Determinants of suicidal ideation and suicide attempt among former and currently homeless individuals
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ORIGINAL PAPER
Determinants of suicidal ideation and suicide attempt among former and currently homeless individuals Lia Gentil1,2 · Guy Grenier1 · Marie‑Josée Fleury1,2 Received: 11 June 2020 / Accepted: 1 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purposes This study identified determinants associated with suicidal ideation, suicide attempt and no suicidal behavior in a 12-month period among 455 former or currently homeless individuals in Quebec (Canada). Methods Study recruitment took place in 27 organizations located in two major Quebec urban areas, where services for homelessness are offered. Independent variables including clinical, socio-demographic, and service use/outcome variables were measured with eight standardized instruments. Significant associations between these variables and suicidal ideation or attempt in bivariate analyses were produced to build a multinomial logistic regression model using a block approach. Results Of 455 participants, 72 (15.8%) reported suicidal ideation and 30 (6.6%) suicide attempt, while 353 (77.6%) had not experienced suicidal behavior. Suicide ideation was particularly high among those with generalized anxiety disorder and substance use disorders, and suicide attempt even higher. Participants with higher functional disability and hospitalizations had a higher incidence of suicide attempt, whereas participants with schizophrenia spectrum and other psychotic disorders, those placed in foster care during childhood and with higher stigma scores experienced more suicidal ideation. Conclusions Suicidal ideation and suicide attempt among currently or recently homeless individuals were both strongly associated with clinical variables. Based on the study results, specific interventions may be promoted to improve screening of homeless individuals with suicidal behavior and prevent hospitalization such as training programs and brief care management interventions, addiction liaison nurses, improved access to primary or specialized ambulatory services, and further development of case management and outreach programs for homeless individuals, especially those with functional disabilities. Keywords Suicidal ideation · Suicide attempt · Determinants · Homelessness
Introduction Individuals experiencing homelessness are affected by multiple health and social problems which decrease their life expectancy [1, 2]. They show higher proportions of suicidal ideation, suicide attempt and death by suicide than the general population [1]. In fact, they completed suicide ten times more than the general population according to a Canadian study [3], which represents 6% of all deaths in this population [4]. A recent meta-analysis [5] that assessed 20 studies, * Marie‑Josée Fleury [email protected] 1
Douglas Hospital Research Centre, Douglas Mental Health University Institute, 6875 LaSalle Blvd., Montreal, QC H4H 1R3, Canada
Department of Psychiatry, McGill University, Montreal, QC, Canada
2
including 27,497 homeless individuals in tot
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