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Sample records for psychiatric problems homelessness

  1. Utilization of psychiatric emergency services by homeless persons in Spain.

    Science.gov (United States)

    Pascual, Juan Carlos; Malagón, Angeles; Arcega, Jose M; Gines, Jose M; Navinés, Ricard; Gurrea, Alfredo; Garcia-Ribera, Carlos; Bulbena, Antoni

    2008-01-01

    Studies examining the relationship between homeless persons and the use of psychiatric emergency services (PES) in a country with universal access to health care are lacking. This study aimed to determine the prevalence of homelessness in adults visiting a PES in Spain, identify the differences between homeless and non-homeless patients in the use of PES and analyze the factors associated with homelessness and the decision to hospitalize. The study included a total of 11 578 consecutive admissions to a PES in a tertiary hospital in Barcelona, Spain, over a 4-year period. Data collected included socio-demographic and clinical information, and score on the Severity of Psychiatric Illness (SPI) scale. Multivariate logistic regression analyses were used to calculate odds ratios for the factors associated with homelessness and the decision to hospitalize. Five hundred sixty (4.8%) admissions were considered homeless. Homeless patients had more psychotic and drug abuse disorders, greater severity of symptoms, more risk of being a danger to others and more frequent hospitalization needs than non-homeless patients. Factors related to homelessness were male gender, substance abuse and immigrant status from North Africa, Sub-Sahara Africa and Western countries. The decision to hospitalize homeless patients was associated with psychosis diagnosis, suicide risk, danger to others, symptom severity, medical problems and noncompliance with treatment. In an attempt to decrease the use of emergency resources and prevent the risk of homelessness, mental health planners in a universal healthcare system should improve outpatient access for populations with risk factors such as substance abuse and immigration.

  2. Pathways into homelessness: recently homeless adults - problems and service use before and after becoming homeless in Amsterdam

    National Research Council Canada - National Science Library

    van Laere, I.R; de Wit, M.A; Klazinga, N.S

    2009-01-01

    OBJECTIVE: To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. METHODS...

  3. Psychiatric disorders and treatment among newly homeless young adults with histories of foster care.

    Science.gov (United States)

    Thompson, Ronald G; Hasin, Deborah

    2012-09-01

    Although foster care placement is often preceded by stressful events such as child abuse, foster care itself often exposes children to additional severe stressors. A history of foster care, as well as the childhood abuse that often precedes it, is common among homeless young adults. This study examined whether a history of foster care was associated with psychiatric disorders, prior psychiatric counseling, prescription of psychiatric medications, and prior psychiatric hospitalization among newly homeless young adults. A consecutive sample of 423 adults aged 18 to 21 years who sought emergency shelter for the first time between October 1, 2007, and February 29, 2008, were assessed at intake. Logistic regression analyses determined the associations between foster care and any psychiatric disorder (affective, anxiety, personality, and psychotic) and psychiatric treatment. The analyses adjusted for demographic characteristics, childhood abuse, substance use, prior arrest, unemployment, lack of high school diploma, and histories of psychiatric disorders and drug abuse among biological relatives. Homeless young adults with histories of foster care were 70% more likely than those without such histories to report any psychiatric disorder. They were more than twice as likely to have received mental health counseling for a psychiatric disorder, to have been prescribed psychiatric medication, and to have been hospitalized for psychiatric problems. Histories of foster care among homeless young adults should trigger screening for psychiatric disorders to aid in the provision of treatment (counseling, medication, and hospitalization) tailored to the psychiatric needs of this highly vulnerable population.

  4. Homelessness : its definition and various problems

    OpenAIRE

    Shiga, Fumiya

    2008-01-01

    The purpose of this short paper is to review articles or data on homelessness to grasp what it is and its status quo in Australia, including various allied problems. In this short paper, the definitions of homelessness and the related notion of home are reviewed at first because it is important to find the meaning and difference for development in understanding of and gaining an insight into the homelessness. After that, the present situations or characteristics of homelessness and its proble...

  5. Pathways into homelessness: recently homeless adults - problems and service use before and after becoming homeless in Amsterdam

    NARCIS (Netherlands)

    van Laere, I.R.; de Wit, M.A.; Klazinga, N.S.

    2009-01-01

    ABSTRACT: OBJECTIVE: To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. METHODS: Recently homeless adults (last housing lost up to two years ago and legally

  6. Using clinical and criminal involvement factors to explain homelessness among clients of a psychiatric probation and parole service.

    Science.gov (United States)

    Solomon, P; Draine, J

    1999-01-01

    This study sought to examine the rate of homelessness and the extent to which lifetime homelessness was associated with clinical factors, such as diagnosis and treatment history; or criminal factors, such as criminal behavior and arrest history, among psychiatric probationers and parolees. Nearly half of the clients screened had experienced homelessness in their lifetime. In a logistic regression model to explain lifetime homelessness, significant factors were younger age, less education, a greater number of lifetime arrests, a schizophrenia diagnosis, and reporting both an alcohol and drug problem. Implications for service delivery with this population are discussed.

  7. Psychiatric Disorders and Substance Use in Homeless Youth: A Preliminary Comparison of San Francisco and Chicago

    Directory of Open Access Journals (Sweden)

    Ernika G. Quimby

    2012-08-01

    Full Text Available Youth homelessness is a growing problem in the United States. The experience of homelessness appears to have numerous adverse consequences, including psychiatric and substance use disorders. This study compared the frequencies of psychiatric disorders, including substance use, between homeless youth (18–24 years-old in San Francisco (N = 31 and Chicago (N = 56. Subjects were administered the Mini International Neuropsychiatric Interview (M.I.N.I. to assess DSM-IV-TR diagnoses and substance use disorders. Eighty-seven percent of the San Francisco youth, and 81% of the Chicago youth met criteria for at least one M.I.N.I. psychiatric diagnosis. Nearly two-thirds of the youth in both samples met criteria for a mood disorder. Approximately one-third met criteria for an anxiety disorder. Thirty-two percent of the San Francisco sample and 18% of the Chicago met criteria for Antisocial Personality Disorder. Approximately 84% of the San Francisco youth and 48% of the Chicago youth met criteria for a substance-related disorder, and more substances were used by San Francisco youth. In conclusion, the high rate of psychiatric disorders in homeless youth provides clear evidence that the mental health needs of this population are significant. Implications are discussed.

  8. Pathways into homelessness: recently homeless adults problems and service use before and after becoming homeless in Amsterdam

    Directory of Open Access Journals (Sweden)

    de Wit Matty A

    2009-01-01

    Full Text Available Abstract Background To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. Methods Recently homeless adults (last housing lost up to two years ago and legally staying in the Netherlands were sampled in the streets, day centres and overnight shelters in Amsterdam. In April and May 2004, students conducted interviews and collected data on demographics, self reported pathways into homelessness, social and medical problems, and service use, before and after becoming homeless. Results among 120 recently homeless adults, (male 88%, Dutch 50%, average age 38 years, mean duration of homelessness 23 weeks, the main reported pathways into homelessness were evictions 38%, relationship problems 35%, prison 6% and other reasons 22%. Compared to the relationship group, the eviction group was slightly older (average age 39.6 versus 35.5 years; p = 0.08, belonged more often to a migrant group (p = 0.025, and reported more living single (p Conclusion the recently homeless fit the overall profile of the homeless population in Amsterdam: single (Dutch men, around 40 years, with a mix of financial debts, addiction, mental and/or physical health problems. Contacts with services were fragmented and did not prevent homelessness. For homelessness prevention, systematic and outreach social medical care before and during homelessness should be provided.

  9. Risk of psychiatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark

    DEFF Research Database (Denmark)

    Nilsson, Sandra Feodor; Laursen, Thomas Munk; Hjorthøj, Carsten

    2017-01-01

    additional adjustment for factors including parental psychiatric disorders. IRRs in offspring were increased for most specific psychiatric disorders, with the highest risk for attachment disorder when both parents had a history of homelessness (IRR 32·5 [95% CI 24·6–42·9]) and substance use disorder when......Background Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed......–16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental...

  10. Residential treatment for homeless female veterans with psychiatric and substance use disorders: effect on 1-year clinical outcomes.

    Science.gov (United States)

    Harpaz-Rotem, Ilan; Rosenheck, Robert A; Desai, Rani

    2011-01-01

    Limited evidence shows that time-limited residential treatment (RT) is beneficial for homeless people with serious mental illness. The Department of Veterans Affairs has established 11 specialty programs for homeless female veterans. We present data comparing 1-year clinical outcomes in a group of veterans who did and did not receive at least 30 days of RT. Clients of the Homeless Women Veterans Programs were invited to participate in a follow-up study. They were interviewed every 3 months for 1 year. Those who received at least 30 days of RT in the 3 months after program entry (RT group) were compared with other program participants (no or homeless women. This study, in conjunction with others, suggests that provision of stable housing may be an important element of recovery for homeless women with psychiatric problems, excluding substance use.

  11. Pathways into homelessness: recently homeless adults problems and service use before and after becoming homeless in Amsterdam.

    Science.gov (United States)

    van Laere, Igor R; de Wit, Matty A; Klazinga, Niek S

    2009-01-07

    To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. Recently homeless adults (last housing lost up to two years ago and legally staying in the Netherlands) were sampled in the streets, day centres and overnight shelters in Amsterdam. In April and May 2004, students conducted interviews and collected data on demographics, self reported pathways into homelessness, social and medical problems, and service use, before and after becoming homeless. among 120 recently homeless adults, (male 88%, Dutch 50%, average age 38 years, mean duration of homelessness 23 weeks), the main reported pathways into homelessness were evictions 38%, relationship problems 35%, prison 6% and other reasons 22%. Compared to the relationship group, the eviction group was slightly older (average age 39.6 versus 35.5 years; p = 0.08), belonged more often to a migrant group (p = 0.025), and reported more living single (p homelessness, in the total group, contacts with any social service were 38% and with any medical service 27%. Despite these contacts they did not keep their house. During homelessness only contacts with social work and benefit agencies increased, contacts with medical services remained low. the recently homeless fit the overall profile of the homeless population in Amsterdam: single (Dutch) men, around 40 years, with a mix of financial debts, addiction, mental and/or physical health problems. Contacts with services were fragmented and did not prevent homelessness. For homelessness prevention, systematic and outreach social medical care before and during homelessness should be provided.

  12. Psychiatric disorders and mortality among people in homeless shelters in Denmark

    DEFF Research Database (Denmark)

    Nielsen, Sandra Feodor; Hjorthøj, Carsten Rygaard; Erlangsen, Annette

    2011-01-01

    BACKGROUND: The increased mortality of homeless people compared with non-homeless people might be linked to psychiatric disorders. However, homeless people are, because of their insufficient accommodation, difficult to sample and monitor, which has limited previous studies. We aimed to assess...... registered psychiatric disorders, mortality, and predictors of mortality in the homeless shelter population in Denmark. METHODS: We did a nationwide, prospective, register-based cohort study of homeless people aged 16 years and older who were registered in the Danish Homeless Register between Jan 1, 1999......, and Dec 31, 2009. We calculated the proportion of registered psychiatric disorders, overall and cause-specific standardised mortality ratio (SMR), and life expectancy. Hazard ratios (HRs) were used to assess predictors of death. FINDINGS: 32,711 homeless people (23,040 men and 9671 women) were included...

  13. Biomarkers of problem drinking in homeless patients

    DEFF Research Database (Denmark)

    Hesse, Morten; Thiesen, Henrik

    2010-01-01

    of alcohol drinking. Material and methods. Concentrations of carbohydrate-deficient transferrin (%CDT), γ glutamyl transferase (γGT), aspartate aminotransferase (ASAT), and mean corpuscular volume (MCV), together with a combined index of the %CDT and  γGT, the Antilla Index (AI), were studied in 104 homeless...... patients with (n=87) or without (n=24) problem drinking according to the Fast Alcohol Screening Test. Results. Concentrations of all markers were significantly higher in the alcoholic patients than in other homeless patients. The best agreement between liver markers and self-reported status was found...... between the combined %CDT and γGT index (kappa=0.61, phomeless populations....

  14. Impact of the seeking safety program on clinical outcomes among homeless female veterans with psychiatric disorders.

    Science.gov (United States)

    Desai, Rani A; Harpaz-Rotem, Ilan; Najavits, Lisa M; Rosenheck, Robert A

    2008-09-01

    Seeking Safety is a manualized cognitive-behavioral therapy intervention that is designed to treat clients with comorbid substance abuse and trauma histories. This study examined its effectiveness when used with homeless women veterans with psychiatric or substance abuse problems at 11 Department of Veterans Affairs medical centers that had Homeless Women Veterans Programs. The intervention consists of 25 sessions that cover topics to help build safety in clients' lives and is present-focused, offering psychoeducation and coping skills. A cohort of homeless women veterans (N=359) was recruited before Seeking Safety was implemented (phase I). After clinicians were trained and certified in Seeking Safety, a postimplementation cohort was recruited and offered Seeking Safety treatment (phase II, N=91). Phase I lasted from January 2000 to June 2003. Phase II lasted from June 2003 to December 2005. The intervention lasted for six months. All participants were interviewed every three months for one year and received intensive case management and other services during the study. Mixed models were used to compare one-year clinical outcomes across phases. There were few differences across groups at baseline. All women entering the Homeless Women Veterans Programs showed significant improvement on most clinical outcome measures over one year. The Seeking Safety cohort reported significantly better outcomes over one year in employment, social support, general symptoms of psychiatric distress, and symptoms of posttraumatic stress disorder, particularly in the avoidance and arousal clusters. However, the Seeking Safety cohort was significantly more likely to have used drugs in the past 30 days. Seeking Safety appears to have had a moderately beneficial impact on several clinical outcomes. Although the nonequivalent comparison groups and low follow-up rates limit the internal validity of these results, availability of Seeking Safety may be of benefit for homeless female veterans

  15. Medical, psychiatric and demographic factors associated with suicidal behavior in homeless veterans.

    Science.gov (United States)

    Goldstein, Gerald; Luther, James Francis; Haas, Gretchen Louise

    2012-08-30

    This study assessed potential for suicidal behaviors associated with sociodemographic, predisposing physical and mental health factors and self-reported psychological problems among homeless veterans in a large northeastern region. Data were obtained from a demographic and clinical history interview conducted with 3595 homeless veterans. Odds-ratio (OR) statistics were used to assess potential for suicidal behavior. Statistically significant ratios were similar for ideation and attempts. The highest ratios were for self-report of depression and difficulty controlling violence, but statistically significant ratios were found for reporting sleeping in a treatment facility the night before the interview, receiving VA support for a psychiatric condition, and the diagnoses of Alcoholism, Mood Disorder and Post Traumatic Stress Disorder (PTSD). Low but statistically significant odds-ratios were obtained for most of the physical health items. A negative odds-ratio was obtained for African-American ethnicity. Logistic regression results indicated that for ideation and attempts items entered first involved subjective report of trouble controlling violent behavior and experiencing depression. High odds ratios for the interview items concerning experiencing serious depression and having difficulties controlling violence may have strong implications for treatment and management of homeless veterans. There may be up to 14-1 odds that an individual who reports being seriously depressed or having difficulty inhibiting aggression may have a serious potential for suicidal behaviors. Published by Elsevier Ireland Ltd.

  16. Risk of psychiatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark: a nationwide, register-based, cohort study.

    Science.gov (United States)

    Nilsson, Sandra Feodor; Laursen, Thomas Munk; Hjorthøj, Carsten; Thorup, Anne; Nordentoft, Merete

    2017-12-01

    Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0-16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental information, and the outcome, psychiatric disorders in the offspring, was obtained from the Danish Psychiatric Central Research Register and the Danish National Patient Register. We analysed the association between parental history of homelessness and risk of psychiatric disorders in offspring by survival analysis using Poisson regression and incidence rate ratios (IRRs), adjusted for year and offspring characteristics, and additionally adjusted for parental factors (age at offspring's birth and parental psychiatric disorders). 17 238 (2%) offspring had either one or two parents with a history of homelessness, and 56 330 (5%) children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15·1 cases per 1000 person-years (95% CI 14·4-15·8) in offspring with at least one parent with a history of homelessness, compared with 6·0 per 1000 person-years (95% CI 6·0-6·1) in those whose parents had no such history (IRR 2·5 [95% CI 2·3-2·7] for mother homeless, 2·3 [2·2-2·5] for father homeless, and 2·8 [2·4-3·2

  17. Risk of psychiatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark: a nationwide, register-based, cohort study

    Directory of Open Access Journals (Sweden)

    Sandra Feodor Nilsson, MSc

    2017-12-01

    Full Text Available Summary: Background: Children and adolescents from deprived backgrounds have high rates of psychiatric problems. Parental and social factors are crucial for children's healthy and positive development, but whether psychiatric morbidity is associated with parental social marginalisation is unknown. We aimed to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. Methods: We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0–16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental information, and the outcome, psychiatric disorders in the offspring, was obtained from the Danish Psychiatric Central Research Register and the Danish National Patient Register. We analysed the association between parental history of homelessness and risk of psychiatric disorders in offspring by survival analysis using Poisson regression and incidence rate ratios (IRRs, adjusted for year and offspring characteristics, and additionally adjusted for parental factors (age at offspring's birth and parental psychiatric disorders. Findings: 17 238 (2% offspring had either one or two parents with a history of homelessness, and 56 330 (5% children and adolescents were diagnosed with any psychiatric disorder during the study period. The incidence of any psychiatric disorder was 15·1 cases per 1000 person-years (95% CI 14·4–15·8 in offspring with at least one parent with a history of homelessness, compared with 6·0 per 1000 person-years (95% CI 6·0–6·1 in those whose parents had no such history (IRR 2·5 [95

  18. Housing retention in single-site housing first for chronically homeless individuals with severe alcohol problems.

    Science.gov (United States)

    Collins, Susan E; Malone, Daniel K; Clifasefi, Seema L

    2013-12-01

    We studied housing retention and its predictors in the single-site Housing First model. Participants (n = 111) were chronically homeless people with severe alcohol problems who lived in a single-site Housing First program and participated in a larger nonrandomized controlled trial (2005-2008) conducted in Seattle, Washington. At baseline, participants responded to self-report questionnaires assessing demographic, illness burden, alcohol and other drug use, and psychiatric variables. Housing status was recorded over 2 years. Participants were interested in housing, although a sizable minority did not believe they would be able to maintain abstinence-based housing. Only 23% of participants returned to homelessness during the 2-year follow-up. Commonly cited risk factors--alcohol and other drug use, illness burden, psychiatric symptoms, and homelessness history--did not predict resumed homelessness. Active drinkers were more likely to stay in this housing project than nondrinkers. We found that single-site Housing First programming fills a gap in housing options for chronically homeless people with severe alcohol problems.

  19. Psychiatric Disorders, High-Risk Behaviors, and Chronicity of Episodes Among Predominantly African American Homeless Chicago Youth

    Science.gov (United States)

    Castro, Anne L.; Gustafson, Erika L.; Ford, Ashley E.; Edidin, Jennifer P.; Smith, Dale L.; Hunter, Scott J.; Karnik, Niranjan S.

    2014-01-01

    Objective This cross-sectional study investigated the relationships between psychiatric and substance-related disorders, high-risk behaviors, and the onset, duration, and frequency of homelessness among homeless youth in Chicago. Methods Sixty-six homeless youth were recruited from two shelters in Chicago. Demographic characteristics, psychopathology, substance use, and risk behaviors were assessed for each participant. Results Increased frequency and duration of homeless episodes were positively correlated with higher rates of psychiatric diagnoses. Increased number of psychiatric diagnoses was positively correlated with increased high-risk behaviors. Participants with diagnoses of Current Suicidality, Manic Episodes, Obsessive Compulsive Disorder, Substance Abuse, and Psychotic Disorder had a higher chronicity of homelessness than those without diagnoses. Conclusions Significant differences were evident between the three time parameters, suggesting that stratification of data by different time variables may benefit homelessness research by identifying meaningful subgroups who may benefit from individualized interventions. PMID:25130234

  20. A tale of two veterans: homeless vs domiciled veterans presenting to a psychiatric urgent care clinic.

    Science.gov (United States)

    Lee, Haoyu; Iglewicz, Alana; Golshan, Shah; Zisook, Sidney

    2013-11-01

    The relationship between homelessness among veterans and mental illness and suicidality has not been clearly defined. To further examine this relationship, we compared rates of mental illness and suicidality among homeless and domiciled veterans seeking urgent psychiatric care at a US Department of Veterans Affairs (VA) facility. Information was collected by survey from 482 consecutive veterans seeking care at the Psychiatric Emergency Clinic (PEC) at the VA San Diego Healthcare System. A total of 73 homeless veterans were designated the homeless group and 73 domiciled veterans were randomly selected as the domiciled group. Suicidality and mental illnesses were assessed by self-assessment questionnaires and chart review of diagnoses. The homeless group had significantly higher rates of past suicide attempts (47% vs 27%) and recent reckless or self-harming behavior (33% vs 18%) compared with the domiciled group but significantly lower rates of depressive disorder (25% vs 44%), as diagnosed by a PEC physician. There were no differences between groups on the questionnaires for posttraumatic stress disorder (PTSD), depression, or alcohol abuse. Nor were there differences in diagnoses of bipolar disorder, PTSD, anxiety disorder, schizophrenia/schizoaffective disorder, or alcohol abuse. Veterans seeking help from a VA-based urgent psychiatric care clinic often are burdened by substantial depression, alcohol use disorders, PTSD, and both past and present suicide risk.

  1. Risk of psychiatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark

    DEFF Research Database (Denmark)

    Nilsson, Sandra Feodor; Laursen, Thomas Munk; Hjorthøj, Carsten

    2017-01-01

    to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. Methods We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0......–16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental...... information, and the outcome, psychiatric disorders in the offspring, was obtained from the Danish Psychiatric Central Research Register and the Danish National Patient Register. We analysed the association between parental history of homelessness and risk of psychiatric disorders in offspring by survival...

