless people in Toronto is 71 per 100 000 (about 10 times the average Ontario rate). Sexual and reproductive health is a major issue for street youth. Common risk factors for HIV infection in homeless youth in Canada include prostitution, multiple sexual partners, inconsistent use of condoms and injection drug use. Sexually transmitted diseases are widespread, even among street youth who do not work as prostitutes; gonorrhea and Chlamydia are the most prevalent infections.

Violence is a constant threat to the health of homeless people. A survey in Toronto found that 40% of homeless individuals had been assaulted and 21% of homeless women had been raped in the previous year. Homeless men are about 9 times more likely to be murdered than their counterparts in the general population. Unintentional injuries are a leading cause of morbidity and mortality, especially among homeless men. Injuries are often the result of falls or being struck by a motor vehicle.

Exposure to the elements is a major hazard. In cold weather, the risk of frostbite and hypothermia is substantial, and deaths due to freezing are not uncommon. In hot weather, severe sunburn and heatstroke can occur. The health concerns of the street youth living in the GTA have been neglected for a greater deal.

Street youth often treated as misfits and very high discrimination is imposed on them. Most of the civilized citizens do not want to interact with them. No employer wants to hire them. They are not welcomed to the coffee shops although they carry legal tender to pay for their coffee like anyone else. Their social skills are limited; they are unable to learn new skills. This becomes a vicious cycle and they become trapped and unable to free themselves from the streets even when they get support from the social service agencies.

The bad experiences that they underwent at the streets often hound them and they have already lost the sense of trust. They do not have faith in the justice system, low and enforcement and even social service agencies. By living in the streets for a long time they get use to the existing environment and make no active effort to change the situation.

How they fit in to the society is not a dilemma question. They were part of the society and still they are even though they have been rejected by the mainstream. The research and other ground experiences elsewhere have shown that with proper psychosocial care they can successfully integrate in to the society.

They can be rehabilitated and turned in to productive citizens. The first stages of transformation might be somewhat difficult. Establishing trust and respect, empathy and caring hand can change the negative effects and the experiences that they underwent as street youth. It is highly essential to breakdown the vicious cycle that keep them in the streets. Teaching them new skills and vocational training would help them to have a positive change in their lives.

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