title: Differential experiences of discrimination among ethnoracially diverse persons experiencing mental illness and homelessness.
abstract: BACKGROUND
  This mixed methods study explored the characteristics of and experiences with perceived discrimination in an ethnically diverse urban sample of adults experiencing homelessness and mental illness.
  
  
  METHODS
  Data were collected in Toronto, Ontario, as part of a 4-year national randomized field trial of the Housing First treatment model. Rates of perceived discrimination were captured from survey questions regarding perceived discrimination among 231 ethnoracially diverse participants with moderate mental health needs. The qualitative component included thirty six in-depth interviews which explored how individuals who bear these multiple identities of oppression navigate stigma and discrimination, and what affects their capacity to do so.
  
  
  RESULTS
  Quantitative analysis revealed very high rates of perceived discrimination related to: homelessness/poverty (61.5%), race/ethnicity/skin colour (50.6%) and mental illness/substance use (43.7%). Immigrants and those who had been homeless three or more years reported higher perceived discrimination on all three domains. Analysis of qualitative interviews revealed three common themes related to navigating these experiences of discrimination among participants: 1) social distancing; 2) old and new labels/identities; and, 3) 'homeland' cultures.
  
  
  CONCLUSIONS
  These study findings underscore poverty and homelessness as major sources of perceived discrimination, and expose underlying complexities in the navigation of multiple identities in responding to stigma and discrimination.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN42520374 . Registered 18 August 2009.
authors.affiliation: Centre for Research on Inner City Health, Li KaShing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, M5C 1N8, Canada. zergers@smh.ca.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Zerger
authors.affiliation: Centre for Research on Inner City Health, Li KaShing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, M5C 1N8, Canada. sarah.bacon@mail.utoronto.ca.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bacon
authors.affiliation: Université du Québec à Montréal, 405 Rue Sainte-Catherine Est, Montréal, Québec, H2L 2C4, Canada. Simon.corneau@gmail.com.
authors.forename: Simon
authors.initials: S
authors.lastname: Corneau
authors.affiliation: Centre for Research on Inner City Health, Li KaShing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, M5C 1N8, Canada. Skosanna@gmail.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Skosireva
authors.affiliation: Health Services and Health Equity Research, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada. Kwame.McKenzie@camh.ca.
authors.forename: Kwame
authors.initials: K
authors.lastname: McKenzie
authors.affiliation: Centre for Research on Inner City Health, Li KaShing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, M5C 1N8, Canada. susangapka@yahoo.ca.
authors.forename: Susan
authors.initials: S
authors.lastname: Gapka
authors.affiliation: Centre for Research on Inner City Health, Li KaShing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, M5C 1N8, Canada. O'CampoP@smh.ca.|Dalla Lana School of Public Health, University of Toronto, 55 College St, Toronto, ON, M5T 3M7, Canada. O'CampoP@smh.ca.
authors.forename: Patricia
authors.initials: P
authors.lastname: O'Campo
authors.affiliation: Across Boundaries: An Ethno-racial Mental Health Centre, 51 Clarkson Ave, Toronto (Ontario), M6E 2T5, Canada. aseefa@acrossboundaries.ca.
authors.forename: Aseefa
authors.initials: A
authors.lastname: Sarang
authors.affiliation: Centre for Research on Inner City Health, Li KaShing Knowledge Institute of St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, M5C 1N8, Canada. StergiopoulosV@smh.ca.|Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada. StergiopoulosV@smh.ca.
authors.forename: Vicky
authors.initials: V
authors.lastname: Stergiopoulos
mesh_terms: D000328:Adult; D005006:Ethnicity / Q000208:ethnology / Q000523:psychology; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000523:psychology*; D008875:Middle Aged; D009864:Ontario / Q000208:ethnology; D012929:Psychological Distance; D044469:Racial Groups / Q000208:ethnology / Q000523:psychology; D063505:Racism / Q000208:ethnology* / Q000523:psychology*; D057545:Social Stigma; D055815:Young Adult