  2. Countervailing Social Network Influences on Problem Behaviors among Homeless Youth

    Science.gov (United States)

    Rice, Eric; Stein, Judith A.; Milburn, Norweeta

    2008-01-01

    The impact of countervailing social network influences (i.e., pro-social, anti-social or HIV risk peers) on problem behaviors (i.e., HIV drug risk, HIV sex risk or anti-social behaviors) among 696 homeless youth was assessed using structural equation modeling. Results revealed that older youth were less likely to report having pro-social peers and…

  3. Intellectual disability among Dutch homeless people: Prevalence and related psychosocial problems

    NARCIS (Netherlands)

    B. van Straaten (Barbara); C.Th.M. Schrijvers (Carola); J. Van Der Laan (Jorien); S.N. Boersma (Sandra N.); G. Rodenburg (Gerda); J.R.L.M. Wolf (Judith R. L. M.); H. van de Mheen (Dike)

    2014-01-01

    textabstractBackground: There is a higher prevalence of intellectual disability (ID) among homeless people than in the general population. However, little is known about the additional psychosocial problems faced by homeless people with ID. We describe the prevalence of ID in a cohort of homeless

  4. Intellectual Disability among Dutch Homeless People: Prevalence and Related Psychosocial Problems

    NARCIS (Netherlands)

    Straaten, B. Van; Schrijvers, C.T.; Laan, J. van der; Boersma, S.N.; Rodenburg, G.; Wolf, J.R.L.M.; Mheen, D. Van de

    2014-01-01

    BACKGROUND: There is a higher prevalence of intellectual disability (ID) among homeless people than in the general population. However, little is known about the additional psychosocial problems faced by homeless people with ID. We describe the prevalence of ID in a cohort of homeless people in the

  5. Untangling the Complex Needs of People Experiencing Gambling Problems and Homelessness

    Science.gov (United States)

    Holdsworth, Louise; Tiyce, Margaret

    2013-01-01

    People with gambling problems are now recognised among those at increased risk of homelessness, and the link between housing and gambling problems has been identified as an area requiring further research. This paper discusses the findings of a qualitative study that explored the relationship between gambling problems and homelessness. Interviews…

  6. Increased risk for substance use and health-related problems among homeless veterans.

    Science.gov (United States)

    Dunne, Eugene M; Burrell, Larry E; Diggins, Allyson D; Whitehead, Nicole Ennis; Latimer, William W

    2015-10-01

    The first aim of this study was to compare self-reported causes of homelessness between veterans and nonveterans. A second aim examined whether homeless male veterans were more likely than homeless male nonveterans to experience current problems with addictions, mental health, and physical health. Additionally, a third aim was to compare frequency of emergency room visits and treatment needs between the two groups. Secondary data analyses compared male homeless veterans and nonveterans (N = 353) enrolled in the Alachua County Point in Time study in central Florida. Participants completed a questionnaire on demographics and health variables. Additional questions included recent emergency room visits and medical or other needs not being met. Veterans reported higher rates of substance use and mental health problems as a primary cause of homelessness when compared to nonveterans. Homeless veterans were more likely than nonveterans to report current problems with addictions (OR = 6.29, 95% CI: 3.43-11.53, p homeless veterans (53.1%) reported an ER visit in the past year compared to only 40.9% of nonveterans (OR = 1.73, 95% CI: 1.07-2.80, p Veterans may be more likely to become homeless due to addiction and mental health and over half of homeless veterans are presenting to hospital emergency rooms. Given the greater utilization among homeless veterans, emergency rooms may serve as a prime opportunity to provide brief treatment and referrals for needed services. © American Academy of Addiction Psychiatry.

  7. Recent violence in a community-based sample of homeless and unstably housed women with high levels of psychiatric comorbidity.

    Science.gov (United States)

    Riley, Elise D; Cohen, Jennifer; Knight, Kelly R; Decker, Alyson; Marson, Kara; Shumway, Martha

    2014-09-01

    We determined associations between co-occurring psychiatric conditions and violence against homeless and unstably housed women. Between 2008 and 2010, we interviewed homeless and unstably housed women recruited from community venues about violence, socioeconomic factors, and psychiatric conditions. We used multivariable logistic regression to determine independent correlates of violence. Among 291 women, 97% screened positive for 1 or more psychiatric conditions. Types of violence perpetrated by primary partners and persons who were not primary partners (non-primary partners) included emotional violence (24% vs 50%; P violence (11% vs 19%; P violence (7% vs 22%; P violence increased with each additional psychiatric diagnosis and decreasing levels of social isolation. All types of violence were more commonly perpetrated by non-primary partners, suggesting that an exclusive focus on domestic violence screening in health care or social service settings will miss most of the violence in this population. Contrary to some previous studies, the odds of violence decreased as social isolation increased, suggesting that social isolation may be protective in homeless and unstably housed communities with high levels of comorbidity and limited options.

  8. Psychopathology in Young People Experiencing Homelessness: A Systematic Review

    Science.gov (United States)

    Shelton, Katherine H.; van den Bree, Marianne B. M.; Los, Férenc J.

    2013-01-01

    Understanding mental health issues faced by young homeless persons is instrumental to the development of successful targeted interventions. No systematic review of recent published literature on psychopathology in this group has been completed. We conducted a systematic review of published research examining the prevalence of psychiatric problems among young homeless people. We examined the temporal relationship between homelessness and psychopathology. We collated 46 articles according to the PRISMA Statement. All studies that used a full psychiatric assessment consistently reported a prevalence of any psychiatric disorder from 48% to 98%. Although there was a lack of longitudinal studies of the temporal relationship between psychiatric disorders and homelessness, findings suggested a reciprocal link. Supporting young people at risk for homelessness could reduce homelessness incidence and improve mental health. PMID:23597340

  9. Intellectual disability among Dutch homeless people: prevalence and related psychosocial problems.

    Science.gov (United States)

    Van Straaten, Barbara; Schrijvers, Carola T M; Van der Laan, Jorien; Boersma, Sandra N; Rodenburg, Gerda; Wolf, Judith R L M; Van de Mheen, Dike

    2014-01-01

    There is a higher prevalence of intellectual disability (ID) among homeless people than in the general population. However, little is known about the additional psychosocial problems faced by homeless people with ID. We describe the prevalence of ID in a cohort of homeless people in the Netherlands, and report relationships between ID and psychosocial problems in terms of psychological distress, substance (mis)use and dependence, as well as demographic characteristics in this cohort. This cross-sectional study is part of a cohort study among homeless people in the four major cities of the Netherlands. Data were derived from 387 homeless people who were interviewed and screened for ID six months after the baseline measurement. Multivariate logistic regression analyses and χ2 tests were performed to analyze relationships between ID, psychosocial problems and demographic characteristics. Of all cohort members, 29.5% had a suspected ID. Participants with a suspected ID had a higher mean age, were more likely to be male and to fall in the lowest category of education than participants without a suspected ID. Having a suspected ID was related to general psychological distress (OR  = 1.56, ppsychosocial problems than among homeless people without ID. Homeless people with a suspected ID appear to be a vulnerable subgroup within the homeless population. This endorses the importance of the extra attention required for this subgroup.

  10. Homelessness as social and individual problem – possibilities and prevention

    Directory of Open Access Journals (Sweden)

    Małgorzata Piechowicz

    2012-12-01

    Full Text Available This article consists of several parts. The first part includes definitional considerations over the notion of homelessness. It also describes social situation of the homeless, whereas the second part concentrates on both the analysis of causes and effects of homelessness and on the attempt to show the scale of this phenomenon. The last part of the article focuses on the prevention of homelessness. It emphasizes the importance of interdisciplinarity of preventive and compensatory actions in the scope of the discussed phenomenon.

  11. Substance abuse treatment and psychiatric comorbidity: do benefits spill over? analysis of data from a prospective trial among cocaine-dependent homeless persons

    Directory of Open Access Journals (Sweden)

    Kertesz Stefan G

    2006-09-01

    Full Text Available Abstract Background Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Results Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996–1998 were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression and anxiety-related disorders (e.g. post-traumatic stress disorder. Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32% and anxiety-related disorders (-20% (p = 0.12. Conclusion Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population.

  12. Causes of homelessness prevalence: Relationship between homelessness and disability.

    Science.gov (United States)

    Nishio, Akihiro; Horita, Ryo; Sado, Tadahiro; Mizutani, Seiko; Watanabe, Takahiro; Uehara, Ryosuke; Yamamoto, Mayumi

    2017-03-01

    Many studies have reported that the prevalence of mental illness and cognitive disability is higher among homeless individuals compared to the general population, and the rates of mental illness among the homeless population have recently increased. This study: (i) compares causes of homelessness or barriers to escaping homelessness for people with/without mental illness/cognitive disability; (ii) reveals problems with the Japanese homeless policy; and (iii) proposes an effective and necessary support system. The participants were 114 homeless individuals. A psychiatric diagnostic interview and the Wechsler Adult Intelligence Scale, version III were used to measure participants' mental health and cognitive abilities. A questionnaire was administered comprising 17 items related to the causes of their homelessness and barriers to escaping from it. Participants were divided into four groups - with/without mental illness or cognitive disability - and Fisher's exact test was used to compare the questionnaire results. Individuals with cognitive disabilities considered bad relationships with their family members to be the cause of their homelessness. Conversely, normal individuals considered their homelessness to be the result of debt more so than did individuals with mental problems. Individuals with mental illness had more difficulties escaping homelessness than did either normal individuals or individuals with cognitive disability. This tendency was observed most strongly among individuals with both mental illness and cognitive disability. Most homeless individuals considered economic problems to be the cause of their homelessness; however, difficulties with human relationships were also important factors and were more difficult for participants to acknowledge. Furthermore, these difficulties were exacerbated among those individuals with mental problems. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  13. Intellectual disability among Dutch homeless people: prevalence and related psychosocial problems.

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    Barbara Van Straaten

    Full Text Available BACKGROUND: There is a higher prevalence of intellectual disability (ID among homeless people than in the general population. However, little is known about the additional psychosocial problems faced by homeless people with ID. We describe the prevalence of ID in a cohort of homeless people in the Netherlands, and report relationships between ID and psychosocial problems in terms of psychological distress, substance (misuse and dependence, as well as demographic characteristics in this cohort. METHODS: This cross-sectional study is part of a cohort study among homeless people in the four major cities of the Netherlands. Data were derived from 387 homeless people who were interviewed and screened for ID six months after the baseline measurement. Multivariate logistic regression analyses and χ2 tests were performed to analyze relationships between ID, psychosocial problems and demographic characteristics. FINDINGS: Of all cohort members, 29.5% had a suspected ID. Participants with a suspected ID had a higher mean age, were more likely to be male and to fall in the lowest category of education than participants without a suspected ID. Having a suspected ID was related to general psychological distress (OR  = 1.56, p<0.05, somatization (OR  = 1.84, p<0.01, depression (OR  = 1.58, p<0.05 and substance dependence (OR  = 1.88, p<0.05. No relationships were found between a suspected ID and anxiety, regular substance use, substance misuse and primary substance of use. CONCLUSION: The prevalence of ID among Dutch homeless people is higher than in the general population, and is related to more psychosocial problems than among homeless people without ID. Homeless people with a suspected ID appear to be a vulnerable subgroup within the homeless population. This endorses the importance of the extra attention required for this subgroup.

  14. Psychiatric Symptoms in Children with Gross Motor Problems

    Science.gov (United States)

    Emck, Claudia; Bosscher, Ruud J.; van Wieringen, Piet C. W.; Doreleijers, Theo; Beek, Peter J.

    2012-01-01

    Children with psychiatric disorders often demonstrate gross motor problems. This study investigates if the reverse also holds true by assessing psychiatric symptoms present in children with gross motor problems. Emotional, behavioral, and autism spectrum disorders (ASD), as well as psychosocial problems, were assessed in a sample of 40 children…

  15. Caring for homeless persons with serious mental illness in general hospitals.

    Science.gov (United States)

    Bauer, Leah K; Baggett, Travis P; Stern, Theodore A; O'Connell, Jim J; Shtasel, Derri

    2013-01-01

    The care of homeless persons with serious mental illness remains a common and challenging problem in general hospital settings. This article aims to review data on homelessness and its psychiatric comorbidities, and to expand the skills of providers who encounter homeless individuals in general hospital settings. Literature review reveals patient, provider, and systems factors that contribute to suboptimal health outcomes in homeless individuals. Diagnostic rigor, integrated medical and psychiatric care, trauma-informed interventions, special considerations in capacity evaluations, and health care reform initiatives can improve the treatment of homeless persons with serious mental illness. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  16. Psychiatric disorders in women with fertility problems

    DEFF Research Database (Denmark)

    Baldur-Felskov, Birgitte; Kjaer, S K; Albieri, V

    2013-01-01

    Do women who don't succeed in giving birth after an infertility evaluation have a higher risk of psychiatric disorders compared with women who do?......Do women who don't succeed in giving birth after an infertility evaluation have a higher risk of psychiatric disorders compared with women who do?...

  17. Psychiatric Disorders and Behavior Problems in People with Intellectual Disability

    Science.gov (United States)

    Myrbakk, Even; von Tetzchner, Stephen

    2008-01-01

    The relationship between behavior problems and psychiatric disorders in individuals with intellectual disability is still unresolved. The present study compares the prevalence and pattern of psychiatric disorders in individuals with intellectual disability who were assessed on the ABC to have moderate and severe behavior problems and a matched…

  18. Overdose Deaths Among Homeless Persons

    Science.gov (United States)

    ... Twitter Overdose Deaths Among Homeless Persons January 2013 Homelessness is a persistent problem—nearly 690,000 people ... will ultimately help address the tragic problem of homelessness too, as many homeless people cite drug or ...

  19. Psychiatric Problems in Patients with Breast Cancer

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    Munevver Tunel

    2012-06-01

    Full Text Available Cancer is a physical disorder with concurrent mental and social components. During cancer, the feelings of fear, hopelessness, guilt, helplessness, abandonment perceived as a crisis leading to destruction in the suffering person. Breast cancer is the most common type of cancer among women. Prevalence of psychiatric disorders among cancer patients is approximately 50% and most of disorders are related with the occurrence of cancer and cancer treatment. Majority of patients present with major depression, adjustment disorder, anxiety disorders, sleep disorders, suicidial ideation, and delirium. Treatment of psychiatric disorders and cancer therapy should be conducted along with special consideration of drug interactions. This article reviews the adaptation process experienced by individuals during diagnosis and treatment of breast cancer, it psychological effects, resulting psychiatric comorbidites and their treatments. [Archives Medical Review Journal 2012; 21(3.000: 189-219

  20. Service provision and barriers to care for homeless people with mental health problems across 14 European capital cities

    NARCIS (Netherlands)

    Canavan, Réamonn; Barry, Margaret M.; Matanov, Aleksandra; Barros, Henrique; Gabor, Edina; Greacen, Tim; Holcnerová, Petra; Kluge, Ulrike; Nicaise, Pablo; Moskalewicz, Jacek; Díaz-Olalla, José Manuel; Strassmayr, Christa; Schene, Aart H.; Soares, Joaquim J. F.; Gaddini, Andrea; Priebe, Stefan

    2012-01-01

    Background: Mental health problems are disproportionately higher amongst homeless people. Many barriers exist for homeless people with mental health problems in accessing treatment yet little research has been done on service provision and quality of care for this group. The aim of this paper is to

  1. Service provision and barriers to care for homeless people with mental health problems across 14 European capital cities

    LENUS (Irish Health Repository)

    Canavan, Réamonn

    2012-07-27

    AbstractBackgroundMental health problems are disproportionately higher amongst homeless people. Many barriers exist for homeless people with mental health problems in accessing treatment yet little research has been done on service provision and quality of care for this group. The aim of this paper is to assess current service provision and identify barriers to care for homeless people with mental health problems in 14 European capital cities.MethodTwo methods of data collection were employed; (i) In two highly deprived areas in each of the 14 European capital cities, homeless-specific services providing mental health, social care or general health services were assessed. Data were obtained on service characteristics, staff and programmes provided. (ii) Semi-structured interviews were conducted in each area with experts in mental health care provision for homeless people in order to determine the barriers to care and ways to overcome them.ResultsAcross the 14 capital cities, 111 homeless-specific services were assessed. Input from professionally qualified mental health staff was reported as low, as were levels of active outreach and case finding. Out-of-hours service provision appears inadequate and high levels of service exclusion criteria were evident. Prejudice in the services towards homeless people, a lack of co-ordination amongst services, and the difficulties homeless people face in obtaining health insurance were identified as major barriers to service provision.ConclusionsWhile there is variability in service provision across European capital cities, the reported barriers to service accessibility are common. Homeless-specific services are more responsive to the initial needs of homeless people with mental health problems, while generic services tend to be more conducive to long term care. Further research is needed to determine the effectiveness of different service delivery models, including the most effective coordination of homeless specific and generic

  2. Service provision and barriers to care for homeless people with mental health problems across 14 European capital cities

    Directory of Open Access Journals (Sweden)

    Canavan Réamonn

    2012-07-01

    Full Text Available Abstract Background Mental health problems are disproportionately higher amongst homeless people. Many barriers exist for homeless people with mental health problems in accessing treatment yet little research has been done on service provision and quality of care for this group. The aim of this paper is to assess current service provision and identify barriers to care for homeless people with mental health problems in 14 European capital cities. Method Two methods of data collection were employed; (i In two highly deprived areas in each of the 14 European capital cities, homeless-specific services providing mental health, social care or general health services were assessed. Data were obtained on service characteristics, staff and programmes provided. (ii Semi-structured interviews were conducted in each area with experts in mental health care provision for homeless people in order to determine the barriers to care and ways to overcome them. Results Across the 14 capital cities, 111 homeless-specific services were assessed. Input from professionally qualified mental health staff was reported as low, as were levels of active outreach and case finding. Out-of-hours service provision appears inadequate and high levels of service exclusion criteria were evident. Prejudice in the services towards homeless people, a lack of co-ordination amongst services, and the difficulties homeless people face in obtaining health insurance were identified as major barriers to service provision. Conclusions While there is variability in service provision across European capital cities, the reported barriers to service accessibility are common. Homeless-specific services are more responsive to the initial needs of homeless people with mental health problems, while generic services tend to be more conducive to long term care. Further research is needed to determine the effectiveness of different service delivery models, including the most effective coordination of

  3. Engagement with health and social care services: perceptions of homeless young people with mental health problems.

    Science.gov (United States)

    Darbyshire, Philip; Muir-Cochrane, Eimear; Fereday, Jennifer; Jureidini, Jon; Drummond, Andrew

    2006-11-01

    The present qualitative study describes and discusses the perspectives and experiences of young homeless people with mental health problems in relation to their interactions with health and social care services. Working in partnership with Streetlink, a supported accommodation assistance programme in Adelaide, Australia, the authors interviewed 10 homeless young people, aged from 16 to 24 years of age, who had experienced mental health problems. In-depth interviews elicited accounts of the best and worst of the participants' experiences of health and social care services. Access to services was not identified as being a significant problem in comparison with the participants' concerns regarding the quality of the services encountered. The central findings stress the importance of a respectful and supportive climate in relation to the qualities of service provision that the young people identified as valuable for their continuing treatment or consultation.

  4. Perinatal problems and psychiatric comorbidity among children with ADHD.

    Science.gov (United States)

    Owens, Elizabeth B; Hinshaw, Stephen P

    2013-01-01

    Among two large, independent samples of girls with attention-deficit/hyperactivity disorder (ADHD), we examined associations between specific (maternal gestational smoking and drug use, early labor, low birth weight, and infant breathing problems at birth) and cumulative prenatal and perinatal risk factors and psychiatric comorbidity during childhood. Data from the (a) Multimodal Treatment Study of Children with ADHD, a randomized clinical trial with 579 children aged 7 to 9.9 years with combined-type ADHD, and the (b) Berkeley Girls ADHD Longitudinal Sample, a naturalistic study of 140 girls with ADHD (93 combined-type and 47 inattentive-type) who were first seen when they were 6 to 12 years old, were analyzed separately. In each sample, perinatal risk factors were assessed retrospectively by maternal report, and current childhood psychiatric comorbidity was assessed using maternal report on the Diagnostic Interview Schedule for Children. Consistent findings across these two studies show that infant breathing problems, early labor, and total perinatal problems predicted childhood comorbid depression but not comorbid anxiety or externalizing disorders. These associations remained significant, in both samples, with control of family socioeconomic status (SES) and maternal symptoms of ADHD and depression. Results attenuated slightly with control of the number of child comorbidities plus SES and maternal symptoms. Accumulating evidence suggests that perinatal risk factors are important precursors of childhood psychiatric comorbidity and that the association between these risk factors and detrimental psychiatric outcomes cannot be explained by maternal psychiatric symptoms or SES during childhood.

  5. Psychiatric problems in children with hemiplegia: cross sectional epidemiological survey.

    Science.gov (United States)

    Goodman, R.; Graham, P.

    1996-01-01

    OBJECTIVE--To examine the prevalence and predictors of psychiatric problems in children with hemiplegia. DESIGN--Cross sectional questionnaire survey of an epidemiological sample with individual assessments of a representative subgroup. The questionnaire survey was repeated on school age subjects four years later. SUBJECTS--428 hemiplegic children age 2 1/2-16 years, of whom 149 (aged 6-10 years) were individually assessed. MAIN OUTCOME MEASURES--Psychiatric symptom scores and the occurrence of psychiatric disorder. RESULTS--Psychiatric disorders affected 61% (95% confidence interval 53% to 69%) of subjects as judged by individual assessments and 54% (49% to 59%) and 42% (37% to 47%) as judged from parent and teacher questionnaires, respectively. Few affected children had been in contact with child mental health services. The strongest consistent predictor of psychiatric problems was intelligence quotient (IQ), which was highly correlated with an index of neurological severity; age, sex, and laterality of lesion had little or no predictive power. CONCLUSION--Though most hemiplegic children have considerable emotional or behavioural difficulties, these psychological complications commonly go unrecognised or untreated. Comprehensive health provision for children with chronic neurodevelopmental disorders such as hemiplegia should be psychologically as well as physically oriented. PMID:8616413

  6. Working with Students with Psychiatric Disabilities or Other Emotional Problems

    Science.gov (United States)

    Mazza, Elena T.

    2015-01-01

    The professional literature on gatekeeping in social work education has grown; however, there remains a dearth in the literature regarding how educators truly work to engage students who are experiencing a psychiatric disability or other emotional problem. This qualitative study explored the experiences of 26 social work educators from 22 colleges…

  7. Alcohol Use and Abuse in a University Psychiatric Health Service: Prevalence and Patterns of Comorbidity with Other Psychiatric Problems.

