Service restrictions refer to temporary or permanent bans of individuals from a program or an organization's services, and are widely used in emergency shelter systems. Limited research exists on how service restrictions unfold and their impacts on people experiencing homelessness. This qualitative study used in-depth interviews with timeline mapping to examine the antecedents and consequences of service restrictions from emergency shelters among people experiencing homelessness in two cities in Ontario, Canada. A total of 49 people experiencing homelessness who had been restricted from an emergency shelter program in the past year were recruited and included in the study analysis. A pragmatic and integrative approach was used for data analysis that involved the development of meta-matrices to identify prominent and divergent perspectives and experiences with regard to service restriction antecedents and consequences. Study findings underscored that service restrictions were often the result of violence and aggression, primarily between service users. There were regional differences in other service restriction reasons, including substance use and possession. Service restrictions affected the shelter status of almost all participants, with many subsequently experiencing unsheltered homelessness, and cycling through institutional health, social, and criminal justice services (i.e., institutional circuitry). Other health and social consequences included substance use relapses and hospitalizations; cold-related injuries due to post-restriction unsheltered homelessness; suicidality; food insecurity; diminished contact with support network and connections; and intense feelings of anger, fear, and hopelessness. Overall, the study findings advance our understanding of the role of homeless services in pathways into unsheltered homelessness and institutional circuitry, which raise critical questions about how to mitigate the harms associated with service restrictions, while concurrently facilitating safety and upholding the rights of people experiencing homelessness and emergency shelter staff.

Background: There is conflicting evidence on the suicide rates of different public safety personnel (PSP). There have been few studies that compare suicides in PSP with the general population and none that have used a detailed comparison of coroner records. Aims: The current study estimates suicide rates among different PSP and compares PSP suicides with the general population. Method: We identified coroner records of PSP suicides from January 2014 to December 2018 and compared each one to two matched general population controls. Results: We identified 36 PSP suicides and 72 general population controls. Police had a higher suicide rate than other PSP groups. PSP were more likely to die by firearm, be separated/divorced or married, die in a motor vehicle, have problems at work, and have a PTSD diagnosis. PSP were less likely to die by jumping. Limitations: The study may have not identified all PSP suicides. Apart from the cause of death, data in coroner records are not systematically collected, so information may be incomplete. Conclusion: PSP suicides appear different than the general population. Death records need to have an occupation identifier to enable monitoring of trends in occupational groups, such as PSP.

We aimed to determine the mental health and cognitive outcomes at six months in people who had not been hospitalized with COVID-19 and who had tested positive or negative for COVID-19 in Eastern Ontario, Canada. Participants were matched 1:1 six months following their COVID-19 polymerase chain reaction test. X2, t-test, and Mann–Whitney U tests were conducted to compare self-report and observer-rated mental health and cognitive outcomes between the two groups. We also conducted an age and gender-adjusted logistic regression analysis to explore risk factors associated with depression, anxiety, and cognitive impairment among those who had tested positive for COVID-19. A total of 324 participants were enrolled (n = 162 per arm). Overall, 40.7% of those in the COVID-positive group were men, with an average age of 37.9 (SD 13.2) years. In the COVID-negative group, 41.4% were men, with an average age of 36.7 (SD 12.8). There were no statistically significant differences in mental health outcomes between the groups. On cognitive testing, while 21% of the COVID-positive participants and 14% of the COVID-negative participants had scores indicating significant cognitive impairment, the difference between groups was not significant, though this warrants further investigation in future research. In non-hospitalized patients who have tested positive for COVID-19, there is no evidence of an increase in mental health disorders compared to people who tested negative. Any increases in mental health disorders during the pandemic may be the effect of social changes rather than an effect of the virus itself. The exception may be the cognitive changes in those who tested positive.