The role of spirituality and religiosity on the suicide ideation and depressive symptoms of middle to old age Brazilian homeless individuals

In the crowded streets of São Paulo, a hidden population faces a unique kind of aging. While most people grow older within the safety of their homes, surrounded by family and routine, a specific group of individuals over fifty finds themselves living without shelter. For these people, the harsh reality of the street accelerates the aging process, bringing with it a heavy burden of chronic illness, isolation, and deep psychological distress. Among the most severe of these struggles are feelings of hopelessness that can lead to thoughts of ending one's life, and the heavy fog of depression. In the face of such overwhelming adversity, many humans instinctively turn toward something larger than themselves for comfort. This is where the concepts of religion and spirituality come into play. Religion often refers to the structured practices, rituals, and community gatherings of a specific faith, while spirituality is a more personal, internal journey toward meaning and connection with the transcendent. For decades, researchers have wondered if these beliefs act as a shield against mental suffering, or if, in some cases, they might add to the burden. Understanding this dynamic is crucial, not just for academic curiosity, but because it could reshape how society offers care to its most vulnerable citizens.

A team of researchers from medical schools in Brazil set out to investigate this exact question among homeless men and women aged fifty and older in São Paulo. They wanted to see how the strength of a person's religious faith and spiritual beliefs related to their levels of depression and their thoughts of suicide. To do this, the team worked closely with a non-governmental organization that already had the trust of the homeless community. Over the course of two months in 2019, medical students, trained specifically to handle sensitive conversations, approached individuals living on the streets. They spoke with 162 people who had been without a permanent home for at least six months. The researchers asked detailed questions about the participants' lives, their health, and their substance use, but they also delved deep into their inner worlds. They measured how often people attended religious services, how much they prayed privately, and how important God or a higher power was to them. They also asked about their spiritual well-being, specifically whether they felt a sense of peace, a reason to live, and comfort in their beliefs. Crucially, they also looked at how people used their faith to cope with stress, distinguishing between those who found strength and love in their beliefs and those who felt punished, guilty, or abandoned by a higher power.

The picture that emerged from these conversations was stark. The average participant was nearly fifty-nine years old, and the vast majority were men. More than half were divorced, separated, or widowed, and a significant portion had no formal education. The mental health toll was severe: nearly forty-two percent of the group showed signs of significant depression, and almost twenty percent reported having thoughts of killing themselves. These numbers highlighted the extreme vulnerability of this population. However, when the researchers looked at how faith intersected with these struggles, a complex pattern appeared. For many, faith acted as a protective buffer. Those who reported higher levels of intrinsic religiosity—meaning they felt religion was a core, guiding part of their life rather than just a social habit—tended to have lower scores for depression. Similarly, individuals who felt a deep sense of meaning and peace in their lives, regardless of whether they belonged to a specific church, reported fewer depressive symptoms and less severe thoughts of suicide. In these cases, the belief system seemed to provide a framework for resilience, offering a sense of purpose that countered the despair of the streets.

Yet, the study also revealed that faith is not a simple cure-all; it can sometimes function in the opposite direction. The researchers found that for some individuals, their spiritual or religious beliefs were a source of additional pain. When people interpreted their suffering as a punishment from God, or when they felt a sense of spiritual struggle and conflict, the results were worse. These individuals, who engaged in what the researchers called negative spiritual coping, showed higher levels of depression and more intense suicidal thoughts. It appeared that for this group, the very beliefs that might offer comfort to others were reinforcing their feelings of guilt and hopelessness. This duality suggests that the impact of religion and spirituality is not uniform; it depends entirely on how the individual experiences and interprets their faith. The study did not find that faith simply "fixed" the problems of homelessness, but rather that it played a dual role, capable of either supporting mental health or exacerbating it, depending on the nature of the person's spiritual journey.

These findings offer a clear message for those who design public health strategies and social support systems. The data suggests that ignoring the spiritual dimension of a homeless person's life is a missed opportunity, but treating it as a universal solution is a mistake. Interventions need to be tailored to the individual. For some, connecting with a supportive religious community or exploring a sense of inner peace could be a vital part of their recovery. For others, addressing feelings of spiritual conflict or guilt may be necessary to alleviate their suffering. The researchers concluded that mental health care for the homeless should not just focus on housing or medical treatment, but must also incorporate an understanding of these deep, personal dimensions. By recognizing that faith can be both a source of strength and a source of pain, society can develop more sensitive and effective ways to support the mental well-being of those living on the margins.