    Science.gov (United States)

    Ross, Helen E.; Tisdall, Gordon W.

    1994-01-01

    Examined use and abuse of alcohol and other drugs in university psychiatric health service and patterns of comorbidity with other psychiatric problems. Psychiatric service students (n=110) tended to drink less than did undergraduate comparison group and to report similar frequencies of adverse consequences. Alcohol disorders were significantly…

  8. Hospital utilization and personality characteristics of veterans with psychiatric problems.

    Science.gov (United States)

    Williams, W; Weiss, T W; Edens, A; Johnson, M; Thornby, J I

    1998-03-01

    The relationship between hospital utilization and psychometric, demographic, and diagnostic data was examined among veterans with psychiatric problems. Data were obtained from the records of 500 psychiatric inpatients admitted to a Veterans Affairs medical center between 1984 and 1987 and followed for four years. All patients completed the Minnesota Multiphasic Personality Inventory, the California Personality Inventory, the Millon Clinical Multiaxial Inventory, and the Psychological Inventory of Personality and Symptoms. Stepwise linear regression analysis was used to predict the number and length of inpatient stays, and Cox and logistic regression analyses predicted rehospitalization. Higher rates of psychiatric hospital utilization were found among patients who were unmarried, who had disabilities connected with their military service, who had lower levels of adaptive functioning, and who were diagnosed as having posttraumatic stress disorder, drug or alcohol use disorder, or passive-aggressive or antisocial personality disorder. Higher utilization was also found among those whom psychometric data characterized as less responsible and more compulsive. The data also predicted the length of subsequent medical hospitalization and identified patients who stayed out of the hospital longer and who were not rehospitalized. Hospital utilization was found to be a function of psychiatric diagnosis, marital status, and various personality factors. Factors relating to social disadvantage also played a role. Axis I diagnoses, particularly substance use disorders, were as important as, if not more important than, axis II diagnoses in predicting utilization.

  9. Homeless Families, Children, and Youth in Stanislaus County--Problems and Solutions.

    Science.gov (United States)

    Boley, Ellen

    The homeless crisis in America is a complex issue with no "quick fixes." In Stanislaus County, California, it seems that there are many programs operating in isolation of one another. Approximately 5% of the county's population is homeless. Homeless persons have survival needs for food and clothing, hygiene, health care, affordable…

  10. Relative contributions of parent substance use and childhood maltreatment to chronic homelessness, depression, and substance abuse problems among homeless women: mediating roles of self-esteem and abuse in adulthood.

    Science.gov (United States)

    Stein, Judith A; Leslie, Michelle Burden; Nyamathi, Adeline

    2002-10-01

    This study, using latent variable methodology, explores simultaneously the relative effects of childhood abuse and early parental substance abuse on later chronic homelessness, depression, and substance abuse problems in a sample of homeless women. We also examine whether self-esteem and recent violence can serve as mediators between the childhood predictors and the dysfunctional outcomes. The sample consists of 581 homeless women residing in shelters or sober living centers in Los Angeles (54% African-American, 23% Latina, 22% White, mean age=33.5 years). Multiple-indicator latent variables served as predictors and outcomes in structural models. Childhood abuse was indicated by sexual, physical, and verbal abuse. Childhood abuse directly predicted later physical abuse, chronic homelessness, depression, and less self-esteem. Parent substance use directly predicted later substance use problems among the women. Recent physical abuse predicted chronic homelessness, depression, and substance use problems. Greater self-esteem predicted less depression and fewer substance use problems. Childhood abuse also had significant indirect effects on depression, chronic homelessness, and drug and alcohol problems mediated through later physical abuse and self-esteem. Although there was a strong relationship between childhood abuse and parent drug use, childhood abuse was the more pervasive and devastating predictor of dysfunctional outcomes. Childhood abuse predicted a wider range of problems including lower self-esteem, more victimization, more depression, and chronic homelessness, and indirectly predicted drug and alcohol problems. The mediating roles of recent physical abuse and self-esteem suggest salient leverage points for change through empowerment training and self-esteem enhancement in homeless women.

  11. Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status

    Directory of Open Access Journals (Sweden)

    Kiss Alex

    2010-02-01

    Full Text Available Abstract Background Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status. Methods Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale were examined using regression analyses. Results Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years and for a longer duration (mean 4.8 vs. 2.9 years. Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively. Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI -6.5 to -3.2 but not with poorer physical health status (-0.03 points, 95% CI -1.3 to 1.3. Conclusions Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status.

  12. Social phobia and other psychiatric problems in children with strabismus.

    Science.gov (United States)

    Cumurcu, Tongabay; Cumurcu, Birgul Elbozan; Ozcan, Ozlem; Demirel, Soner; Duz, Cem; Porgalı, Esra; Doganay, Selim

    2011-06-01

    To investigate the rate of social phobia, anxiety, depression, and other psychiatric problems in children with strabismus. Prospective, cross-sectional, case-control study. Forty-two children with strabismus and 47 control subjects 8-13 years of age were enrolled in this study. After the ophthalmologist's examination, all cases were assessed by a psychiatrist based on the structured interview technique of Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version (Kiddie-SADS-PL). The Screen for Child Anxiety Related Emotional Disorders (SCARED) was administered to each subject to evaluate social phobia. All participants completed the Children's Depression Inventory (CDI). Age as well as sex and income were comparable between the strabismus patients and control groups. Social phobia was diagnosed in 8 (19.04%) of the 42 strabismic children and in 1 (2.12%) of the control subjects. The CDI and SCARED (total score, social phobia, separation anxiety) scores of strabismus patients were significantly higher than the control group (p = 0.001, p = 0.004, p = 0.0001, p = 0.05, respectively). A relationship between strabismus in children and social phobia, depression, and anxiety on a symptom basis was underlined by our data. Copyright © 2011. Published by Elsevier Inc.

  13. [Mental health of homeless persons. Critical review of the Anglo-Saxon literature].

    Science.gov (United States)

    Ducq, H; Guesdon, I; Roelandt, J L

    1997-01-01

    Because the visibility of homeless persons congregating in urban areas has increased since the 1980's, the relationship between homelessness and mental illness has caused more and more concern. A multitude of epidemiological surveys have been organized in Great Britain, Australia, Canada, and mainly in United States, and have attempted to evaluate scientifically the psychiatric morbidity of this population. This literature review reveals disparity of epidemiological methods in assessing the type and extent of mental illness among homeless adults. The lack of consensual definition of homelessness, the choice of different settings in which the research is organized (street, health centres, shelters), and the use of diverse instruments of psychiatric evaluation (diagnosis by clinician, by scale or by structured diagnostic interview) lead to a great disparity of the results. Thus, 1/3 of the homeless adults had prior history of psychiatric hospitalisation. Rates of psychosis range to 70% and it is estimated that 4% to 74% of the homeless persons suffer from affective disorders. Substance abuse disorder remains a problem for a significant number of these individuals, with a high frequency of dual diagnosis. Such divergent data highlight the anglo-saxon debate between those who accuse desinstitutionnalisation as a reason of homelessness, and those who blame the socioeconomic background.

  14. Lower Sensitivity to Happy and Angry Facial Emotions in Young Adults with Psychiatric Problems

    Science.gov (United States)

    Vrijen, Charlotte; Hartman, Catharina A.; Lodder, Gerine M. A.; Verhagen, Maaike; de Jonge, Peter; Oldehinkel, Albertine J.

    2016-01-01

    Many psychiatric problem domains have been associated with emotion-specific biases or general deficiencies in facial emotion identification. However, both within and between psychiatric problem domains, large variability exists in the types of emotion identification problems that were reported. Moreover, since the domain-specificity of the findings was often not addressed, it remains unclear whether patterns found for specific problem domains can be better explained by co-occurrence of other psychiatric problems or by more generic characteristics of psychopathology, for example, problem severity. In this study, we aimed to investigate associations between emotion identification biases and five psychiatric problem domains, and to determine the domain-specificity of these biases. Data were collected as part of the ‘No Fun No Glory’ study and involved 2,577 young adults. The study participants completed a dynamic facial emotion identification task involving happy, sad, angry, and fearful faces, and filled in the Adult Self-Report Questionnaire, of which we used the scales depressive problems, anxiety problems, avoidance problems, Attention-Deficit Hyperactivity Disorder (ADHD) problems and antisocial problems. Our results suggest that participants with antisocial problems were significantly less sensitive to happy facial emotions, participants with ADHD problems were less sensitive to angry emotions, and participants with avoidance problems were less sensitive to both angry and happy emotions. These effects could not be fully explained by co-occurring psychiatric problems. Whereas this seems to indicate domain-specificity, inspection of the overall pattern of effect sizes regardless of statistical significance reveals generic patterns as well, in that for all psychiatric problem domains the effect sizes for happy and angry emotions were larger than the effect sizes for sad and fearful emotions. As happy and angry emotions are strongly associated with approach and

  15. Lower sensitivity to happy and angry facial emotions in young adults with psychiatric problems

    Directory of Open Access Journals (Sweden)

    Charlotte Vrijen

    2016-11-01

    Full Text Available Many psychiatric problem domains have been associated with emotion-specific biases or general deficiencies in facial emotion identification. However, both within and between psychiatric problem domains, large variability exists in the types of emotion identification problems that were reported. Moreover, since the domain-specificity of the findings was often not addressed, it remains unclear whether patterns found for specific problem domains can be better explained by co-occurrence of other psychiatric problems or by more generic characteristics of psychopathology, for example, problem severity. In this study, we aimed to investigate associations between emotion identification biases and five psychiatric problem domains, and to determine the domain-specificity of these biases. Data were collected as part of the ‘No Fun No Glory’ study and involved 2,577 young adults. The study participants completed a dynamic facial emotion identification task involving happy, sad, angry, and fearful faces, and filled in the Adult Self-Report Questionnaire, of which we used the scales depressive problems, anxiety problems, avoidance problems, Attention-Deficit Hyperactivity Disorder (ADHD problems and antisocial problems. Our results suggest that participants with antisocial problems were significantly less sensitive to happy facial emotions, participants with ADHD problems were less sensitive to angry emotions, and participants with avoidance problems were less sensitive to both angry and happy emotions. These effects could not be fully explained by co-occurring psychiatric problems. Whereas this seems to indicate domain-specificity, inspection of the overall pattern of effect sizes regardless of statistical significance reveals generic patterns as well, in that for all psychiatric problem domains the effect sizes for happy and angry emotions were larger than the effect sizes for sad and fearful emotions. As happy and angry emotions are strongly associated

  16. Access to palliative care of homeless people: perceived barriers and facilitators from different viewpoints.

    NARCIS (Netherlands)

    Veer, A.J.E. de; Stringer, B.; Meijel, B. van; Verkaik, R.; Francke, A.

    2015-01-01

    Background: Homeless people may have various physical, psychosocial and psychiatric problems, including substance abuse. They have a shorter life-expectancy (< 20 yrs) in comparison with the general population and often avoid help for the problems mentioned. They relatively often suffer from

  17. Genes, Parental Psychiatric Symptoms and Child Emotional Problems: Nurture versus Nature: There and Back Again

    NARCIS (Netherlands)

    F.P. Velders (Fleur)

    2012-01-01

    textabstractChildhood psychiatric disorders are common, show a high comorbidity and are associated with a long-term vulnerability for mental health problems, which underscores the importance of a better understanding of their etiology. Psychiatric symptoms of the parents place children at risk for

  18. Sleep-related problems and minor psychiatric disorders among Brazilian shift workers.

    Science.gov (United States)

    Olinto, Maria Teresa Anselmo; Garcez, Anderson; Henn, Ruth Liane; Macagnan, Jamile Block Araldi; Paniz, Vera Maria Vieira; Pattussi, Marcos Pascoal

    2017-11-01

    The aim of this study was to explore the association between sleep-related problems with the occurrence of minor psychiatric disorders in shift workers of southern Brazil. A cross-sectional study with 1202 workers (785 females) aged 18-50 years was carried out. Minor psychiatric disorders were assessed using the Self-Reporting Questionnaire (SRQ-20), and four sleep problems were collected and analyzed: sleep deprivation (≤ 5h), difficulty falling asleep, waking up during sleep, and sleep medication use. Results show that the overall prevalence of minor psychiatric disorders was 26.8%, but it was more prevalent among females than males (30.2% vs. 20.4%). Nightshift work was significantly associated with the occurrence of sleep-related problems. After adjusting for confounding factors, the number of sleep-related problems showed a positive linear trend with psychiatric disorders in both sexes. Having two or more sleep-related problems was associated with increased probability of psychiatric disorders approximately three-fold among males and two-fold among females, when compared with those without sleep problems. In conclusion, this study demonstrated that sleep-related problems have a strong and independent association with psychiatric disorders among shift workers. Furthermore, the prevalence of both conditions was higher among females than males; however, the strength of these associations was higher in males. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Psychiatric screening of admissions to an accident and emergency ward.

    Science.gov (United States)

    Bell, G; Reinstein, D Z; Rajiyah, G; Rosser, R

    1991-04-01

    One hundred medical and surgical patients admitted to an accident and emergency ward were screened for psychiatric disorder. A psychiatric diagnosis was made in 37 patients, 32 of whom were correctly identified by the GHQ. Psychiatric morbidity was associated with being single, lower social class, unemployment, homelessness and living in Bloomsbury Health District or north-east London. It was also associated with not being registered with a GP. The 14 overdose patients were no more likely to receive a psychiatric diagnosis than other patients, yet constituted most of the psychiatric referrals. Few patients were asked by medical staff about emotional worries or problems. A desire to be asked such questions and a past psychiatric history were associated with a psychiatric diagnosis. Routine screening of psychiatric morbidity in both medical and surgical patients and appropriate psychiatric referral of identified patients is recommended. A system of facilitating GP registration is necessary, as much of the morbidity identified could be contained within primary care.

  20. Sleep problems in children and adolescents with epilepsy: Associations with psychiatric comorbidity.

    Science.gov (United States)

    Hansen, Berit Hjelde; Alfstad, Kristin Å; van Roy, Betty; Henning, Oliver; Lossius, Morten I

    2016-09-01

    Sleep problems are common in pediatric epilepsy and may influence seizure control, daytime functioning, and overall quality of life. Knowledge of factors contributing to sleep problems is likely to improve treatment. The aim of this study was to investigate associations between psychiatric comorbidity and parent-reported and self-reported sleep problems in a sample of children and adolescents with epilepsy. Participants were children and adolescents (N=94), aged 10-19years, with generalized or focal epilepsy who had been referred to a tertiary epilepsy treatment center in Norway. Participants underwent a thorough clinical assessment and 24h of EEG registration. Information on sleep problems was obtained from parents using the Children's Sleep Habit Questionnaire (CSHQ) and from self-reporting using the Sleep Self-Report (SSR) questionnaire. Psychiatric diagnoses were established using the semistructured psychiatric interview Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL). Both the total and subdomain CSHQ and SSR scores were high in comparison with scores from population-based samples. Having one or more psychiatric disorder(s) was significantly associated with elevated scores on both the CSHQ and the SSR. With the exception of parent-reported parasomnias, associations between sleep problems and psychiatric disorders remained significant after adjusting for relevant epilepsy variables. Psychiatric comorbidity explained about one-third of the variance of the reported sleep problems in children and adolescents with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations

    Science.gov (United States)

    Fazel, Seena; Geddes, John R; Kushel, Margot

    2015-01-01

    In the European Union, more than 400 000 individuals are homeless on any one night and more than 600 000 are homeless in the USA. The causes of homelessness are an interaction between individual and structural factors. Individual factors include poverty, family problems, and mental health and substance misuse problems. The availability of low-cost housing is thought to be the most important structural determinant for homelessness. Homeless people have higher rates of premature mortality than the rest of the population, especially from suicide and unintentional injuries, and an increased prevalence of a range of infectious diseases, mental disorders, and substance misuse. High rates of non-communicable diseases have also been described with evidence of accelerated ageing. Although engagement with health services and adherence to treatments is often compromised, homeless people typically attend the emergency department more often than non-homeless people. We discuss several recommendations to improve the surveillance of morbidity and mortality in homeless people. Programmes focused on high-risk groups, such as individuals leaving prisons, psychiatric hospitals, and the child welfare system, and the introduction of national and state-wide plans that target homeless people are likely to improve outcomes. PMID:25390578

  2. Psychiatric Illness and Behavioural Problems in Adults with Learning Disability and Epilepsy

    Directory of Open Access Journals (Sweden)

    Shoumitro Deb

    1999-01-01

    Full Text Available We retrospectively collected data on the rate and type of psychiatric illness and behavioural problems on 143 adults with learning disability and epilepsy. 55% behavioural problems. 19% verbal aggression and temper tantrums, and 13% injurious behaviour. The overall rates of behavioural problems and different types of behaviours found in the current study cohort are similar to what was found before in learning disabled adults in general, as well as in epileptic and non-epileptic learning disabled adults. Psychiatric diagnosis was made in 12.6% combined diagnosis of schizophrenia, delusional disorder and schizo-affective disorder was most common (5% diagnosis of depressive episode (3% bipolar affective disorder.

  3. Homeless, Not Hopeless. An Informational Guide for School Personnel: Understanding and Educating Homeless Students.

    Science.gov (United States)

    Seifert, Elli; Stauffer, Carol

    This guide explains how to educate homeless students within the public schools, focusing on the Saint Paul, Minnesota, public schools. Section 1 defines homelessness. Section 2 presents data on the increasing numbers of homeless students in the area. Section 3 describes common problems faced by homeless students, including family mobility,…

  4. Homelessness and Hunger*

    Science.gov (United States)

    Lee, Barrett A; Greif, Meredith J

    2014-01-01

    We employ data from the National Survey of Homeless Assistance Providers and Clients to examine the character and correlates of hunger among homeless people. Our analysis, couched in an adaptation framework, finds more support for the differentiation hypothesis than for the leveling hypothesis: Complex patterns of food insecurity exist at the individual level, and they vary with the resources available (e.g., higher monthly income, regular shelter use) and obstacles faced (e.g., alcohol, drug, and physical and mental health problems). The chronically homeless, who suffer from multiple deficits, appear particularly food-insecure, a finding that favors the desperation hypothesis over its street-wisdom alternative. We conclude that hunger is not uniformly experienced by members of the homeless population. Rather, some individuals are better situated than others to cope with the stressful nature of homelessness when addressing their sustenance needs. PMID:18418982

  5. Homeless youths and young adults in Los Angeles: prevalence of mental health problems and the relationship between mental health and substance abuse disorders.

    Science.gov (United States)

    Unger, J B; Kipke, M D; Simon, T R; Montgomery, S B; Johnson, C J

    1997-06-01

    Although understanding of the subsistence patterns, service utilization, and HIV-risk behaviors of homeless youths and young adults in increasing, relatively little is known about the epidemiology of mental health problems in this group or the relationships between mental health problems and substance use. This study measured symptoms of depression, low self-esteem, ADHD, suicidality, self-injurious behavior (SIB), and drug and alcohol use disorder in a sample of homeless youth and young adults living in Hollywood, CA. Results indicated extremely high prevalences of mental health problems as compared with corresponding rates of mental health problems found among housed youths in previous studies. Prevalence of mental health problems differed by age and ethnicity. African Americans were at lower risk of suicidal thoughts and SIB than were those of other ethnicities. Older respondents and females were at increased risk of depressive symptoms, and younger respondents were at increased risk of SIB. Previous history of sexual abuse and/or assault was associated with increased risk of suicidality and SIB. Risk factors for drug abuse disorders included ethnicity other than African American, homelessness for 1 year or more, suicidality, SIB, depressive symptoms, and low self-esteem. Risk factors for alcohol abuse disorder included male gender, white ethnicity, homelessness for 1 year or more, suicidality, and SIB. Extremely high rates of mental health problems and substance abuse disorders in this sample suggest the need for street-based and nontraditional mental health services targeted toward these youths and young adults.

  6. Interventions for comorbid problem gambling and psychiatric disorders: Advancing a developing field of research.

    Science.gov (United States)

    Dowling, N A; Merkouris, S S; Lorains, F K

    2016-07-01

    Despite significant psychiatric comorbidity in problem gambling, there is little evidence on which to base treatment recommendations for subpopulations of problem gamblers with comorbid psychiatric disorders. This mini-review draws on two separate systematic searches to identify possible interventions for comorbid problem gambling and psychiatric disorders, highlight the gaps in the currently available evidence base, and stimulate further research in this area. In this mini-review, only 21 studies that have conducted post-hoc analyses to explore the influence of psychiatric disorders or problem gambling subtypes on gambling outcomes from different types of treatment were identified. The findings of these studies suggest that most gambling treatments are not contraindicated by psychiatric disorders. Moreover, only 6 randomized studies comparing the efficacy of interventions targeted towards specific comorbidity subgroups with a control/comparison group were identified. The results of these studies provide preliminary evidence for modified dialectical behavior therapy for comorbid substance use, the addition of naltrexone to cognitive-behavioral therapy (CBT) for comorbid alcohol use problems, and the addition of N-acetylcysteine to tobacco support programs and imaginal desensitisation/motivational interviewing for comorbid nicotine dependence. They also suggest that lithium for comorbid bipolar disorder, escitalopram for comorbid anxiety disorders, and the addition of CBT to standard drug treatment for comorbid schizophrenia may be effective. Future research evaluating interventions sequenced according to disorder severity or the functional relationship between the gambling behavior and comorbid symptomatology, identifying psychiatric disorders as moderators of the efficacy of problem gambling interventions, and evaluating interventions matched to client comorbidity could advance this immature field of study. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Knowledge and practices of general practitioners regarding psychiatric problems

    Directory of Open Access Journals (Sweden)

    R K Chaudhary

    2009-01-01

    Full Text Available Background: Mental health problems account for 12% of global disease burden and non-psychiatrist medical practitioners deal with a large proportion of this burden. This study was planned to assess the knowledge, attitude and treatment practices of non-psychiatrist medical practitioners regarding mental health problems. Materials and Methods: One hundred Allopathic and 25 each of Homeopathic and Ayurvedic medical practitioners were interviewed and assessed using a semi-structured performa. Results: Majority (95% of them were aware regarding etiology, increasing incidence and treatment facilities available for mental health problems. Treatment modalities include counseling and medication but 69.9% of them had not received any formal training in administering them. Conclusions: 98.5% practitioners providing mental health services at the primary level feel the need to be properly trained and oriented in the management of these patients to improve quality of healthcare.

