Characteristics of Adults With Addictions and Mental Health Problems Who Have Experienced Homelessness: A Population-Based Study From Alberta, Canada: Caractéristiques des adultes aux prises avec des problèmes de dépendance et de santé mentale et ayant connu l'itinérance : une étude fondée sur la population de l'Alberta, Canada.

Objective: This study seeks to understand the characteristics of individuals with addictions and other mental health (AMH) conditions who had a history of homelessness compared to those who did not experience homelessness.

Method: This cross-sectional analysis used linked administrative data from Alberta, Canada on April 1, 2018. People with AMH who experienced homelessness in the year prior to index were identified using hospitalisations and emergency department (ED) visits. We used multivariable logistic regression to evaluate the association between a set of descriptive variables and homelessness, adjusted for age and sex.

Results: Among the 622,614 individuals with AMH conditions, 3,390 (0.54%) had an indicator of homelessness. People experiencing homelessness (PEH) were younger (mean = 39 vs. 42 years, p < .001) and more frequently male (66% vs. 41%, p < .001) than individuals not experiencing homelessness. PEH were also more likely to be diagnosed with multiple AMH disorders (44.8% diagnosed with ≥ 4 AMH conditions vs. 3.8% of individuals without homelessness). PEH were more likely to have a history of visiting a psychiatrist (adjusted odds ratio (AOR) = 8.11, 95% CI [7.47-8.80], having an ED visit for AMH reasons (AOR = 25.44, 95% CI [22.94-28.21], and to have been hospitalised for AMH reasons (AOR = 13.53, 95%CI [12.61-14.52]).

Conclusions: Within the population of individuals with diagnosed AMH conditions, PEH demonstrated increased AMH complexity, greater healthcare utilisation and a greater likelihood of almost all AMH disorders. Given the complex mental health needs of this group, they will require more intensive mental health and general medical services that must be integrated with housing and additional social support systems.