Why Do Homeless People Commit Suicide?: Analysis of Mental Health and Substance Use As Risk Factors

Background: The impact of the economic recession has caused the number of homeless to increase dramatically. The rates of mental health and substance-related disorders of people experiencing homelessness were higher than in the general population. Also, mental health issues and substance use are significant risk determinants for suicide among homeless population. Based on the comprehensive literature review, this study tested two hypotheses. First, high levels of depressive symptoms and anxiety will be associated with an increase in suicidal ideation and attempts among homeless people. Second, high levels of drug abuse and alcohol abuse will be related to an increase in suicidal ideation and attempts among them.

Methods: This cross-sectional study used purposive and convenience sampling methods to recruit 156 adults experiencing homelessness from seven homeless shelters in Kansas. Face-to-face interviews were conducted from April to May, 2009. Respondents ranged in age from 19 to 72, with a mean of 41 years; 66% were male. Regarding ethnicity, 61.9% of the respondents were Caucasian, while 17.4% were African American. Never-married respondents comprised 39.1%, and 30% of the respondents were divorced. This study used the following scales: Center for Epidemiologic Studies Depression scale to measure depressive symptoms; Generalized Anxiety Disorder scale to measure anxiety; Drug Abuse Screening Test to measure drug abuse; Short Michigan Alcoholism Screening Test to measure alcohol abuse. Three different analytic methods were used to test the hypotheses. First, to analyze the demographic variables, the study implemented univariate descriptive statistics. Second, to gain the information of the basic correlation among main variables, a correlation matrix was used. Third, a logistic regression analysis was conducted to understand relationships between independent variables (depressive symptoms, anxiety, and drug and alcohol abuse) and dependent variables (suicidal ideation and attempt).

Results: The logistic regression results showed that people with anxiety were 1.17 times more likely than those without anxiety to have suicidal ideation (β = .15, p ≤ .05, OR = 1.17) and 1.32 times more likely have suicide attempts (β = .274, p ≤ .001, OR = 1.32). People with drug abuse were 1.24 times more likely than those without drug abuse to have suicidal ideation (β = .22, p ≤ .05, OR = 1.24).

Implications: The current findings highlight the importance of anxiety and drug abuse as significant risk factors for suicidal ideation and suicide attempt among homeless population. Based on the findings, we suggest that case managers at homeless shelters need to provide screening and referrals for treatment to people experiencing homelessness with substance abuse and mental health issues, such as anxiety. In a future study, a probability sampling method will be necessary for obtaining generalized findings in various states. In addition, a future study is recommended to include people under the age of 18 experiencing homelessness along with mental health and substance abuse problems.