  8. Long-term and chronic homelessness in homeless women and women with children.

    Science.gov (United States)

    Zlotnick, Cheryl; Tam, Tammy; Bradley, Kimberly

    2010-09-01

    The Chronic Homelessness initiative has directed millions of federal dollars to services for single "unaccompanied homeless" individuals, specifically excluding women living with their children. Using a data set with a nationally representative sample of homeless adults, we calculated the prevalence rates and profiles of long-term homelessness in homeless women (n = 849). With the exception of the criterion of being a single "unaccompanied individual," many women, including women with children, met the criteria for chronic homelessness including having a disability of mental health or substance abuse problems. Our findings suggest that the federal definition of chronic homelessness needs to be revised.

  9. Predictors of homeless veterans' irregular discharge status from a domiciliary care program.

    Science.gov (United States)

    Wenzel, S L; Bakhtiar, L; Caskey, N H; Hardie, E; Redford, C; Sadler, N; Gelberg, L

    1995-01-01

    This study addresses the relationship of homeless veterans' discharge status from a domiciliary care program to biopsychosocial characteristics presented at admission into the program. Hypotheses were that younger age, less education, and substance abuse or psychiatric disorder would predict an irregular discharge. Research participants were 367 homeless male veterans who had been admitted to a domiciliary care program at the West Los Angeles Veterans Affairs Medical Center for treatment of medical, psychiatric, or substance disorders. Status of veterans' program discharge (regular or irregular) served as the outcome measure. Logistic regression analysis revealed that irregular discharge from the program was more likely among veterans who were black, who had poor employment histories, or who had problems with alcohol. Results are discussed in light of the need to maintain homeless veterans in treatment programs so that they can achieve maximum benefit from available programs.

  10. Early childhood adversities and trajectories of psychiatric problems in adoptees: Evidence for long lasting effects

    NARCIS (Netherlands)

    E.J.M. Vegt, van der (Esther); J. van der Ende (Jan); R.F. Ferdinand (Robert); F.C. Verhulst (Frank); H.W. Tiemeier (Henning)

    2009-01-01

    textabstractThe aim of the present study is to investigate whether early childhood adversities determine the longitudinal course of psychiatric problems from childhood to adulthood; in particular if the impact of early maltreatment on psychopathology decreases as time passes. A sample of 1,984

  11. Psychiatric Problems and Trauma Exposure in Nondetained Delinquent and Nondelinquent Adolescents

    Science.gov (United States)

    Adams, Zachary W.; McCart, Michael R.; Zajac, Kristyn; Danielson, Carla Kmett; Sawyer, Genelle K.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2013-01-01

    This study examined the prevalence of and associations between specific psychiatric disorders, substance use problems, and trauma exposure in a sample of delinquent and nondelinquent adolescents. A nationally representative sample of adolescents ("n" = 3,614; "M" age = 14.5 years, "SD" = 1.7; 51% male; 71% White,…

  12. Experiences of Social Work Educators Working with Students with Psychiatric Disabilities or Emotional Problems

    Science.gov (United States)

    Mazza, Elena

    2015-01-01

    Social work educators have an ethical responsibility to graduate students who are academically, behaviorally, and professionally prepared to enter the social work profession. Although a student's suitability to the profession is not necessarily hindered because of the effects of a psychiatric disability or an emotional problem, sometimes it is.…

  13. Who Am I? A Life Story Intervention for Persons with Intellectual Disability and Psychiatric Problems

    Science.gov (United States)

    Westerhof, Gerben J.; Beernink, Janny; Sools, Anneke

    2016-01-01

    This article describes an innovative intervention based on narrative and life review therapy that is tailored to people with intellectual disability (ID) and psychiatric problems. The current study provides a first evaluation of the intervention. A symptom checklist (SCL-90) was used in a pre- and post-follow-up design, and a qualitative…

  14. Elderly homeless veterans in Los Angeles: chronicity and precipitants of homelessness.

    Science.gov (United States)

    van den Berk-Clark, Carissa; McGuire, James

    2013-12-01

    We compared the characteristics of chronically homeless and acutely homeless elderly veterans to better understand precipitants of homelessness. We conducted interviews with 33 chronically and 26 acutely homeless veterans aged 65 years and older receiving transitional housing services in Los Angeles, California, between 2003 and 2005. We asked questions regarding their sociodemographic characteristics and other social status measures. Other precipitants of homelessness were acquired via observation and open-ended and structured questions. Both veterans groups were more similar than different, with substantial levels of physical, psychiatric, and social impairment. They differed significantly in homelessness history, with chronically homeless veterans having more homelessness episodes and more total time homeless. They were also less educated and had smaller social networks. In response to open-ended questioning, elderly homeless veterans revealed how health and substance use issues interacted with loss of social support and eviction to exacerbate homelessness. Assessment of a range of factors is needed to address risk factors and events leading to homelessness. Further research with larger samples is needed to confirm the characteristics and needs of the elderly homeless veteran population.

  15. BMI Correlation with Psychiatric Problems Among 10-18 Years Iranian Students

    Directory of Open Access Journals (Sweden)

    Glayol Ardalan

    2012-03-01

    Full Text Available Obesity and its related emotional and physical consequences are a worldwide problem. Obese individuals are usually stigmatized. This study is proposed to assess the correlation between body mass index, gender and age with psychiatric symptoms among Iranian students. A number of 9172 students aged 10-18 years (53.5% girls and 46.5% boys from all provinces of Iran participated in this study. Data was collected using the global school based health survey questionnaire of the World Health Organization (GSHS-WHO. Overall, prevalence of predictors of having emotional problems, depression and anxiety were 27.8%, 29.7% and 11.5% respectively. Girls had significantly higher prevalence of predictors of psychiatric symptoms. Overall obesity was a protective factor against emotional problems OR (CI95%:0.79(0.65-0.98, but it was attributable to obese boys OR (CI95%:0.72(0.55-0.95. Depression and anxiety symptoms were higher in intermediate school girls and high school girls and boys. More attention should be paid to girls' psychological problems. Besides, obesity had an indirect relation with predictors of having psychiatric problems in Iranian boys and it might be due to: (1 parents beliefs about heaviness as a predictor of healthiness, (2 boys lower vulnerability to psychological consequences of obesity and (3 lower pressure from parents on their obese sons to lose weight.

  16. Agreement between Self-Report and Archival Public Service Utilization Data among Chronically Homeless Individuals with Severe Alcohol Problems

    Science.gov (United States)

    Clifasefi, Seema L.; Collins, Susan E.; Tanzer, Kenneth; Burlingham, Bonnie; Hoang, Sara E.; Larimer, Mary E.

    2011-01-01

    Public service utilization data are often used as key outcomes in studies on homelessness. Although self-report data on these outcomes are accessible and cost-effective, various factors may affect retrospective recall in homeless populations. It is therefore necessary to establish validity of self-report to ensure the integrity of studies…

  17. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

    Science.gov (United States)

    Brown, Rebecca T; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B

    2016-01-01

    Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

  18. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

    Directory of Open Access Journals (Sweden)

    Rebecca T Brown

    Full Text Available Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years, young adulthood (ages 18-25, and middle adulthood (ages 26-49. We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment and lower attainment of adult milestones (i.e., marriage, full-time employment compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

  19. Forgotten Youth: Homeless LGBT Youth of Color and the Runaway and Homeless Youth Act

    National Research Council Canada - National Science Library

    Michelle Page

    2017-01-01

    .... [...]this Comment focuses on how and why this problem occurs, the effects it has on homeless LGBT youth of color, and then proposes specific revisions to the Runaway and Homeless Youth Act that would...

  20. Consumer preference programs for individuals who are homeless and have psychiatric disabilities: a drop-in center and a supported housing program.

    Science.gov (United States)

    Tsemberis, Sam J; Moran, Linda; Shinn, Marybeth; Asmussen, Sara M; Shern, David L

    2003-12-01

    We illustrate Fairweather's approach to Experimental Social Innovation and Dissemination with two experimental studies of programs to reduce homelessness for 168 and 225 people with mental illness and often substance abuse. Literally homeless participants were randomly assigned to programs that emphasized consumer choice or to the usual continuum of care, in which housing and services are contingent on sobriety and progress in treatment. A drop-in center that eliminated barriers to access to services was more successful than control programs in reducing homelessness, but after 24 months only 38% of participants had moved to community housing. A subsequent apartment program, in which individuals in the experimental condition moved to subsidized apartments directly from the street, with services under their control, had 79% in stable housing (compared to 27% in the control group) at the end of 6 months. Groups in this study did not differ on substance abuse or psychosocial outcomes.

  1. [Morbidity spectrum and drug therapy of homeless persons in Munich].

    Science.gov (United States)

    Egen, V

    1998-01-01

    In Germany there are currently approx. 200,000 homeless single people, and the trend is rising. As a result of the situation in which they find themselves, many of these persons are ill and in need of medical treatment. A study was performed in Munich/Germany, focussing on a medical practice providing care for the homeless, to investigate their illnesses and pharmacological therapy. The medical practice was located in a municipal shelter. Each year about 350 different destitute homeless men--about 15 per cent of all single homeless people in Munich--were cared for. The men, whose ages ranged from about 17 to 74 years were single and the majority lived in shelters, bed and breakfast accommodations, or shared apartments. About ten per cent lived on the street. For the study, 171 randomly selected medical records were analysed for the period of July 1994 to June 1995. The homeless men suffered principally from the following illnesses: psychiatric illnesses (36%), infectious and parasitic diseases (31%), skin diseases (30%), injuries (29%), diseases of the skeleton, of the muscles and of the connective tissues (28%), diseases of the respiratory organs (27%), cardiovascular diseases (24%), and diseases of the digestive organs (17%). Seventy-five per cent of the patients received drug treatment. In the case of 37% of the patients, wounds were treated and dressed in the medical practice itself. The most frequently prescribed drugs were: analgesics (12%), antibiotics (10%), antihypertensives (10%), gastrointestinal treatments (9%), treatments for colds (9%), and dermatopharmacological preparations (6%). It was surprising that only 16% of the psychic ill patients were treated with drugs, while over 60% of the other illnesses were mostly treated pharmacologically. The interaction with alcohol was the reason for that. The study showed that the practice did not sufficiently reach women and homeless people living on the street. The homeless situation, the personal and social

  2. Desired Destinations of Homeless Women: Realizing Aspirations Within the Context of Homelessness.

    Science.gov (United States)

    Biederman, Donna J; Forlan, Nicole

    2016-08-01

    Despite recent decreases, homelessness remains a substantial problem in the United States. Homelessness is associated with poor health, and homeless women experience earlier mortality than their housed counterparts. Understanding the aspirations of homeless women may offer service providers avenues for intervention to increase well-being among this vulnerable population. This study, a secondary analysis of transcribed interviews (n = 20), provides insight into the aspirations of homeless women. Opportunities for service providers to intervene on these aspirations within the context of homelessness are offered.

  3. Veterans and Homelessness

    Science.gov (United States)

    2013-11-29

    health care and rehabilitation services for homeless veterans (the Health Care for Homeless Veterans and Domiciliary Care for Homeless Veterans...Health Care for Homeless Veterans ................................................................................... 19 Domiciliary Care for Homeless...for Homeless Veterans (HCHV), Domiciliary Care for Homeless Veterans (DCHV), the Compensated Work Therapy/Therapeutic Residences Program, and the

  4. Development and piloting of a treatment foster care program for older youth with psychiatric problems.

    Science.gov (United States)

    McMillen, J Curtis; Narendorf, Sarah Carter; Robinson, Debra; Havlicek, Judy; Fedoravicius, Nicole; Bertram, Julie; McNelly, David

    2015-01-01

    Older youth in out-of-home care often live in restrictive settings and face psychiatric issues without sufficient family support. This paper reports on the development and piloting of a manualized treatment foster care program designed to step down older youth with high psychiatric needs from residential programs to treatment foster care homes. A team of researchers and agency partners set out to develop a treatment foster care model for older youth based on Multi-dimensional Treatment Foster Care (MTFC). After matching youth by mental health condition and determining for whom randomization would be allowed, 14 youth were randomized to treatment as usual or a treatment foster home intervention. Stakeholders were interviewed qualitatively at multiple time points. Quantitative measures assessed mental health symptoms, days in locked facilities, employment and educational outcomes. Development efforts led to substantial variations from the MTFC model and a new model, Treatment Foster Care for Older Youth was piloted. Feasibility monitoring suggested that it was difficult, but possible to recruit and randomize youth from and out of residential homes and that foster parents could be recruited to serve them. Qualitative data pointed to some qualified clinical successes. Stakeholders viewed two team roles - that of psychiatric nurse and skills coaches - very highly. However, results also suggested that foster parents and some staff did not tolerate the intervention well and struggled to address the emotion dysregulation issues of the young people they served. Quantitative data demonstrated that the intervention was not keeping youth out of locked facilities. The intervention needed further refinement prior to a broader trial. Intervention development work continued until components were developed to help address emotion regulation problems among fostered youth. Psychiatric nurses and skills coaches who work with youth in community settings hold promise as important

  5. Indigenous homelessness

    DEFF Research Database (Denmark)

    and scope of Indigenous homelessness in the Canada, Australia, and New Zealand. They argue that effective policy and support programs aimed at relieving Indigenous homelessness must be rooted in Indigenous conceptions of home, land, and kinship, and cannot ignore the context of systemic inequality......, institutionalization, landlessness, among other things, that stem from a history of colonialism. Indigenous Homelessness: Perspectives from Canada, New Zealand and Australia provides a comprehensive exploration of the Indigenous experience of homelessness. It testifies to ongoing cultural resilience and lays......Being homeless in one’s homeland is a colonial legacy for many Indigenous people in settler societies. The construction of Commonwealth nation-states from colonial settler societies depended on the dispossession of Indigenous peoples from their lands. The legacy of that dispossession and related...

  6. Problem-gambling severity and psychiatric disorders among American-Indian/Alaska native adults.

    Science.gov (United States)

    Kong, Grace; Smith, Philip H; Pilver, Corey; Hoff, Rani; Potenza, Marc N

    2016-03-01

    Little is known about the association between problem-gambling severity and psychiatric disorders among American-Indian/Alaska-Native (AI/AN) individuals. Thus, we examined these factors among a nationally representative sample of AI/AN and other American adults in the USA. Using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) data, we conducted separate Wald tests and multinomial logistic regression analyses comparing AI/AN to black/African American, white/Caucasian, and all other racial/ethnic groups, respectively. Relative to other American adults, AI/AN adults were least likely to report non-/low-frequency gambling (NG: AI/AN 66.5%, white/Caucasian 70.5%, black/African American 72.8%, other racial/ethnic group 72.3%) and most likely to report low-risk gambling (LRG: AI/AN 30.1%, white/Caucasian 26.5%, black/African American 23.4%, other racial/ethnic group 24.7%). The association between at-risk/problem-gambling (ARPG) and any past-year Axis-I disorder was stronger among AI/AN versus other American adults. Although ARPG and LRG were associated with multiple past-year Axis-I and lifetime Axis-II psychiatric disorders in both AI/AN and other American adults, LRG was more strongly associated with both Axis-I disorders (particularly major depression, generalized anxiety disorder and nicotine dependence) and Cluster-B Axis-II (particularly antisocial personality disorder) disorders in AI/AN versus other American adults. A stronger association between problem-gambling severity and past-year psychiatric disorders among AI/AN relative to other American adults suggests the importance of enhancing mental health and problem-gambling prevention and treatment strategies that may help AI/AN individuals. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Psychiatric Problems in Children and Adolescents with Sickle cell Disease, Based on Parent and Teacher Reports

    Directory of Open Access Journals (Sweden)

    Özalp Ekinci

    2012-09-01

    Full Text Available OBJECTIVE: This study aimed to investigate the occurrence of psychiatric problems in children and adolescents with sickle cell disease (SCD. METHODS: The Child Behavior Checklist for ages 4-18 years (CBCL/4-18, Conners’ Parent Rating Scale (CPRS, Conners’ Teacher Rating Scale (CTRS-R, and The Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale, clinician and parent forms (T-DSM-IV-S were given to the caregivers and teachers of 31 children with SCD aged between 7-18 years and the caregivers and teachers of 34 age matched controls with irondeficiency anemia. RESULTS: The SCD patients had higher scores on all 4 of scales. Among the subscales, internalizing problems, and attention problems were more prominent in the SCD patients. CONCLUSION: Children and adolescents with SCD appear to have an increased risk for psychiatric problems. Regular psychological evaluation and referral to child and adolescent psychiatry clinics may facilitate timely diagnosis and effective treatment of at-risk children and adolescents.

  8. [Psychological and psychiatric problems in cancer patients: relationship to the localization of the disease].

    Science.gov (United States)

    Moussas, G I; Papadopoulou, A G; Christodoulaki, A G; Karkanias, A P

    2012-01-01

    Cancer may be localized in a variety of areas in the human body. This localization is associated with significant issues concerning not only therapy and prognosis but also psychological and psychiatric problems that the patient may be confronted with. The psychic impact on the patient is determined to a significant degree by the symbolism the affected organ carries. The symbolic significance of a sick body area triggers emotions and sets in motion self-defence mechanisms. In this way, patients deal with the new psychic reality that cancer creates. Therapeutic choices may include interventions, involving mutilation, which cause disfigurement and major consequences in the body image which result in narcissistic injuries. The phenomenology of anxiety and depressive disorders is connected to the affected body area. The appearance of cancer not only in sexual organs but also in other body areas, may disturb sexual function and therefore lead to sexual disorders. Especially, head and neck are connected with vital functions. This area of the body has had a major impact on psychic reality since early life. Complicated psychic functions have developed in relation to organs of the head and neck. Therefore, localization of cancer in this area leads to individual psychological and psychiatric problems, since eating and breathing are harmed, verbal communication becomes difficult and body image alters. Also, increased incidence of alcohol and nicotine abuse in these patients reflects special aspects of psychic structure and personality. Because of severe somatic symptoms and poor prognosis, lung cancer patients feel hopelessness and helplessness. Patients with gynaecological cancer are confronted with a disease that affects organs like breast and internal female sexual organs associated with femininity, attractiveness and fertility. Dietary habits are often a source of guilt for patients who suffer from cancer of the gastrointestinal tract. Additionally, stomas, as colostomy

  9. History of foster care among homeless adults with mental illness in Vancouver, British Columbia: a precursor to trajectories of risk.

    Science.gov (United States)

    Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

    2015-02-26

    It is well documented that a disproportionate number of homeless adults have childhood histories of foster care placement(s). This study examines the relationship between foster care placement as a predictor of adult substance use disorders (including frequency, severity and type), mental illness, vocational functioning, service use and duration of homelessness among a sample of homeless adults with mental illness. We hypothesize that a history of foster care predicts earlier, more severe and more frequent substance use, multiple mental disorder diagnoses, discontinuous work history, and longer durations of homelessness. This study was conducted using baseline data from two randomized controlled trials in Vancouver, British Columbia for participants who responded to a series of questions pertaining to out-of-home care at 12 months follow-up (n = 442). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; vocational functioning; and service use. In multivariable regression models, a history of foster care placement independently predicted incomplete high school, duration of homelessness, discontinuous work history, less severe types of mental illness, multiple mental disorders, early initiation of drug and/or alcohol use, and daily drug use. This is the first Canadian study to investigate the relationship between a history of foster care and current substance use among homeless adults with mental illness, controlling for several other potential confounding factors. It is important to screen homeless youth who exit foster care for substance use, and to provide integrated treatment for concurrent disorders to homeless youth and adults who have both psychiatric and substance use problems. Both trials are registered with the International Standard Randomized Control Trial Number Register and were assigned ISRCTN57595077 (Vancouver At Home Study: Housing First plus

  10. Adult ADHD Is Associated With Gambling Severity and Psychiatric Comorbidity Among Treatment-Seeking Problem Gamblers.

    Science.gov (United States)

    Brandt, Laura; Fischer, Gabriele

    2017-02-01

    The aim of this study is as follows: (a) exploring retrospective childhood and adult ADHD symptomatology in treatment-seeking gamblers, (b) providing detailed characteristics of the association between pathological gambling (PG) and ADHD, and (c) identifying risk factors for a history of ADHD. Eighty problem gamblers (20% female) were examined using a standardized interview (PG: Diagnostic and Statistical Manual of Mental Disorders [4th ed.; DSM-IV] criteria, Gambling Attitudes and Beliefs Survey; ADHD: Wender Utah Rating Scale- deutsche Kurzform, Adult ADHD Self-Report Scale; comorbidities: Mini International Neuropsychiatric Interview). Forty-three percentage of patients screened positive for childhood ADHD, and in 11%, ADHD persisted in adulthood. Patients with adult ADHD had more severe gambling problems ( p = .009, d = 1.03) and a higher number of psychiatric comorbidities ( p gamblers.

  11. Homelessness Felt

    OpenAIRE

    Robinson, Catherine

    2011-01-01

    The felt—as both methodology and experiential terrain—remains under-explored and under-theorised in research on homelessness.  This experimental piece traces the multi-sensory engagement of ethnographic and biographic fieldwork undertaken for separate projects with homeless people in two capital cities on Australia’s east coast.  The epistemological contributions and emotional dimensions of seeing, tasting, touching, smelling and listening are explored.  Throu...

  12. Homelessness as a predictor of mortality

    DEFF Research Database (Denmark)

    Feodor Nilsson, Sandra; Laursen, Thomas Munk; Hjorthøj, Carsten

    2018-01-01

    Purpose: The purpose of this study was to examine the association between homelessness and psychiatric disorders, including substance use disorders, on one hand, and cause-specific and all-cause mortality on the other in a high-income country. Methods: A historical nationwide register-based cohort...... study of the Danish population from 15 years of age between 2000 and 2011 was conducted. The association between homelessness, psychiatric disorders, and mortality was analysed by Poisson Regression adjusting for important confounders. Standardised mortality ratios (SMRs) were calculated for people...... with a history of homelessness compared with the general population using direct age-standardisation. Results: During 51,892,324 person-years of observation, 656,448 died. People with at least one homeless shelter contact accounted for 173,592 person-years with 4345 deaths. The excess mortality in the population...

