Cody Evans describes one of the most harrowing nights he spent without a proper roof over his head.

It was wintertime, on a night his plans to crash on friend's couch fell through. His immediate surroundings, the Ancaster Meadowlands, provided little cover from the elements.

He sought shelter in a shed outside a hardware store. "I'm sitting there and the snow is coming through the vent. And I'm freezing."

But to Evans, the obvious alternative was simply not an option. Then a teen, he'd bounced between stints in shelters and living on his own, and vowed never to sleep in a shelter bed again.

Mental Health 101: Youth and the Hidden Crisis in Our Community

Where: McIntyre Performing Arts Centre, Mohawk College

When: Oct. 24, doors open at 7 p.m., town hall session from 7:30 to 8:30 p.m.

Cost: Free

The event will also be streamed live at cbc.ca/mentalhealth101. You can also visit the site to read the other stories in our series.

"I'd be too paranoid to sleep in the same room with people I don't know," said Evans, who has post-traumatic stress disorder, attention deficit hyperactivity disorder (ADHD) and a non-verbal learning disability.

Like many homeless and street-involved youth, Evans, now 23, has struggled with serious mental health problems for much of his life. He grew up in a single-parent family, and said his mother, though she tried to get Evan professional help, wasn't capable of addressing his needs. Frustrated with his home life, Evans struck out on his own at age 16.

The prevalence of mental health issues among homeless and street-involved youth is extremely high, said Loretta Hill-Finamore, director of youth services for the Good Shepherd, which manages Notre Dame House, a Hamilton youth shelter.

"Last year, we saw 701 youths come through the program. Over half were identified as having mental health issues."

The relationship between mental health and youth homelessness is a close but complicated one, according to Sheila Harms, a child and youth psychiatrist with McMaster Children's Hospital who works with homeless and street-involved youth.

Mental health and homelessness

"It's a really interesting question of the chicken or the egg."

"A lot of the young people I've been working with have pre-existing mental health issues that would have been identified in early childhood — learning disabilities, ADHD, acting-out behaviours. Over time, for whatever reason, the family system hasn't been able to contain them or provide the type of course that's needed," she said.

Some youth, according to Hill-Finamore, suffer mental health problems as a result of neglect or abuse.

Leaving home, though, doesn't necessarily fix their problems.

"If every day you're looking for food, you're looking for a safe place to live, a lot of people struggle with their mental health," Hill-Finamore said. "Kids are scared. Kids are forced to do all kinds of things to survive. And that contributes to mental illness."

Trouble with shelters

Even youth who seek help in shelters can endure trauma in those, supposedly safer, environs. Those who have behavioural problems sometimes get into conflicts or exhibit behaviour that forces them to leave the facility.

Evans, who first left home in 2005, says until a few years ago, downtown shelters were mostly unequipped to deal with youth with severe mental health problems.

"It became a very unhelpful service. It became, 'Well, you're not doing what you're supposed to be doing — get out,' or 'you're just causing problems.'"

Evans said the cycle didn't necessarily compound his mental health problems, but rather delayed his issues from being properly treated. It's a process he likens to "kicking the can down the road."

Hill-Finamore said that though youth shelters have become much more proactive about addressing mental health, they do not have the resources to needs of youth in the system.

Waiting list

Ontario's Ministry of Children and Youth Services provides Hamilton shelters with funding for a total of 1.6 mental health clinicians for homeless and street-involved youth.

"Last year alone, they were able to help 306 of the highest-risk youth," she said, noting the waiting list for treatment for severe cases was 67 names long.

The outcomes for youth who do not get proper treatment, she added, can sometimes be dire.

Many street-involved youth self-medicate with alcohol and drugs, behaviours that carry high risks.

"Since January, we know of three youth who overdosed from intravenous drug use," Hill-Finamore said.

Hopes for the future  

Currently, Evans is completing his high-school diploma and has a part-time job at Tim Hortons. Eventually, he hopes to work as a professional in the information-technology field.

He attributes part of his hopeful outlook to having a team of professionals who advise him on different aspects of his daily life, including his education, mental health, employment and life skills.

But to get that far, he had to vigourously — and persistently — advocate for himself, to constantly seek out services that could help him get his life on track.

"My mother was always fighting to get me help, always challenging to do more."

"Watching that, seeing that and learning that from my mother was a big tool that I brought to the table when it came to, 'Now, it's my turn to take care of me.'"