  13. Overweight in adolescent, psychiatric inpatients: A problem of general or food-specific impulsivity?

    Science.gov (United States)

    Deux, Natalie; Schlarb, Angelika A; Martin, Franziska; Holtmann, Martin; Hebebrand, Johannes; Legenbauer, Tanja

    2017-05-01

    Adolescent psychiatric patients are vulnerable to weight problems and show an overrepresentation of overweight compared to the healthy population. One potential factor that can contribute to the etiology of overweight is higher impulsivity. As of yet, it is unclear whether it is a general impulse control deficit or weight-related aspects such as lower impulse control in response to food that have an impact on body weight. As this may have therapeutic implications, the current study investigated differences between overweight and non-overweight adolescent psychiatric inpatients (N = 98; aged 12-20) in relation to trait impulsivity and behavioral inhibition performance. The Barratt Impulsiveness Scale and two go/no-go paradigms with neutral and food-related stimulus materials were applied. Results indicated no significant differences concerning trait impulsivity, but revealed that overweight inpatients had significantly more difficulties in inhibition performance (i.e. they reacted more impulsively) in response to both food and neutral stimuli compared to non-overweight inpatients. Furthermore, no specific inhibition deficit for high-caloric vs. low-caloric food cues emerged in overweight inpatients, whereas non-overweight participants showed significantly lower inhibition skills in response to high-caloric than low-caloric food stimuli. The results highlight a rather general, non-food-specific reduced inhibition performance in an overweight adolescent psychiatric population. Further research is necessary to enhance the understanding of the role of impulsivity in terms of body weight status in this high-risk group of adolescent inpatients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Supporting Children and Families Experiencing Homelessness: CCDF State Guide

    Science.gov (United States)

    Bires, Carie; Garcia, Carmen; Zhu, Julia

    2015-01-01

    Homelessness has a devastating impact on children. Research has shown that homelessness puts children at increased risk of health problems, developmental delays, academic underachievement and mental health problems. Homelessness also has a disproportionate impact on the youngest children, who account for more than half of all children in…

  15. Problems in setting up an executing large-scale psychiatric epidemiological studies.

    Science.gov (United States)

    Offord, D R; Boyle, M H

    1986-01-01

    This paper focuses on problems that can be encountered in conceptualizing, executing and writing up large-scale psychiatric epidemiological studies. It makes no attempt to cover fundamental issues of design and analysis, rather it centers on problems associated with projects of considerable size. In the conceptual area, it discusses the prerequisites to be considered before deciding to launch such a study. It notes the administrative and scientific uses of epidemiological studies and considers the strengths and weaknesses of large-scale studies to address those concerns. Issues in carrying out such studies are discussed including decisions about study design, sampling method and instrumentation. All are dependent on the central purpose of the study but trade-offs between feasibility and scientific rigor are always present. Data collection and analysis problems highlighted in large-scale studies are examined. They include the difficulty, in the former, of adequately motivating and supervising field personnel and, in the latter, of dealing with problems that accompany missing data and complicated sampling strategies. Potential problems in data access and use and writing up the results are seen as arising from the presence of a large investigative team with diverse interests. Lastly, the comparative worth of these studies is considered.

  16. Religiosity and mental health of pre-adolescents with psychiatric problems and their parents: the TRAILS study

    NARCIS (Netherlands)

    Jagt-Jelsma, W. van der; Vries-Schot, M.R. de; Jong, R. de; Hartman, C.A.; Verhulst, F.C.; Klip, H.; Deurzen, P.A. van; Buitelaar, J.K.

    2015-01-01

    BACKGROUND: This study investigated the association between the religiosity of parents and pre-adolescents, and pre-adolescents' psychiatric problems. METHOD: In a clinic-referred cohort of 543 pre-adolescents at least once referred to a mental health outpatient clinic mental health problems were

  17. Religiosity and mental health of pre-adolescents with psychiatric problems and their parents : The TRAILS study

    NARCIS (Netherlands)

    van der Jagt-Jelsma, W.; de Vries-Schot, M. R.; de Jong, Rint; Hartman, C. A.; Verhulst, F. C.; Klip, H.; van Deurzen, P. A. M.; Buitelaar, J. K.

    2015-01-01

    Background: This study investigated the association between the religiosity of parents and pre-adolescents, and pre-adolescents' psychiatric problems. Method: In a clinic-referred cohort of 543 pre-adolescents at least once referred to a mental health outpatient clinic mental health problems were

  18. Psychiatric disorders in adult children of problem drinkers: prevalence, first onset and comparison with other risk factors.

    Science.gov (United States)

    Cuijpers, P; Langendoen, Y; Bijl, R V

    1999-10-01

    (1) To confirm the increased risk of psychiatric disorders in Adult Children of Alcoholics (ACOAs); (2) to test if the age of onset of the disorders differs for ACOAs versus non-ACOAs; (3) to estimate the weight of being an ACOA compared to other risk factors including childhood traumas, other parental problem behaviours and current risk factors. A random sample of the Dutch population (N = 7147) was interviewed (response rate: 69.7%). Psychiatric disorders were assessed using the CIDI. Parental problem drinking, other parental problem behaviours and childhood traumas were assessed using self-report measures. (1) ACOAs had a significantly higher life-time, 12-month and 1-month prevalence of mood, anxiety and abuse/dependence disorders. Sons of problem drinkers also had a higher prevalence of eating disorders and schizophrenia. The prevalence rates were particularly high for the children of fathers with drinking problems. (2) The first onset of the mood and anxiety disorders took place at a younger age in ACOAs than in non-ACOAs. (3) Relative to other parental problem behaviours and childhood traumas, parental problem drinking is a strong predictor of psychiatric disorders, in particular abuse/dependence disorders. Children of fathers with a drinking problem are a high-risk group for psychiatric disorder. From a public health perspective it is an important target to break through this continuing circle. The further development of prevention and early treatment interventions at schools, youth care and addiction treatment centres is an important issue.

  19. Characteristics of Telephone Applicants to a Residential Rehabilitation Program for Homeless Veterans.

    Science.gov (United States)

    Seidner, Andrea L.; And Others

    1990-01-01

    Gathered descriptive data on 163 telephone applicants to residential rehabilitation program for homeless veterans and compared data with general veteran and homeless populations. Found subjects to be young, educated group of homeless men with histories of relatively high, stable functioning and high rates of medical, substance abuse, psychiatric,…

  20. The Relationship between Literacy and Depression and Anxiety in Homeless Adults

    Science.gov (United States)

    Holland, Mark Edward

    2014-01-01

    Homelessness is a problem that has correlating social, psychological, and health problems. The pathways that lead to homelessness are plentiful and varied, as are the risk factors that are associated with chronic homelessness. Much of the research that has been completed with homeless individuals has focused on substance use or psychological…

  1. Factor structure and risk factors for the health status of homeless veterans.

    Science.gov (United States)

    Goldstein, Gerald; Luther, James F; Haas, Gretchen L; Appelt, Cathleen J; Gordon, Adam J

    2010-12-01

    Homeless veterans have numerous health problems that have been previously characterized as falling into four major subgroups; addiction, psychosis, vascular disorders, and generalized medical and psychiatric illness. Comorbid conditions are common, often involving a combination of psychiatric and medical disorders. Using data from the same survey of homeless veterans that was used to establish these subgroups with cluster analysis, the present study examined the structure of these subgroup patterns through the use of factor analysis. This analysis yielded a five factor solution. They were named "Cardiac", Mood, Stress, Addiction, and Psychosis factors. Factor scores were computed and an odds ratio analysis was accomplished to determine the association between obtaining a high score on a given factor with a number of sociodemographic and homelessness related variables. It was concluded that health status of homeless veterans is a complex condition, but has a clear latent structure demonstrated by factor analysis. Scoring high or low on a particular factor is associated with numerous historical and sociodemographic considerations, notably age, ethnicity, and employment status.

  2. Homelessness Felt

    Directory of Open Access Journals (Sweden)

    Catherine Robinson

    2011-04-01

    Full Text Available The felt—as both methodology and experiential terrain—remains under-explored and under-theorised in research on homelessness.  This experimental piece traces the multi-sensory engagement of ethnographic and biographic fieldwork undertaken for separate projects with homeless people in two capital cities on Australia’s east coast.  The epistemological contributions and emotional dimensions of seeing, tasting, touching, smelling and listening are explored.  Through a series of short ‘felt’ reflections, consideration of the critical role of corporeality in coming to know and inscribe the experiences of others is prompted.  The feeling, researching body is posited as central to new, productive and holistic intertwinings with felt-experience and the mixed trajectories of grief, humour, violence and trauma that often characterise persistent homelessness are made vivid.

  3. Homelessness Felt

    Directory of Open Access Journals (Sweden)

    Catherine Robinson

    2011-04-01

    Full Text Available The felt—as both methodology and experiential terrain—remains under-explored and under-theorised in research on homelessness.  This experimental piece traces the multi-sensory engagement of ethnographic and biographic fieldwork undertaken for separate projects with homeless people in two capital cities on Australia’s east coast.  The epistemological contributions and emotional dimensions of seeing, tasting, touching, smelling and listening are explored.  Through a series of short ‘felt’ reflections, consideration of the critical role of corporeality in coming to know and inscribe the experiences of others is prompted.  The feeling, researching body is posited as central to new, productive and holistic intertwinings with felt-experience and the mixed trajectories of grief, humour, violence and trauma that often characterise persistent homelessness are made vivid. 

  4. Concomitant psychiatric problems and hormonal treatment induced metabolic syndrome in gender dysphoria individuals: a 2 year follow-up study.

    Science.gov (United States)

    Colizzi, Marco; Costa, Rosalia; Scaramuzzi, Francesca; Palumbo, Claudia; Tyropani, Margarita; Pace, Valeria; Quagliarella, Luca; Brescia, Francesco; Natilla, Lilia Carmen; Loverro, Giuseppe; Todarello, Orlando

    2015-04-01

    Several studies indicate increased prevalence of metabolic syndrome (MetS) among patients with psychiatric disorders as well as among individuals with gender dysphoria (GD) treated by cross-sex hormonal treatment. However, the MetS prevalence among hormone treated GD individuals suffering from psychiatric problems has not been detected. From a sample of 146 GD patients we selected 122 metabolically healthy individuals in order to investigate the prevalence of MetS after the beginning of the cross-sex hormonal treatment in a 2 year follow-up assessment. Furthermore, we assessed differences in MetS prevalence between hormone treated GD patients with and without concomitant psychiatric problems. When treated with hormone therapy, GD patients reported changes in several parameters which are clustered in MetS, with statistically significant differences compared to baseline. Glyco-insulinemic alterations were more pronounced in male to female patients (MtFs). However, weight gain, waist circumference increases, blood pressure increases, and lipid alterations were similar in MtFs and female to male patients (FtMs). 14.8% of the sample at year 1 and 17.2% at year 2 developed MetS. Among patients with concomitant psychiatric problems, 50% at year 1 and 55% at year 2 developed MetS against 8% at year 1 and 10% at year 2 of patients without concomitant psychiatric problems. This study indicates that sex hormones induce MetS in a relatively low proportion of healthy GD individuals and especially during the first year of hormonal treatment. Most importantly, concomitant psychiatric problems are associated with considerably greater MetS prevalence in hormone treated GD individuals. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Homeless and Housed Inpatients with Schizophrenia: Disparities in Service Access upon Discharge from Hospital

    Science.gov (United States)

    Burra, Tara A.; Hwang, Stephen W.; Rourke, Sean B.; Stergiopoulos, Vicky

    2012-01-01

    This study examines differences in services available at the time of discharge for homeless and housed psychiatric inpatients. Participants diagnosed with schizophrenia or schizoaffective disorder were recruited from a general hospital psychiatric inpatient unit. Thirty homeless individuals and 21 housed controls (matched for diagnosis, gender,…

  6. Homelessness Assistance and Resources

    Science.gov (United States)

    ... Email Updates Need Housing Assistance? Home Homelessness Assistance Homelessness Assistance Programs CoC CoC Program Page NOFAs Laws, ... VI UT VT VA WA WV WI WY Homelessness Declines in Most Communities of the U.S. with ...

  7. People Experiencing Chronic Homelessness

    Science.gov (United States)

    ... Home Goals Ending Chronic Homelessness Share Ending Chronic Homelessness Last updated on August 04, 2017 We can ... the USICH newsletter. We know how to end homelessness. Let's do it, together. Sign up for our ...

  8. Economic Recession, Teacher-Reported Cuts to School Resources, and Children's Economic and Psychiatric Problems in Young Adulthood

    Science.gov (United States)

    Huurre, Taina; Santalahti, Päivi; Kiviruusu, Olli; Solantaus, Tytti

    2015-01-01

    The study investigated whether cuts to school resources made during economic recession contribute to children's psychiatric and economic problems in early adulthood. The cohort consisted of 817 Finnish children. Data was gathered from teachers during a recession (child age 12) and from national registers on children's post-recession use of…

  9. The Dynamics of Families Who Are Homeless: Implications for Early Childhood Educators

    Science.gov (United States)

    Swick, Kevin J.

    2004-01-01

    Family homelessness has emerged as a serious global problem (Stronge, 2000). Over the past 25 years in the United States, the makeup of the homeless population has changed significantly. As De Angelis (1994) reports: The landscape of homelessness has changed since the early 1980s, when nearly all homeless people were men. Today,…

  10. Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Herbrecht Evelyn

    2009-06-01

    Full Text Available Abstract Background Individuals with autism spectrum disorders (ASDs often display symptoms from other diagnostic categories. Studies of clinical and psychosocial outcome in adult patients with ASDs without concomitant intellectual disability are few. The objective of this paper is to describe the clinical psychiatric presentation and important outcome measures of a large group of normal-intelligence adult patients with ASDs. Methods Autistic symptomatology according to the DSM-IV-criteria and the Gillberg & Gillberg research criteria, patterns of comorbid psychopathology and psychosocial outcome were assessed in 122 consecutively referred adults with normal intelligence ASDs. The subjects consisted of 5 patients with autistic disorder (AD, 67 with Asperger's disorder (AS and 50 with pervasive developmental disorder not otherwise specified (PDD NOS. This study group consists of subjects pooled from two studies with highly similar protocols, all seen on an outpatient basis by one of three clinicians. Results Core autistic symptoms were highly prevalent in all ASD subgroups. Though AD subjects had the most pervasive problems, restrictions in non-verbal communication were common across all three subgroups and, contrary to current DSM criteria, so were verbal communication deficits. Lifetime psychiatric axis I comorbidity was very common, most notably mood and anxiety disorders, but also ADHD and psychotic disorders. The frequency of these diagnoses did not differ between the ASD subgroups or between males and females. Antisocial personality disorder and substance abuse were more common in the PDD NOS group. Of all subjects, few led an independent life and very few had ever had a long-term relationship. Female subjects more often reported having been bullied at school than male subjects. Conclusion ASDs are clinical syndromes characterized by impaired social interaction and non-verbal communication in adulthood as well as in childhood. They also

  11. Spirituality and Mental Health among Homeless Mothers

    Science.gov (United States)

    Hodge, David R.; Moser, Stephanie E.; Shafer, Michael S.

    2012-01-01

    Mothers are one of the fastest growing segments of the homeless population in the United States. Although mental health problems often contribute to homelessness, little is known about the factors that affect mothers' mental health. To help identify protective factors, this longitudinal study examined the relationship between spirituality and…

  12. A Taxonomy of medical comorbidity for veterans who are homeless.

    Science.gov (United States)

    Goldstein, Gerald; Luther, James F; Jacoby, Aaron M; Haas, Gretchen L; Gordon, Adam J

    2008-08-01

    Homeless veterans have numerous medical and behavioral health problems. Grouping homeless people based on comorbidity patterns may assist in determining severity of illness and triaging health care more effectively. We sought to determine if a finite number of profiles could be identified related to demographic characteristics, living situation, length of homelessness, and referral areas using interview data from 2,733 veterans who were presently or recently homeless. We considered 12 disorders: eye problems, hypertension, cardiovascular problems, COPD/emphysema, tuberculosis, gastrointestinal problems, hepatic disease, neurologic disorders, orthopedic problems, skin problems, and trauma. Ratings were evaluated using cluster analysis. Comparison statistics were used to compare intercluster differences in demographics, homeless situation, and referral recommendations. A four-cluster solution is proposed: generalized illness, hepatic disease, lung disease, and neurologic disorder. Medical health problems are common and heterogeneous in homeless individuals. Classifications of these problems may be useful in planning treatment and predicting outcome.

  13. Suicide and unintentional injury mortality among homeless people

    DEFF Research Database (Denmark)

    Nilsson, Sandra Feodor; Hjorthøj, Carsten Rygaard; Erlangsen, Annette

    2014-01-01

    BACKGROUND: Homeless people have elevated mortality, especially due to external causes. We aimed to examine suicide and unintentional injury mortality levels and identify predictors in the homeless population. METHODS: A nationwide, register-based cohort study of homeless people aged 16 years...... and older was carried out using the Danish Homeless Register, 1999-2008. RESULTS: In all, 32 010 homeless people (70.5% men) were observed. For men, the mortality rate was 174.4 [95% confidence interval (CI) = 150.6-198.1] per 100 000 person-years for suicide and 463.3 (95% CI = 424...... and unintentional injury. CONCLUSION: People in the homeless shelter population with a history of a psychiatric disorder constitute a high-risk group regarding the elevated suicide and unintentional injury mortality....

  14. Feigned symptoms among defendants claiming psychiatric problems: Survey of 45 Malingerers

    Science.gov (United States)

    Saberi, Seyed Mehdi; Sheikhazadi, Ardeshir; Ghorbani, Mazaher; Nasrabadi, Zaynab Nasri; Meysamie, Ali Pasha

    2013-01-01

    Objective In many jurisdictions, psychiatric problems are intended for commutation. Therefore, a forensic psychiatrist has an important role in detection of malingering. While several studies evaluate diagnostic tests, it is less known what symptoms are more likely to be imitated by malingerers. Method In a prospective study 45 malingerers, who were diagnosed according to interviews by two forensic psychiatrists, from defendants with a judicial order for evaluation of mental status and criminal responsibility during a period of eighteen months were examined in legal medicine center of Tehran. Participants were assessed in another interview to determine symptoms. Dichotomous symptoms in felony and misdemeanor groups were analyzed using fisher's exact test. The level of statistical significance was set at P < 0.05. Results Thirty-eight malingerers were charged with misdemeanors and seven with felonies. Behavioral symptoms were most frequently faked by 35 participants (77.8%). Participants charged with criminal accusation had a significantly lower mean age (P=0.032) and a higher level of education (P=0.008) than other non-criminal defendants. A statistically significant increase in memory function problems was demonstrated in the misdemeanor group (P=0.040). With regard to dual symptom imitation, statistically significant correlations were observed between thought content and perceptual symptoms (P=0.048) for felonies and mood & affect and thought process symptoms (P=0.034), mood & affect and behavioral symptoms (P=0.000) and cognitive function and behavioral symptoms (P=0.039) for misdemeanors. In general, many simulators attempted to mimic simple symptoms of behavioral disorders. Probably felony offenses need less accurate programming; therefore, their rates are higher in older, less educated participants. Conclusion This study demonstrated that differences between presenting symptoms among different offenses may not be useful in detection of malingering,; however

  15. Feigned Symptoms among Defendants Claiming Psychiatric Problems: Survey of 45 Malingerers

    Directory of Open Access Journals (Sweden)

    Seyed Mehdi Saberi

    2013-03-01

    Full Text Available Objective: In many jurisdictions, psychiatric problems are intended for commutation. Therefore, a forensic psychiatrist has an important role in detection of malingering. While several studies evaluate diagnostic tests, it is less known what symptoms are more likely to be imitated by malingerers.Method: In a prospective study [t1] 45 [t2] malingerers, who were diagnosed according to interviews by two forensic psychiatrists, from defendants [t3] with a judicial order for evaluation of mental status and criminal responsibility during a period of eighteen months were examined in legal medicine center of Tehran.[t4] [t5] Participants were assessed in another interview to determine symptoms. Dichotomous symptoms in felony and misdemeanor groups were analyzed using fisher’s exact test. The level of statistical significance was set at P<0.05. [t6] Results: Thirty-eight malingerers were charged with misdemeanors and seven with felonies. Behavioral symptoms were most frequently faked by 35 participants (77.8%. Participants charged with criminal accusation had a significantly lower mean age (P=0.032 and a higher level of education (P=0.008 than other non-criminal defendants. A statistically significant increase in memory function problems was demonstrated in the misdemeanor group (P=0.040. With regard to dual symptom imitation, statistically significant correlations were observed between thought content and perceptual symptoms (P=0.048 for felonies and mood & affect and thought process symptoms (P=0.034, mood & affect and behavioral symptoms (P=0.000 and cognitive function and behavioral symptoms (P=0.039 for misdemeanors. In general, many simulators attempted to mimic simple symptoms of behavioral disorders. Probably felony offenses need less accurate programming; therefore, their rates are higher in older, less educated participants.Conclusion: This study demonstrated that differences between presenting symptoms among different offenses may not be

  16. Homelessness among the Elderly in Bangkok Metropolitan.

    Science.gov (United States)

    Viwatpanich, Kanvee

    2015-03-01

    The combination between quantitative and qualitative research, "Homelessness among the Elderly in Bangkok Metropolitan" aimed to study causes of homelessness, patterns of living, problems, health status, social and health needs. Purposive sampling of 60 older homeless people could be divided into two groups; temporary and permanent homeless. Causes of homelessness were health problems, money problems, family background, emotional management, cultural sensitivities, limitation of extended family, financial management, political control, and domestic violence. Their living problems included:financial insecurity, police suppression, social and medical services, attacks from the young generations, sexual harassment, stealing, and social hierarchy of homelessness. 63.3% reported having hearing problems and a peptic ulcer before becoming homeless. These evolved into musculo-skeletal problems, accident-injuries, and skin diseases. 95% performed ADL/IADLs independently, 78.3% were depressed, 5% diagnosed with severe stress depression. 70% rated themselves happier than the rest ofthe population, and 75% were identified as having normal cognition. 58.3% had a good relationship with a religious network, 55% still had some contacts with theirfamily members. More than 90% indicated that they were satisfied, could sustainin a life on the street, were happy with theirfreedom, liked being close to green areas, learned about human life,fulfilled the dhamma, and felt close to the king.

  17. Homelessness in a national sample of incarcerated veterans in state and federal prisons.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; McGuire, James F

    2014-05-01

    The Veterans Health Administration (VHA) has been increasing efforts to reach out to assist incarcerated veterans. While previous studies have shown strong associations between incarceration and homelessness, few studies have examined distinctive characteristics of incarcerated homeless and non-homeless veterans. National administrative data on 30,348 incarcerated veterans served by the Health Care for Re-entry Veterans (HCRV) program were analyzed. Incarcerated veterans were classified into four groups based on their history of past homelessness: not homeless, transiently homeless, episodically homeless, and chronically homeless. Multinomial logistic regression was used to compare groups on sociodemographic characteristics, criminal justice status, clinical status, and their interest in using VHA services. Of the sample, 70 % were classified as not homeless, 8 % as transiently homeless, 11 % as episodically homeless, and 11 % as chronically homeless. Thus, 30 % of the sample had a homeless history, which is five times the 6 % rate of past homelessness among adult men in the general population. Compared to non-homeless incarcerated veterans, all three homeless groups reported significantly more mental health problems, more substance abuse, more times arrested in their lifetime, more likely to be incarcerated for a non-violent offense, and were more interested in receiving VHA services after release from prison. Together, these findings suggest re-entry programs, like HCRV, can address relevant mental health-related service needs, especially among formerly homeless veterans and veterans in need of services are receptive to the offer of assistance.

  18. Development and piloting of a treatment foster care program for older youth with psychiatric problems

    National Research Council Canada - National Science Library

    McMillen, J Curtis; Narendorf, Sarah Carter; Robinson, Debra; Havlicek, Judy; Fedoravicius, Nicole; Bertram, Julie; McNelly, David

    2015-01-01

    .... This paper reports on the development and piloting of a manualized treatment foster care program designed to step down older youth with high psychiatric needs from residential programs to treatment foster care homes...

  19. Youth Homelessness 2006

    Science.gov (United States)

    MacKenzie, David; Chamberlain, Chris

    2008-01-01

    The third national census of homeless school students, conducted in 2006, found that the number of homeless students had decreased since 2001. There were 9,389 homeless students in 2006 compared with 12,227 in 2001. Three groups were over-represented in the homeless population: Indigenous students, young people from single parent and blended…

  20. Disordered gambling and co-morbidity of psychiatric disorders among college students: an examination of problem drinking, anxiety and depression.

    Science.gov (United States)

    Martin, Ryan J; Usdan, Stuart; Cremeens, Jennifer; Vail-Smith, Karen

    2014-06-01

    We assessed the occurrence of co-morbid psychiatric disorders (i.e., problem drinking, anxiety, and depression) among college students who met the threshold for disordered gambling. The participants included a large sample of undergraduate students (n = 1,430) who were enrolled in an introductory health course at a large, southeastern university in Spring 2011 and completed an online assessment that included scales to assess disordered gambling, problem drinking, anxiety, and depression. We calculated screening scores, computed prevalence rates for each disorder, and calculated Pearson correlations and Chi square tests to examine correlations and co-morbid relationships between the four disorders. Analyses indicated that all disorders were significantly associated (p college students who experience disordered gambling (and other psychiatric disorders) are at increased risk of experiencing co-occurring disorders, it might be useful for college health professionals to concurrently screen and intervene for co-occurring disorders.

  1. Mobile phone technology: a new paradigm for the prevention, treatment, and research of the non-sheltered "street" homeless?

    Science.gov (United States)

    Eyrich-Garg, Karin M

    2010-05-01

    Individuals experiencing homelessness have disproportionately high rates of health problems. Those who perceive themselves as having greater access to their social support networks have better physical and mental health outcomes as well as lower rates of victimization. Mobile phones offer a connection to others without the physical constraints of landlines and, therefore, may make communication (e.g., access to one's social support networks) more feasible for homeless individuals. This, in turn, could lead toward better health outcomes. This exploratory study examined mobile phone possession and use among a sample of 100 homeless men and women who do not use the shelter system in Philadelphia, PA. Interviews were comprised of the Homeless Supplement to the Diagnostic Interview Schedule, a technology module created for this investigation, and the substance use and psychiatric sections of the Addiction Severity Index. Almost half (44%) of the sample had a mobile phone. In the past 30 days, 100% of those with mobile phones placed or received a call, over half (61%) sent or received a text message, and one fifth (20%) accessed the Internet via their mobile phone. Participants possessed and used mobile phones to increase their sense of safety, responsibility (employment, stable housing, personal business, and sobriety or "clean time"), and social connectedness. Mobile phones could potentially be used by public health/health care providers to disseminate information to the street homeless, to enhance communication between the street homeless and providers, and to increase access for the street homeless to prevention, intervention, and aftercare services. Finally, this technology could also be used by researchers to collect data with this transient population.

  2. Pathways to youth homelessness.

    Science.gov (United States)

    Martijn, Claudine; Sharpe, Louise

    2006-01-01

    Research documents high levels of psychopathology among homeless youth. Most research, however, has not distinguished between disorders that are present prior to homelessness and those that develop following homelessness. Hence whether psychological disorders are the cause or consequence of homelessness has not been established. The aim of this study is to investigate causal pathways to homelessness amongst currently homeless youth in Australia. The study uses a quasi-qualitative methodology to generate hypotheses for larger-scale research. High rates of psychological disorders were confirmed in the sample 35 homeless youth aged 14-25. The rates of psychological disorders at the point of homelessness were greater than in normative samples, but the rates of clinical disorder increased further once homeless. Further in-depth analyses were conducted to identify the temporal sequence for each individual with a view to establishing a set of causal pathways to homelessness and trajectories following homelessness that characterised the people in the sample. Five pathways to homelessness and five trajectories following homelessness were identified that accounted for the entire sample. Each pathway constituted a series of interactions between different factors similar to that described by Craig and Hodson (1998. Psychological Medicine, 28, 1379-1388) as "complex subsidiary pathways". The major findings were that (1) trauma is a common experience amongst homeless youth prior to homelessness and figured in the causal pathways to homelessness for over half of the sample; (2) once homeless, for the majority of youth there is an increase in the number of psychological diagnoses including drug and alcohol diagnoses; and (3) crime did not precede homelessness for all but one youth; however, following homelessness, involvement in criminal activity was common and became a distinguishing factor amongst youth. The implications of these findings for future research and service

  3. Residential treatment for dually diagnosed homeless veterans: a comparison of program types.

    Science.gov (United States)

    Kasprow, W J; Rosenheck, R; Frisman, L; DiLella, D

    1999-01-01

    This study compared two types of residential programs that treat dually diagnosed homeless veterans. Programs specializing in the treatment of substance abuse disorders (SA) and those programs addressing both psychiatric disorders and substance abuse problems within the same setting (DDX) were compared on (1) program characteristics, (2) clients' perceived environment, and (3) outcomes of treatment. The study was based on surveys and discharge reports from residential treatment facilities that were under contract to the Department of Veterans Affairs Health Care for Homeless Veterans program, a national outreach and case management program operating at 71 sites across the nation. Program characteristics surveys were completed by program administrators, perceived environment surveys were completed by veterans in treatment, and discharge reports were completed by VA case managers. DDX programs were characterized by lower expectations for functioning, more acceptance of problem behavior, and more accommodation for choice and privacy, relative to SA programs after adjusting for baseline differences. Dually diagnosed veterans in DDX programs perceived these programs as less controlling than SA programs, but also as having lower involvement and less practical and personal problem orientations. At discharge, a lower percentage of veterans from DDX than SA programs left without staff consultation. A higher percentage of veterans from DDX than SA programs were discharged to community housing rather than to further institutional treatment. Program effects were not different for psychotic and non-psychotic veterans. Although differences were modest, integration of substance abuse and psychiatric treatment may promote a faster return to community living for dually diagnosed homeless veterans. Such integration did not differentially benefit dually diagnosed veterans whose psychiatric problems included a psychotic disorder.

  4. Buprenorphine shared medical appointments for the treatment of opioid dependence in a homeless clinic.

    Science.gov (United States)

    Doorley, Sara L; Ho, Cheryl J; Echeverria, Elizabeth; Preston, Charles; Ngo, Huy; Kamal, Ahmad; Cunningham, Chinazo O

    2017-01-01

    Opioid misuse and dependence are prevalent and rising problems in the United States. Treatment with buprenorphine is a successful treatment option for individuals with opioid dependence. This study describes and preliminarily evaluates a unique delivery system that provides buprenorphine treatment via a shared medical appointment. A retrospective medical record review on all 77 opioid-dependent patients referred for a buprenorphine shared medical appointment in a homeless clinic from 2010 to 2012. Most patients were currently homeless (61%), unemployed (92%), had an Axis I psychiatric diagnosis (81%), and had recent polysubstance use (53%). Of the 77 patients, 95% attended at least 1 shared medical appointment. Treatment retention at 12 and 24 weeks was 86% and 70%, respectively. In a patient population with complex social and mental health histories, buprenorphine treatment via a shared medical appointment had high retention rates. Findings can help guide the development of unique delivery systems to serve real-world complex patients with opioid dependence.

  5. Comparisons of family environment between homeless and non-homeless individuals with schizophrenia in Xiangtan, Hunan.

    Science.gov (United States)

    Chen, Jinliang; Chen, Jindong; Li, Shuchun; Liu, Jun; Ouyang, Guohua; Luo, Wenxuan; Guo, Xiaofeng; Li, Ting; Li, Kaijie; Li, Zhenkuo; Wang, Gan

    2015-06-25

    Homelessness is an increasingly important problem for individuals with serious mental illness in China. Identify the characteristics of families that are associated with homelessness among individuals with schizophrenia. Participants were 1856 homeless individuals with schizophrenia (defined as those who had no place of residence or involved caregivers for 7 consecutive days) and 1728 non-homeless individuals with schizophrenia from Xiangtan, Hunan. The self-completion Family Environment Scale-Chinese Version (FES-CV) was administered to these participants after their acute psychotic symptoms resolved. Compared to individuals in the non-homeless group, those in the homeless group were older and more likely to be non-locals (i.e., from outside of Xiangtan), be residents of rural (versus urban) communities, have temporary (versus permanent) jobs, be married, and have a low level of education. After controlling for demographic differences using multivariate logistic regression models, homelessness was independently associated higher scores in the FES-CV intellectual-cultural orientation, organization, achievement orientation, and control subscales and with lower scores in the FES-CV cohesion, moralreligious emphasis, independence, and active-recreational orientation subscales. After controlling for sociodemographic factors, certain aspects of the family environment areassociated with being homeless among patients with schizophrenia in China. Further work is needed to identify interventions that can reduce the risk of homelessness in high-risk individuals.

  6. The health of homeless children revisited.

    Science.gov (United States)

    Grant, Roy; Shapiro, Alan; Joseph, Sharon; Goldsmith, Sandra; Rigual-Lynch, Lourdes; Redlener, Irwin

    2007-01-01

    To the extent that representative data are available for specific health conditions (eg, under-immunization, asthma prevalence), the authors' data suggest that the gap between the health status of homeless children and housed children in minority, low-income families is narrowing. Studies of the health status of homeless children allow a window into the health status of medically underserved children whose needs may not be readily documented because of their lack of access to the health care system. Although prevalence rates of most of the health conditions discussed in this article exceeded national norms, they were generally consistent with rates characteristic of health disparities based on race-ethnicity and income. It must be emphasized that in most instances, children were seen for their first pediatric visit within weeks of entering the homeless shelter system. The health conditions identified were often present before the child and family became homeless. The high prevalence of asthma among homeless children should therefore be a matter of concern to health providers and payors, because the authors' data strongly suggest that this is not confined to children in homeless shelters as a special population. Similarly, childhood obesity predates homelessness (or at least the episode of homelessness during which health care was provided) and as such the authors' data may indicate the extent of this problem more generally among medically underserved children in the communities of origin. These conditions seem to be exacerbated by the specific conditions associated with homeless shelter life. Asthma care, assuming it was previously available, is disrupted when housing is lost, and shelter conditions may have multiple asthma triggers. Nutrition often suffers as a result of inadequate access to nutritious food and cooking facilities in shelters, as indicated by the high rate of iron-deficiency anemia among very young children. It is clear that homeless children in

  7. A study of suicide and attempted suicide by self-immolation in an Irish psychiatric population: an increasing problem.

    LENUS (Irish Health Repository)

    O'Donoghue, J M

    2012-02-03

    In the Western World self-immolation is an uncommon but dramatic method of attempting suicide. In-patients who attempt suicide by fire-setting tend to be female with severe psychopathology. In a previous study from the South of Ireland, seven cases from a psychiatric and prison population were identified in a five year period from 1984 to 1989. This would represent an annual rate of 1.07 per cent of burns treated in the burns unit at Cork University Hospital. In this study 12 cases were identified for the years 1994 and 1995. This represents an increase of 3.5 per cent from 1.07 to 4.6 per cent of all burns treated at the same institution. Ten of these patients had a previous psychiatric history and eight of them were resident on a psychiatric ward when they committed the act. Seven of the patients were found to have a high degree of suicide intent of whom four died of their injuries, which gives a mortality rate for this group of 33 per cent. Effective prevention policies are necessary if this increasing problem is to be curtailed.

  8. Veterans and Homelessness

    National Research Council Canada - National Science Library

    Perl, Libby

    2007-01-01

    .... The Department of Veterans Affairs (VA) estimates that it has served approximately 300 returning veterans in its homeless programs and has identified over 1,000 more as being at risk of homelessness...

  9. For Homeless Veterans

    Science.gov (United States)

    ... for VA health care services and are experiencing homelessness. VA case managers may connect these Veterans with ... Veterans who have experienced long-term or repeated homelessness. As of Sept. 30, 2015, HUD had allocated ...

  10. Parenting while Being Homeless

    Science.gov (United States)

    Swick, Kevin J.; Williams, Reginald; Fields, Evelyn

    2014-01-01

    This article explores the dynamics of parenting while being in a homeless context. The mosaic of stressors involved in this homeless parenting process are explicated and discussed. In addition, resources and strategies that may support parenting are presented and discussed.

  11. The velo-cardio-facial syndrome: the spectrum of psychiatric problems and cognitive deterioration at adult age.

    Science.gov (United States)

    Evers, L J M; De Die-Smulders, C E M; Smeets, E E J; Clerkx, M G M; Curfs, L M G

    2009-01-01

    The velo-cardio-facial syndrome: the spectrum of psychiatric problems and cognitive deterioration at adult age: Deletion 22q11.2 syndrome, or the velo-cardio-facial syndrome (VCFS), is a syndrome with a known but varied clinical and behavioral phenotype. We report 7 patients with 22q11.2 deletion syndrome and an intellectual disability. Aside from the described behavioral phenotype in literature, a moderate, severe or profound intellectual disability may be present. Special attention should be given to cognitive deterioration.

  12. Organizing homeless people

    DEFF Research Database (Denmark)

    Anker, Jørgen

    2008-01-01

    People who are homeless belong to some of the most vulnerable, dispersed and disorganized groups in welfare societies. Yet in 2001, a national interest organization of homeless people was formed for the first time in Denmark. This article identifies the processes that facilitated the formation...... been homeless. The analysis may thus serve as a case of inspiration for activists and professionals who want to improve homeless people's opportunities for participation in other national settings....

  13. Psychiatric disorders in women with fertility problems: results from a large Danish register-based cohort study.

    Science.gov (United States)

    Baldur-Felskov, B; Kjaer, S K; Albieri, V; Steding-Jessen, M; Kjaer, T; Johansen, C; Dalton, S O; Jensen, A

    2013-03-01

    Do women who don't succeed in giving birth after an infertility evaluation have a higher risk of psychiatric disorders compared with women who do? The results indicated that being unsuccessful in giving birth after an infertility evaluation could be an important risk factor for psychiatric disorders. Several studies have investigated the association between fertility treatment and psychological distress, but the results from these studies show substantial variation and lack of homogeneity that may be due to methodological limitations. A retrospective cohort study was designed using data from a cohort of 98 320 Danish women evaluated for fertility problems during 1973-2008 and linked to several Danish population-based registries. All women were followed from the date of first infertility evaluation until date of hospitalization for the psychiatric disorder in question, date of emigration, date of death or 31 December 2008, whichever occurred first. Owing to the precise linkage between the infertility cohort and the Danish population-based registries, using the unique Danish personal identification number, virtually no women were lost to follow-up. Information on reproductive status for all women in the infertility cohort was obtained by linkage to the Danish Medical Birth Registry. A total of 53 547 (54.5%) women gave birth after the initial infertility evaluation, whereas 44 773 (45.5%) women did not gave birth after the evaluation. To determine psychiatric disorders diagnosed in the women after enrolment in the infertility cohort, the cohort was linked to the Danish Psychiatric Central Registry. A total of 4633 women were hospitalized for a psychiatric disorder. The Cox proportional hazard regression model was applied to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for the association between parity status after the initial infertility evaluation and risk of hospitalization for various groups of psychiatric disorders, including

  14. Teaching Our Homeless Children

    Science.gov (United States)

    Sheldon, George H.

    2011-01-01

    This paper discusses some of the major concerns associated with the instructional process of our homeless children. The reader is provided with a brief overview of the prevalence of this population. According to the National Center on Family Homelessness the number of school children who are homeless is growing rapidly with 1.4 to 1.5 million…

  15. Causes of homelessness among older people in Melbourne, Australia.

    Science.gov (United States)

    Rota-Bartelink, Alice; Lipmann, Bryan

    2007-06-01

    A comparative study of the causes of new episodes of homelessness among people aged 50 years and over has been undertaken in Australia, the United States and England. Semi-structured questionnaires were used to collect information on the circumstances and problems that contributed to homelessness. This paper presents the findings from Australia, where information was obtained from 125 older homeless people (aged 50+ years) and their key workers in Melbourne. All three participating nations followed identical research methodologies. The factors most frequently reported by respondents as contributing to their homelessness were problems with people with whom they lived, followed by physical and mental ill-health and problems associated with the housing itself. The most frequently reported factors by case workers were problems with alcohol, followed by physical and mental health factors. This study demonstrates a significant under-utilisation of housing and support services among recently homeless older people and provides evidence that people who had previously been homeless appear to be more resigned to their homelessness than do those who had not experienced homelessness before. Significant issues relating to depression and gambling were also noted. The findings support the need for more targeted, specialised services to be developed or improved such that older homeless people can readily gain access to them and for improved collaboration or information exchange among housing providers and welfare agencies.

  16. Mother-Child Interaction and Early Language Skills in Children Born to Mothers with Substance Abuse and Psychiatric Problems.

    Science.gov (United States)

    J Haabrekke, Kristin; Siqveland, Torill; Smith, Lars; Wentzel-Larsen, Tore; Walhovd, Kristine B; Moe, Vibeke

    2015-10-01

    This prospective, longitudinal study with data collected at four time points investigated how maternal psychiatric symptoms, substance abuse and maternal intrusiveness in interaction were related to early child language skills. Three groups of mothers were recruited during pregnancy: One from residential treatment institutions for substance abuse (n = 18), one from psychiatric outpatient treatment (n = 22) and one from well-baby clinics (n = 30). Maternal substance abuse and anti-social and borderline personality traits were assessed during pregnancy, postpartum depression at 3 months, maternal intrusiveness in interaction at 12 months, and child language skills at 2 years. Results showed that the mothers in the substance abuse group had the lowest level of education, they were younger and they were more likely to be single mothers than the mothers in the two other groups. There was a significant difference in expressive language between children born to mothers with substance abuse problems and those born to comparison mothers, however not when controlling for maternal age, education and single parenthood. No group differences in receptive language skills were detected. Results further showed that maternal intrusiveness observed in mother-child interaction at 12 months was significantly related to child expressive language at 2 years, also when controlling for socio-demographic risk factors. This suggests that in addition to addressing substance abuse and psychiatric problems, there is a need for applying treatment models promoting sensitive caregiving, in order to enhance child expressive language skills.

  17. Chronic pain among homeless persons: characteristics, treatment, and barriers to management

    Directory of Open Access Journals (Sweden)

    Berends Jon

    2011-07-01

    Full Text Available Abstract Background Little information is available on the problem of chronic pain among homeless individuals. This study aimed to describe the characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use among a representative sample of homeless single adult shelter users who experience chronic pain in Toronto, Canada. Methods Participants were randomly selected at shelters for single homeless adults between September 2007 and February 2008 and screened for chronic pain, defined as having pain in the body for ≥ 3 months or receiving treatment for pain that started ≥ 3 months ago. Cross-sectional surveys obtained information on demographic characteristics, characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use. Whenever possible, participants' physicians were also interviewed. Results Among 152 homeless participants who experienced chronic pain, 11 (8% were classified as Chronic Pain Grade I (low disability-low intensity, 47 (32% as Grade II (low disability-high intensity, 34 (23% as Grade III (high disability-moderately limiting, and 54 (37% as Grade IV (high disability-severely limiting. The most common self-reported barriers to pain management were stress of shelter life, inability to afford prescription medications, and poor sleeping conditions. Participants reported using over-the-counter medications (48%, street drugs (46%, prescribed medications (43%, and alcohol (29% to treat their pain. Of the 61 interviewed physicians, only 51% reported treating the patient's pain. The most common physician-reported difficulties with pain management were reluctance to prescribe narcotics due to the patient's history of substance abuse, psychiatric comorbidities, frequently missed appointments, and difficulty getting the patient to take medications correctly. Conclusions Clinicians who provide healthcare for

  18. Family reintegration of homeless in Maputo and Matola: a descriptive study.

    Science.gov (United States)

    Gouveia, Lídia; Massanganhe, Honório; Mandlate, Flávio; Mabunda, Dirceu; Fumo, Wilza; Mocumbi, Ana Olga; de Jesus Mari, Jair

    2017-01-01

    Homelessness is a global and local social problem with underestimated prevalence. It has been shown to increase the risk of mental illness, raising concerns from mental health providers about the need for effective interventions targeting this population. The aim of this paper is to describe the mental health status of the homeless people in two urban setting in a low-income country, through using standardised clinical and socio-demographic assessments as well assessing potential predictors of family integration versus non-family integration among a group of homeless individuals receiving psychiatric and psychosocial treatment. A descriptive study was performed in Maputo and Matola cities between 2008 and 2010. Homeless people with apparent mental illness were mapped and recruited. The participants were referred from community to hospital, using a multidisciplinary treatment model, according to their clinical condition and later entered a family reintegration process. Seventy-one homeless people were recruited (93.0% male; 80.3% unemployed). The most common diagnosis was schizophrenia and other psychosis (46; 64.8%), followed by mental and behaviour disorder related to substance misuse (21; 29.6%), and intellectual disability (4; 5.6%). Family reintegration was achieved for 53.5% (38 patients). Patients with intellectual disability were less reintegrated and those with disorders related to substance use had better reinsertion in their families (Chi square (2)  = 6.1; p = 0.047). Family reintegration was achieved in more than half of participants after hospitalization. Integration was higher in cases of substance misuse, with those with associated intellectual disability being more difficult to reintegrate. Trial registration Trial Registration Number: NCT02936141, date of registration: 14/10/2016, retrospectively registered.

  19. Homelessness and the transition from foster care to adulthood.

    Science.gov (United States)

    Dworsky, Amy; Courtney, Mark E

    2009-01-01

    Prior research suggests that homelessness is a significant problem among young people aging out of foster care. However, these studies have not attempted to identify potential risk or protective factors that might affect the likelihood of becoming homeless during the transition to adulthood. This paper uses data from a longitudinal study to examine both the occurrence and predictors of homelessness among a sample of young people from three Midwestern states who recently aged out of foster care.

  20. [Girls detained under civil and criminal law in juvenile detention centres; psychiatric disorders, trauma and psychosocial problems].

    Science.gov (United States)

    Hamerlynck, S M J J; Doreleijers, Th A H; Vermeiren, R R J M; Cohen-Kettenis, P T

    2009-01-01

    As from 2008, juveniles sentenced under civil law and juveniles sentenced under criminal law can no longer be assigned to the same juvenile detention centres. The reasoning runs as follows: the centres are unlikely to provide adequate treatment for the 'civil' group, and the 'criminal' group may exert a negative influence on the 'civil' group. Hitherto, there has been no research into the question of whether the problems and treatment requirements of girls in the two categories call for detention in the same detention centres or in different ones. The aim of this study is to investigate differences between the two groups of girls with regard to offence history, sociodemographic characteristics, contact with the social services, psychiatric disorders and trauma. Investigation of a representative sample of 211 female minors in three juvenile detention centres using standard instruments. results 82% of the girls were detained under civil law, 18% under criminal law. There were strong similarities between the groups. However, the 'criminal' group more often had a violent history of delinquency and a non-Dutch background, whereas the 'civil' group more often had a background of residential placements, oppositional-defiant disorder, suicidality and self-harm. Girls detained under civil and under criminal law differed in characteristics such as criminal record, but there were striking similarities in the girls' behavioural problems and psychiatric disorders. It is argued that assignment to a particular type of detention centre should depend on treatment requirements rather than on measures imposed by civil or criminal law.

  1. Affective neuroscientific and neuropsychoanalytic approaches to two intractable psychiatric problems: why depression feels so bad and what addicts really want.

    Science.gov (United States)

    Zellner, Margaret R; Watt, Douglas F; Solms, Mark; Panksepp, Jaak

    2011-10-01

    The affective foundations of depression and addictions are discussed from a cross-species - animal to human - perspective of translational psychiatric research. Depression is hypothesized to arise from an evolutionarily conserved mechanism to terminate protracted activation of separation-distress (PANIC/GRIEF) systems of the brain, a shutdown mechanism which may be in part mediated by down-regulation of dopamine based reward-SEEKING resources. This shutdown of the brain's core motivational machinery is organized by shifts in multiple peptide systems, particularly increased dynorphin (kappa opioids). Addictions are conceived to be primarily mediated by obsessive behaviors sustained by reward-SEEKING circuits in the case of psychostimulant abuse, and also powerful consummatory-PLEASURE responses in the case of opioid abuse, which in turn capture SEEKING circuits. Both forms of addiction, as well as others, eventually deplete reward-SEEKING resources, leading to a state of dysphoria which can only temporarily be reversed by drugs of abuse, thereby promoting a negative affect that sustains addictive cycles. In other words, the opponent affective process - the dysphoria of diminished SEEKING resources - that can be aroused by sustained over-arousal of separation-distress (PANIC/GRIEF) as well as direct pharmacological over-stimulation and depletion of SEEKING resources, may be a common denominator for the genesis of both depression and addiction. Envisioning the foundation of such psychiatric problems as being in imbalances of the basic mammalian emotional systems that engender prototype affective states may provide more robust translational research strategies, coordinated with, rather than simply focusing on, the underlying molecular dynamics. Emotional vocalizations might be one of the best ways to monitor the underlying affective dynamics in commonly used rodent models of psychiatric disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. How Effective Homelessness Prevention Impacts the Length of Shelter Spells.

    Science.gov (United States)

    Goodman, Sarena; Messeri, Peter; O'Flaherty, Brendan

    2014-03-01

    Homelessness prevention programs intervene with households apparently in imminent danger of becoming homeless, and try to keep them housed. If they are at least partially successful, how do they change the average shelter spell of households actually becoming homeless? We use data from 2003 to 2008 for Homebase, a New York City homelessness prevention program that studies have found to be effective in reducing shelter entries. Homebase made no difference in average shelter spells at the community level. This result, like many results about shelter spell length, is not easy to reconcile with the idea that shelter spell length is a reflection of the seriousness of underlying problems.

  3. Staying in School: The Efficacy of the McKinney-Vento Act for Homeless Youth

    Science.gov (United States)

    Ausikaitis, Ashley Etzel; Wynne, Martha Ellen; Persaud, Schevita; Pitt, Rachel; Hosek, Aaron; Reker, Kayse; Turner, Carina; Flores, Sandy; Flores, Sofia

    2015-01-01

    The increasing number of homeless youth in the United States presents many social justice concerns, including issues of educational access, stigma, and self-advocacy. These problems become even more apparent when homelessness and educational attainment intersect. The McKinney-Vento Homeless Assistance Act of 1987 was enacted to address these…

  4. Substance use among Dutch homeless people, a follow-up study: prevalence, pattern and housing status

    NARCIS (Netherlands)

    Straaten, B. Van; Rodenburg, G.; Laan, J. van der; Boersma, S.N.; Wolf, J.R.; Mheen, D. Van de

    2016-01-01

    BACKGROUND: Previous studies have shown that substance use among homeless people is a prevalent problem that is associated with longer durations of homelessness. Most studies of substance use among the homeless were carried out outside Europe and have limited generalizability to European countries.

  5. Substance use among Dutch homeless people, a follow-up study : prevalence, pattern and housing status

    NARCIS (Netherlands)

    Van Straaten, Barbara; Rodenburg, Gerda; Van der Laan, Jorien; Boersma, Sandra N; Wolf, Judith R L M; Van de Mheen, Dike

    2016-01-01

    BACKGROUND: Previous studies have shown that substance use among homeless people is a prevalent problem that is associated with longer durations of homelessness. Most studies of substance use among the homeless were carried out outside Europe and have limited generalizability to European countries.

  6. The long-term co-occurrence of psychiatric illness and behavioral problems following child sexual abuse.

    Science.gov (United States)

    Papalia, Nina L; Luebbers, Stefan; Ogloff, James Rp; Cutajar, Margaret; Mullen, Paul E

    2017-06-01

    There is a growing body of research investigating the relationship between child sexual abuse and a range of adverse outcomes. However, very little is known about the long-term co-occurrence of psychiatric disorders and behavioral problems among this vulnerable population, or the interaction between characteristics of the abuse, such as the nature and timing of the child sexual abuse, and the extent of subsequent adversities. This study aimed to determine the rate and co-occurrence of mental health morbidity, criminal justice system contact, and fatal self-harm among medically confirmed victims of child sexual abuse, and to identify abuse variables associated with a greater likelihood of cumulative adverse experiences. The forensic medical records of 2759 cases of child sexual abuse assessed between 1964 and 1995 were linked with public psychiatric, criminal justice and coronial administrative databases between 13 and 44 years following abuse. Cases were compared to 2677 matched comparisons from the general population. Abuse victims were more likely (odds ratio = 7.2, 95% confidence interval = [4.9, 10.4], p mental illness. Relative to comparisons, female victims demonstrated the largest increase in odds for cumulative outcomes (odds ratio = 9.8, 95% confidence interval = [5.8, 16.8], p Sexual abuse, particularly during adolescence (ages 12-16 years), appears to be a risk factor for co-occurring adverse experiences. This study identifies particular groups of child sexual abuse victims as at-risk and requiring targeted intervention.

  7. Homeless Center: Transitional Housing for Homeless Families

    OpenAIRE

    McMillan, Alexis Sakile

    2017-01-01

    Homelessness in DC has been on the rise for a while but now it is getting to the point where it is becoming a major issue. The Mayor has proposed a plan to end homelessness with seven shelters, one in each ward of DC. The shelter this thesis is proposing would be a combination of a typical homeless center with the added benefits of an overall rehabilitation center. These features combined will provide a place where the homes can transition from their current state to a state where they can th...

  8. Use of VA and Medicare services by dually eligible veterans with psychiatric problems.

    Science.gov (United States)

    Carey, Kathleen; Montez-Rath, Maria E; Rosen, Amy K; Christiansen, Cindy L; Loveland, Susan; Ettner, Susan L

    2008-08-01

    To examine how service accessibility measured by geographic distance affects service sector choices for veterans who are dually eligible for veterans affairs (VA) and Medicare services and who are diagnosed with mental health and/or substance abuse (MH/SA) disorders. Primary VA data sources were the Patient Treatment (acute care), Extended Care (long-term care), and Outpatient Clinic files. VA cost data were obtained from (1) inpatient and outpatient cost files developed by the VA Health Economics and Resource Center and (2) outpatient VA Decision Support System files. Medicare data sources were the denominator, Medicare Provider Analysis Review (MEDPAR), Provider-of-Service, Outpatient Standard Analytic and Physician/Supplier Standard Analytic files. Additional sources included the Area Resource File and Census Bureau data. We identified dually eligible veterans who had either an inpatient or outpatient MH/SA diagnosis in the VA system during fiscal year (FY)'99. We then estimated one- and two-part regression models to explain the effects of geographic distance on both VA and Medicare total and MH/SA costs. Results provide evidence for substitution between the VA and Medicare, demonstrating that poorer geographic access to VA inpatient and outpatient clinics decreased VA expenditures but increased Medicare expenditures, while poorer access to Medicare-certified general and psychiatric hospitals decreased Medicare expenditures but increased VA expenditures. As geographic distance to VA medical facility increases, Medicare plays an increasingly important role in providing mental health services to veterans.

  9. Risk factors for ED use among homeless veterans.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2013-05-01

    Despite national concern about homeless veterans, there has been little examination of their use of emergency department (ED) services. This study examines factors related to the use of ED services in the Veterans Affairs (VA) healthcare system, where insurance is not a barrier to ambulatory healthcare. National VA administrative data from fiscal year 2010 are used to describe the proportions of ED users among homeless and domiciled VA patients. A case-control design is then used to compare homeless ED and non-ED users on sociodemographic and clinical correlates, as well as use of ambulatory care and psychotropic medications. Sixteen percent of domiciled VA patients used EDs at least once during the year and 1% were frequent ED users (>4 ED visits) compared to 45% of homeless VA patients, 10% who were frequent ED users. Among homeless VA patients, those who used EDs were more likely to have a range of psychiatric and medical conditions, and had more service visits and psychotropic medication prescriptions than non-ED users. Multivariate analyses suggest their risk for psychiatric and medical conditions increase their likelihood of using ED services. The high rate of ED use among homeless veterans is associated with significant morbidity, but also greater use of ambulatory care and psychotropics suggesting their ED use may reflect unmet psychosocial needs. Published by Elsevier Inc.

  10. Creating a science of homelessness during the Reagan era.

    Science.gov (United States)

    Jones, Marian Moser

    2015-03-01

    POLICY POINTS: A retrospective analysis of federally funded homeless research in the 1980s serves as a case study of how politics can influence social and behavioral science research agendas today in the United States. These studies of homeless populations, the first funded by the National Institute of Mental Health, demonstrated that only about a third of the homeless population was mentally ill and that a diverse group of people experienced homelessness. This groundbreaking research program set the mold for a generation of research and policy characterizing homelessness as primarily an individual-level problem rather than a problem with the social safety net. A decade after the nation's Skid Rows were razed, homelessness reemerged in the early 1980s as a health policy issue in the United States. While activists advocated for government-funded programs to address homelessness, officials of the Reagan administration questioned the need for a federal response to the problem. In this climate, the National Institute of Mental Health (NIMH) launched a seminal program to investigate mental illness and substance abuse among homeless individuals. This program serves as a key case study of the social and behavioral sciences' role in the policy response to homelessness and how politics has shaped the federal research agenda. Drawing on interviews with former government officials, researchers, social activists, and others, along with archival material, news reports, scientific literature, and government publications, this article examines the emergence and impact of social and behavioral science research on homelessness. Research sponsored by the NIMH and other federal research bodies during the 1980s produced a rough picture of mental illness and substance abuse prevalence among the US homeless population, and private foundations supported projects that looked at this group's health care needs. The Reagan administration's opposition to funding "social research," together

  11. Latent homeless risk profiles of a national sample of homeless veterans and their relation to program referral and admission patterns.

    Science.gov (United States)

    Tsai, Jack; Kasprow, Wesley J; Rosenheck, Robert A

    2013-12-01

    We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. We examined data from the VA's new Homeless Operations Management and Evaluation System on 120,852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class solution compared both referral and admission to VA homeless services. We identified 4 latent classes: relatively few problems, dual diagnosis, poverty-substance abuse-incarceration, and disabling medical problems. Homeless veterans in the first group were more likely to be admitted to the VA's permanent supportive housing program, whereas those in the second group were more likely to be admitted to more restrictive VA residential treatment. Homeless veterans in the third group were more likely to be admitted to the VA's prisoner re-entry program, and those in the fourth group were more likely to be directed to VA medical services. The heterogeneous risk and need profiles of homeless veterans supported the diversity of VA homeless services and encouraged the development of specialized services to meet their diverse needs.

  12. Physical, Financial, and Psychological Abuse Committed Against Older Women by Relatives With Psychiatric Disorders: Extent of the Problem.

    Science.gov (United States)

    Labrum, Travis; Solomon, Phyllis L; Bressi, Sara K

    2015-01-01

    Persons with psychiatric disorders (PD) are known to be at an increased risk of committing elder abuse, with much of this abuse occurring toward women. However, there is no evidence available speaking to the extent of this problem. The objective of the present study is to explore rates of abuse committed against older women by a relative with PD. In conjunction with the University of Pennsylvania, 217 women residing across the United States who are at least 55 years of age and who have a relative with PD completed an online survey. Analyses found that in the past 6 months 15% of survey respondents experienced physical abuse committed by their relative with PD, 20% experienced financial abuse, and 42% experienced psychological abuse. Given these high rates of abuse it is imperative that research into factors predicting abuse be conducted, as such information would help target and determine the nature of interventions.

  13. Hopes, Dreams & Promise: the Future of Homeless Children in America.

    Science.gov (United States)

    Nunez, Ralph da Costa

    This book explores in six chapters the issues behind family homelessness in America and presents some solutions to this increasing problem. Chapter 1 analyzes some of the causes for homelessness with a look at the 1980s, cuts in social programs, the insufficient help provided by federal authorities, and efforts of local initiatives. In chapter 2 a…

  14. Homeless in America, Homeless in California

    OpenAIRE

    Quigley, John M.; Raphael, Steven; Smolensky, Eugene

    2002-01-01

    It is generally believed that the increased incidence of homelessness in the United States has arisen from broad societal factors, such as changes in the institutionalization of the mentally ill, increases in drug addiction and alcohol usage, and so forth. This paper presents a comprehensive test of the alternate hypothesis that variations in homelessness arise from changed circumstances in the housing market and in the income distribution. We assemble essentially all the systematic informati...

  15. Homeless Mentally Ill: Problems and Options in Estimating Numbers and Trends. Report to the Chairman, Committee on Labor and Human Resources, U.S. Senate.

    Science.gov (United States)

    General Accounting Office, Washington, DC. Program Evaluation and Methodology Div.

    In response to a request by the United States Senate Committee on Labor and Human Resources, the General Accounting Office (GAO) examined the methodological soundness of current population estimates of the number of homeless chronically mentally ill persons, and proposed several options for estimating the size of this population. The GAO reviewed…

  16. Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis

    Science.gov (United States)

    Cowlishaw, Sean; Jackson, Alun C; Merkouris, Stephanie S; Francis, Kate L; Christensen, Darren R

    2015-01-01

    Objective: The aim of this paper was to systematically review and meta-analyse the prevalence of co-morbid psychiatric disorders (DSM-IV Axis I disorders) among treatment-seeking problem gamblers. Methods: A systematic search was conducted for peer-reviewed studies that provided prevalence estimates of Axis I psychiatric disorders in individuals seeking psychological or pharmacological treatment for problem gambling (including pathological gambling). Meta-analytic techniques were performed to estimate the weighted mean effect size and heterogeneity across studies. Results: Results from 36 studies identified high rates of co-morbid current (74.8%, 95% CI 36.5–93.9) and lifetime (75.5%, 95% CI 46.5–91.8) Axis I disorders. There were high rates of current mood disorders (23.1%, 95% CI 14.9–34.0), alcohol use disorders (21.2%, 95% CI 15.6–28.1), anxiety disorders (17.6%, 95% CI 10.8–27.3) and substance (non-alcohol) use disorders (7.0%, 95% CI 1.7–24.9). Specifically, the highest mean prevalence of current psychiatric disorders was for nicotine dependence (56.4%, 95% CI 35.7–75.2) and major depressive disorder (29.9%, 95% CI 20.5–41.3), with smaller estimates for alcohol abuse (18.2%, 95% CI 13.4–24.2), alcohol dependence (15.2%, 95% CI 10.2–22.0), social phobia (14.9%, 95% CI 2.0–59.8), generalised anxiety disorder (14.4%, 95% CI 3.9–40.8), panic disorder (13.7%, 95% CI 6.7–26.0), post-traumatic stress disorder (12.3%, 95% CI 3.4–35.7), cannabis use disorder (11.5%, 95% CI 4.8–25.0), attention-deficit hyperactivity disorder (9.3%, 95% CI 4.1–19.6), adjustment disorder (9.2%, 95% CI 4.8–17.2), bipolar disorder (8.8%, 95% CI 4.4–17.1) and obsessive-compulsive disorder (8.2%, 95% CI 3.4–18.6). There were no consistent patterns according to gambling problem severity, type of treatment facility and study jurisdiction. Although these estimates were robust to the inclusion of studies with non-representative sampling biases, they should

  17. Homeless Veterans Eligible for Medicaid Under the Affordable Care Act.

    Science.gov (United States)

    Tsai, Jack; Kasprow, Wesley J; Culhane, Dennis; Rosenheck, Robert A

    2015-12-01

    Among homeless veterans and those at risk of homelessness currently enrolled in Veterans Affairs (VA) health care, this study examined the proportion likely to become eligible for Medicaid in 2014 and their health needs. A total of 114,497 homeless and at-risk veterans were categorized into three groups: currently covered by Medicaid, likely to become eligible for Medicaid, and not likely. Seventy-eight percent of the sample was determined to be likely to become eligible for Medicaid in states that expand Medicaid. Compared with veterans not likely to become eligible for Medicaid, those likely to become eligible were less likely to have general medical and psychiatric conditions and to have a VA service-connected disability but more likely to have substance use disorders. Programs serving homeless and at-risk veterans should anticipate the potential interplay between VA health care and the expansion of Medicaid in states that implement the expansion.

  18. The homeless pregnant woman.

    Science.gov (United States)

    Esen, Umo I

    2017-09-01

    Women who are pregnant and homeless constitute a unique group at significant risk of adverse foetal and maternal outcomes. Despite this heightened risk profile, social housing support to this group of women is less than satisfactory. Concerted effort and more collaborative working is needed by all who provide social, and healthcare services to homeless pregnant women, to improve the lot of these women. Clear definitions and legislative provisions in respect of the homeless will go a long way in reducing ambiguity and close loopholes which currently act to deny the homeless pregnant woman social housing support at a time when it is most needed.

  19. A Population-Based Inquiry of Homeless Episode Characteristics and Early Educational Well-Being.

    Science.gov (United States)

    Fantuzzo, John; Leboeuf, Whitney; Brumley, Benjamin; Perlman, Staci

    2013-06-01

    Child homelessness and educational well-being is an area of national research that requires more precise investigation to address mixed findings. The aim of this study was to extend the investigation of the relations between homelessness and educational well-being by determining if timing and frequency of homeless episodes are differentially associated with children's academic and classroom engagement outcomes. This investigation used a comprehensive research model to study the effects of these homeless episode characteristics within a large urban student cohort. Additionally, this study accounted for co-occurring early risk factors. Findings indicated that having a first homeless episode in early childhood was associated with non-proficiency in mathematics and academic engagement problems. Also more frequent homeless episodes were related to truancy in third grade. These results stress the importance of early intervention for homeless children and underscore the need to further understand the variation in young children's homeless experiences.

  20. Mortality among homeless people with schizophrenia in Sydney, Australia: a 10-year follow-up.

    Science.gov (United States)

    Babidge, N C; Buhrich, N; Butler, T

    2001-02-01

    The aims were first, to describe deaths in a cohort of homeless people compared to the general population and secondly, to compare deaths among the individuals with schizophrenia to those without schizophrenia. Mortality was assessed in a cohort of 708 homeless subjects, 506 with schizophrenia who were referred 10 years previously to psychiatric outreach clinics. Standardized mortality ratios (SMRs) were calculated. Eighty-three people (12%) had died, 19 from suicide. The SMR was 3.76 for homeless men and 3.14 for homeless women. There was a non-significant trend for higher excess mortality among men without schizophrenia compared to men with schizophrenia. SMRs for suicide were significantly elevated among homeless men. Homeless people in inner Sydney have death rates three to four times higher than people in the general population of New South Wales. Excess mortality was greatest for younger age groups.

  1. Developing programs for homeless veterans: understanding driving forces in implementation.

    Science.gov (United States)

    Nakashima, John; McGuire, Jim; Berman, Stephen; Daniels, William

    2004-01-01

    Between 1992 and 2003, services for homeless veterans at the Veterans Affairs Greater Los Angeles Healthcare System went from inappropriate utilization of hospital medical and psychiatric beds, to a continuum of residential treatment, transitional housing, and employment programs through arrangements with private agencies. The authors use elements of Hasenfeld and Brock's Political Economy Model (1991) to explain this transformation in service delivery that was spearheaded by a VA social work leadership team. It is argued that three driving forces crucial to program implementation were present: technological certainty, economic stability, and concentration of power. Evidence of the implementation's impact includes creation of new homeless program beds, a reduction in use of medical/psychiatric beds, and a large number of formerly homeless veterans with housing and employment at program discharge. Study limitations and implications for future studies are discussed.

  2. Down and Out in London: Addictive Behaviors in Homelessness.

    Science.gov (United States)

    Sharman, Steve; Dreyer, Jenny; Clark, Luke; Bowden-Jones, Henrietta

    2016-06-01

    Backgrounds and aims Problem gambling occurs at higher levels in the homeless than the general population. Past work has not established the extent to which problem gambling is a cause or consequence of homelessness. This study sought to replicate recent observations of elevated rates of problem gambling in a British homeless sample, and extend that finding by characterizing (a) the temporal sequencing of the effect, (b) relationships with drug and alcohol misuse, and (c) awareness and access of treatment services for gambling by the homeless. Methods We recruited 72 participants from homeless centers in Westminster, London, and used the Problem Gambling Severity Index to assess gambling involvement, as well as DSM-IV criteria for substance and alcohol use disorders. A life-events scale was administered to establish the temporal ordering of problem gambling and homelessness. Results Problem gambling was evident in 23.6% of the sample. In participants who endorsed any gambling symptomatology, the majority were categorized as problem gamblers. Within those problem gamblers, 82.4% indicated that gambling preceded their homelessness. Participants displayed high rates of substance (31.9%) and alcohol dependence (23.6%); these were not correlated with PGSI scores. Awareness of treatment for gambling was significantly lower than for substance and alcohol use disorders, and actual access of gambling support was minimal. Discussion and conclusions Problem gambling is an under-recognized health issue in the homeless. Our observation that gambling typically precedes homelessness strengthens its role as a causal factor. Despite the elevated prevalence rates, awareness and utilization of gambling support opportunities were low compared with services for substance use disorders.

  3. Treatment of psychiatric problems a growth industry in midst of Chile's booming economy.

    Science.gov (United States)

    Sagaris, L

    1996-07-01

    Five years after an elected government took over from a military regime, Chile has enjoyed booming economic growth and some measure of political stability but the scars of the legacy left by the regime of Augusto Pinochet run deep. Alcohol and drug abuse, family violence, depression and other mental-health problems are reported by a large proportion of the population. Fear is one of the permanent consequences of the military regime, says one sociologist.

  4. A review of physical and mental health in homeless persons.

    Science.gov (United States)

    Martens, W H

    2001-01-01

    To review the physical and mental status in homeless people. A MEDLINE database search covering 5 decades was supplemented by tracing back through references from existing review work. Over 200 articles were extracted, and 106 were selected for review. Homeless persons suffer frequently from physical health problems like tuberculosis, asthma, bronchitis, HIV infection, and as a consequence, they run an increased risk for premature mortality. The prevalence of mental disorders among homeless individuals varies from 80-95% in the USA, Australia, Canada, Norway, and Germany to 25-33% in Ireland and Spain. The most prominent mental disorders among the homeless, which vary from country to country, are depression, affective disorders, substance abuse, psychotic disorders, schizophrenia, and personality disorders. Homelessness is a major public health problem that should have our special interest.

  5. Benefits and liabilities of pets for the homeless.

    Science.gov (United States)

    Kidd, A H; Kidd, R M

    1994-06-01

    Observations in the streets and parks of San Francisco East Bay cities and suburbs suggested that many of the homeless people own and maintain pet animals in spite of circumstances and environmental conditions. Accordingly, 105 homeless adult men and women, half of whom owned pets, were interviewed for this pilot study. Responses indicated that homeless pet-owners were extremely attached to their pets and had owned significantly more pets during childhood and adolescence than nonowners although there were no significant differences in attachment to pets between parents and nonparents or between married and single persons. Providing food and veterinary care for pets, however, was a very significant problem for the majority of the homeless pet-owners. It was clear that many homeless adults did have pets which were important for their mental and physical health and that pet care was associated with unique problems.

  6. Disability and Psychiatric Symptoms in Men Referred for Treatment with Work-Related Problems to Primary Mental Health Care.

    Science.gov (United States)

    Bailey, S Kathleen; Mushquash, Christopher J; Haggarty, John M

    2017-03-24

    The relationship between male sex and employment as barriers to accessing mental health care is unclear. The aim of this research was to examine (1) whether the clinical features of men referred to a shared mental health care (SMHC) service through primary care differed when symptoms were affecting them in the work domain; and (2) empirically re-evaluate the effectiveness of a SMHC model for work-related disability using a pre-post chart review of N = 3960 referrals to SMHC. ANOVA and logistic regression were performed to examine symptoms (Patient Health Questionnaire, PHQ) and disability (World Health Organization Disability Assessment Schedule, WHODAS 2) at entry and discharge. Men were RR (relative risk) = 1.8 (95% C.I.: 1.60-2.05) times more likely to be referred to SMHC with work problems than women. Having greater disability and more severe somatic symptoms increased the likelihood of a work-related referral. There were no significant differences after treatment. Problems in the work domain may play an important role in men's treatment seeking and clinicians' recognition of a mental health care need. This study is relevant because men are underrepresented in mental health (MH) treatment and primary care is the main gateway to accessing MH care. Asking men about functioning in the work domain may increase access to helpful psychiatric services.

  7. Coexisting Psychiatric Problems and Stressful Life Events in Adults with Symptoms of ADHD--A Large Swedish Population-Based Study of Twins

    Science.gov (United States)

    Friedrichs, Bettina; Igl, Wilmar; Larsson, Henrik; Larsson, Jan-Olov

    2012-01-01

    Objective: To explore the associations of subtypes of adult ADHD with other psychiatric problems, stressful life events, and sex differences. Method: Odds ratios were calculated using information from 17,899 participants from a population-based survey of adult twins born in Sweden between 1959 and 1985. Results: Symptoms of attention deficit…

  8. Occupational Outcome in Adult ADHD: Impact of Symptom Profile, Comorbid Psychiatric Problems, and Treatment--A Cross-Sectional Study of 414 Clinically Diagnosed Adult ADHD Patients

    Science.gov (United States)

    Halmoy, Anne; Fasmer, Ole Bernt; Gillberg, Christopher; Haavik, Jan

    2009-01-01

    Objective: To determine the effects of symptom profile, comorbid psychiatric problems, and treatment on occupational outcome in adult ADHD patients. Method: Adult ADHD patients (N = 414) responded to questionnaires rating past and present symptoms of ADHD, comorbid conditions, treatment history, and work status. Results: Of the patients, 24%…

  9. Assessment of health status and quality of life of homeless persons in Belgrade, Serbia

    Directory of Open Access Journals (Sweden)

    Sarajlija Marija

    2014-01-01

    Full Text Available Background/Aim. Homelessness is a problem with social, medical, economic, political and other implications. Despite a large number of studies, reports about health-related quality of life (HRQoL of homeless persons remain sparse. There is a summary of consistent evidence that homeless people have higher prevalence of chronic disease (mental and somatic than general population. The aim of this study was to assess HRQoL and depression in homeless persons in Belgrade, to describe their sociodemographic factors and health status (the presence of chronic mental and somatic diseases and addiction disorders and analyse impact of sociodemographic factors and health status to HRQoL and depression of homeless persons. Methods. The study was conducted in the Shelter for Adult and Elderly Persons in Belgrade, from January 1 to January 31, 2012. A set of questionnaires used in survey included Serbian translation of SF-36 questionnaire, Serbian translation of Beck Depression Inventory-II (BDI-II and sociodemographic questionnaire. Statistical analysis was performed by descriptive and analytic methods. Results. Our study sample consisted of 104 adult participants. The majority of them were male (74% and the mean age in the sample was 48.2 ± 13.0 years. We have found that 35.6% participants had lifetime diagnosis of psychiatric disorder, most frequently depression (lifetime prevalence of 15.4% in the study group. The history of suicide attempts was registered in 28 (26.9% participants. Lifetime illicit drugs use was reported by 12.5%, daily smoking by 82.7% and daily alcohol consumption by 8.7% of the participants. Most common somatic chronic diseases were cardiovascular while chronic lung diseases were the second most frequent. Single chronic disease was present in 33 (31.7% of the participants and comorbidity of 2 chronic diseases was present in 20 of them. A statistically significant difference between participants` HRQoL SF-36 domain scores and norms of

  10. Intellectual Disability and Homelessness

    Science.gov (United States)

    Mercier, C.; Picard, S.

    2011-01-01

    Background: The association between poverty and intellectual disability (ID) has been well documented. However, little is known about persons with ID who face circumstances of extreme poverty, such as homelessness. This paper describes the situation of persons with ID who were or are homeless in Montreal and are currently receiving services from a…

  11. Women and Homelessness

    DEFF Research Database (Denmark)

    Koch-Nielsen, Inger; Munk, Anders; Raun, Mette

    This report has been produced for the Observatory on Homelessness, managed by FEANTSA: European Federation of National Organizations Working with the Homeless. The Observatory is supported financially by the Commission of the European Union. The paper is based on the guidelines set up...

  12. [Psychiatric co-morbidity, body image problems and psychotherapeutic interventions for burn survivors: a review].

    Science.gov (United States)

    Jasper, Stefanie; Rennekampff, Hans-Oliver; de Zwaan, Martina

    2013-11-01

    Due to progress in burn treatment, more patients even with severe burn injuries survive. Despite this positive development, however, there are still negative somatic and mental consequences. These include the life-long care of scars and pain. In addition, posttraumatic-stress disorder and depression are common consequences. Also distress due to disfigurement and body image problems have to be considered, since this is likely to result in social withdrawal, low self-esteem, and reduction of quality of life. Overall, the impact of mental strain on burn victims is quite high. Therefore, psychotherapeutic treatment approaches should be integrated into the care of patients with burns. This might be helpful for both coping and compliance with long-term treatment. This paper provides a review of the mental co-morbidity of burn victims and of psychotherapeutic treatment approaches focusing on changes in body image and the respective social consequences. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Managing Homelessness: Towards a Holistic Paradigm Perspectives from Ireland and Australia

    OpenAIRE

    Hayes, Treasa; O'Neill, Deirdre; Weir, Annette

    2003-01-01

    The problem of homelessness still persists in many advanced capitalist Societies today, despite marked improvements in their overall economic prosperity. The broad objective of this research is ro undertake a comparative study of approaches to addressing the problem of homelessness in two such ocieties - the Republic of Ireland and the State of Victoria in Australia - and to develop an outline model, which addresses the problem of homelessness in a more holistic manner. The two locations of I...

  14. Risk of psychatric disorders in offspring of parents with a history of homelessness during childhood and adolescence in Denmark

    DEFF Research Database (Denmark)

    Nilsson, Sandra Feodor; Munk Laursen, Thomas; Hjorthøj, Carsten

    2017-01-01

    to analyse the association between mother's and father's history of homelessness and the offspring's risk of psychiatric disorders, including substance use disorder, during childhood and adolescence. METHODS:We did a nationwide, register-based cohort study of 1 072 882 children and adolescents aged 0......-16 years, who were living or born in Denmark between Jan 1, 1999, and Dec 31, 2015. Parental homelessness was the primary exposure, data on which were obtained from the Danish Homeless Register. The Danish Civil Registration System was used to extract the population and link offspring to parental...... information, and the outcome, psychiatric disorders in the offspring, was obtained from the Danish Psychiatric Central Research Register and the Danish National Patient Register. We analysed the association between parental history of homelessness and risk of psychiatric disorders in offspring by survival...

  15. Documents of the Komi Republic National Archive on the Solution of the Problem of Children’s Homelessness and Neglect in the Second Half of the 1920s

    Directory of Open Access Journals (Sweden)

    Vladimir N. Bublichenko

    2017-06-01

    Full Text Available The article characterizes the status of the source base which describe the activities of children homelessness and neglect’s eradication in the territory of the Komi Autonomous region in the 1920s. The base is considered in the context of the state policy that was held in regard to unsocial young people in that period. The article presents the original documents of the National archives of the Komi Republic about the regional Department of Education’s work connected with children homelessness and neglect’s eradication in the Komi region. The most important documents are the state authorities’ ordinances and decrees that contain requirement standards how to treat those adolescents who were deprived of family upbringing. The other part of the archival documents includes a list of the factors that produced abandonment and neglect of children in the Komi region; the number of the category of adolescents is given; the public institutions and their activities of dealing with unsocial young people in the region in the 1920s are also described. As follows from the analysis of the archival documents, those punitive and pedagogical actions and activities that were held to eradicate street homelessness and neglect in the early 1920s were effectively positive. It should be noted that the achievements in this field of activity are related to close coordination and interaction between the public authorities, trade unions and social organizations and the Young Communist League.

  16. Caretaker mental health and family environment factors are associated with adolescent psychiatric problems in a Vietnamese sample.

    Science.gov (United States)

    Stratton, Kelcey Jane; Edwards, Alexis Christine; Overstreet, Cassie; Richardson, Lisa; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda Beth

    2014-12-15

    Little is known about risk factors for adolescent mental health in Vietnam. The present study investigated the relationship between caretaker mental health and adolescent mental health in a cross-sectional Vietnamese sample. Primary caretakers completed measures of their own mental distress and general health status using the Self-Reporting Questionnaire-20 (SRQ-20) as well as reports of adolescent mental health using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Multivariate regression models were used to examine the relationships between the caretaker and adolescent health variables. The demographic factors of age, sex, ethnicity, religious affiliation, and household wealth status demonstrated significant relationships with SDQ subscale scores. Caretaker mental health was positively associated with adolescent mental health, and this association remained significant even after accounting for other relevant demographic variables and caretaker general health status. Understanding correlates of adolescent mental health difficulties may help identify youth and families at risk for developing psychiatric problems and inform mental health interventions in Vietnam. Published by Elsevier Ireland Ltd.

  17. Suicidal behavior in a national sample of older homeless veterans.

    Science.gov (United States)

    Schinka, John A; Schinka, Katherine C; Casey, Roger J; Kasprow, Wes; Bossarte, Robert M

    2012-03-01

    We examined self-reported suicidal behavior of older homeless veterans to establish frequencies and predictors of recent suicidal behaviors, and their impact on transitional housing interventions. We analyzed the records of a national sample of 10,111 veterans who participated in a transition housing program over a 6-year period, ending in 2008. Approximately 12% of homeless veterans reported suicidal ideation before program admission; 3% reported a suicide attempt in the 30 days before program admission. Older homeless veterans exhibiting suicidal behavior had histories of high rates of psychiatric disorders and substance abuse. Regression analyses showed that self-report of depression was the primary correlate of suicidal behavior. Suicidal behavior before program entry did not predict intervention outcomes, such as program completion, housing outcome, and employment. Suicidal behavior was prevalent in older homeless veterans and was associated with a history of psychiatric disorder and substance abuse. Self-reported depression was associated with these behaviors at the time of housing intervention. Despite the association with poor mental health history, suicidal behavior in older homeless veterans did not impact outcomes of transitional housing interventions.

  18. The causes of homelessness in later life: findings from a 3-nation study.

    Science.gov (United States)

    Crane, Maureen; Byrne, Kathleen; Fu, Ruby; Lipmann, Bryan; Mirabelli, Frances; Rota-Bartelink, Alice; Ryan, Maureen; Shea, Robert; Watt, Hope; Warnes, Anthony M

    2005-05-01

    This article presents findings from a study of the causes of homelessness among newly homeless older people in selected urban areas of the United States, England, and Australia. Interviews were conducted in each country with > or =122 older people who had become homeless during the last 2 years. Information was also collected from the subjects' key workers about the circumstances and problems that contributed to homelessness. Two-thirds of the subjects had never been homeless before. Antecedent causes were the accommodation was sold or needed repair, rent arrears, death of a close relative, relationship breakdown, and disputes with other tenants and neighbors. Contributory factors were physical and mental health problems, alcohol abuse, and gambling problems. Most subjects became homeless through a combination of personal problems and incapacities, welfare policy gaps, and service delivery deficiencies. Whereas there are nation-specific variations, across the three countries, the principal causes and their interactions are similar.

  19. PSYCHIATRIC DISORDERS AND SLEEP

    Science.gov (United States)

    Krystal, Andrew D.

    2012-01-01

    SYNOPSIS Psychiatric disorders and sleep are related in important ways. In contrast to the longstanding view of this relationship which viewed sleep problems as symptoms of psychiatric disorders, there is growing experimental evidence that the relationship between psychiatric disorders and sleep is complex and includes bi-directional causation. In this article we provide the evidence that supports this point of view, reviewing the data on the sleep disturbances seen in patients with psychiatric disorders but also reviewing the data on the impact of sleep disturbances on psychiatric conditions. Although much has been learned about the psychiatric disorders-sleep relationship, additional research is needed to better understand these relationships. This work promises to improve our ability to understand both of these phenomena and to allow us to better treat the many patients with sleep disorders and with psychiatric disorders. PMID:23099143

  20. The prevalence and characteristics of homelessness in the NSW substance treatment population: implications for practice.

    Science.gov (United States)

    Allan, Julaine; Kemp, Michael

    2014-01-01

    This study examines the prevalence and characteristics of homelessness episodes in Australian substance misuse treatment. A dataset containing all closed substance treatment episodes in NSW, Australia from July 2006 to June 2011 was used. Statistical analysis was used to determine any relationships between demographic and treatment variables and homelessness. Of the 213, 129 treatment episodes in the dataset 12.8% have some form of homelessness. Non-government and residential services have the highest prevalence of homelessness. Sex, age, and drug type have weak relationships with homelessness. Leaving against the advice of the treatment provider is more common in episodes where homelessness is a factor. Homelessness is a problem experienced by a significant proportion of the substance treatment population and treatment providers have an opportunity and an obligation to address it in their treatment delivery.

  1. A Special Need for Others : Social classroom relationships and behavioral problems in children with psychiatric disorders in special education

    NARCIS (Netherlands)

    L.D. Breeman (Linda)

    2015-01-01

    markdownabstract__Abstract__ Children with psychiatric disorders are at risk for experiencing poor psychosocial, emotional, and behavioral adjustment after leaving school (Heijmens Visser, Van der Ende, Koot, & Verhulst, 2003; Wielemaker, 2009). These children thus need a good educational

  2. Psychiatric disorders and behavioral problems in children with Prader-Willi syndrome and the effects of growth hormone treatment

    NARCIS (Netherlands)

    S.T. Lo (Sinddie)

    2015-01-01

    markdownabstract__Abstract__ This thesis includes studies about developmental, behavioral and psychiatric characteristics in children with Prader-Willi syndrome (PWS). Endocrinologists Prader, Labhart, and Willi were the first describing the combination of neonatal hypotonia, short

  3. The Measurement of Adolescent Alcohol Problems via Item Response Theory and Their 15-Year Prospective Associations with Alcohol and Other Psychiatric Disorders.

    Science.gov (United States)

    Windle, Michael; Windle, Rebecca C

    2017-02-01

    A limited number of measures exist to assess alcohol problems during adolescence. Item response theory modeling was used to scale a measure of adolescent alcohol problems, including drinking and driving, and then related to alcohol and other psychiatric disorders that occurred over a 15-year period. High school students (N = 832) completed the 13-item Alcohol Problems Index (API) at age 18 years as part of a long-term longitudinal study of predictors of alcohol use and alcohol disorders. Frequency of drinking and driving was also measured during adolescence. Lifetime psychiatric disorders, including alcohol disorders, were measured during young adulthood. Rasch modeling was used to scale the severity of alcohol problems, and the scaled total score was used to prospectively predict alcohol disorders. The area under the receiver operating characteristic (ROC) curve was also computed between the adolescent alcohol problems and alcohol and other psychiatric disorders across a 15-year period. The prevalence of alcohol disorders was 38.7% (for alcohol dependence, it was 27.7%). Rasch modeling indicated that the API assessed a range of severity of alcohol problems and that drinking and driving were among the less severe indicators. Age 18 API scores significantly correlated with an alcohol diagnosis (0.34), and ROC curve analysis indicated that for adolescent alcohol problem scores, the diagnostic accuracy (or area under the curve) for an alcohol diagnosis by age 33 was 0.70. Our findings supported the unidimensionality and reliability of the API, and statistically significant prospective prediction of young adult alcohol disorders. The measurement of alcohol problems during adolescence, in addition to drinking and driving, may be beneficial in understanding adverse consequences of drinking during adolescence as well as transitions in alcohol use and alcohol disorders across the lifespan. Copyright © 2017 by the Research Society on Alcoholism.

  4. Youth Homelessness in Denmark?

    DEFF Research Database (Denmark)

    Børner Stax, Tobias

    Based on a literature study this chapter reflects upon the existence of youth homelessness in Denmark. The chapter contains reflections upon the juridical measures directed towards youngsters living on the margin of the Danish society and presents two concrete project directed towards young people...... living rough. The chapter is taken form an anthology discussion youth homelessness in the different member states of the European Union....

  5. Homelessness among a nationally representative sample of US veterans: prevalence, service utilization, and correlates.

    Science.gov (United States)

    Tsai, Jack; Link, Bruce; Rosenheck, Robert A; Pietrzak, Robert H

    2016-06-01

    To examine the prevalence of lifetime homelessness among veterans and use of Veterans Affairs (VA) homeless services, as well as their association with sociodemographic and clinical characteristics. A nationally representative sample of 1533 US veterans was surveyed July-August 2015. Among all veterans, 8.5 % reported any lifetime homelessness in their adult life, but only 17.2 % of those reported using VA homeless services. Prevalence of homelessness and VA homeless service use did not significantly differ by gender. Being low income, aged 35-44, and having poor mental and physical health were each independently associated with lifetime homelessness. Veterans who were White or lived in rural areas were significantly less likely to have used VA homeless services. Homelessness remains a substantial problem across different generations of veterans. The low reported uptake of VA homeless services suggests there are barriers to care in this population, especially for veterans who live in rural areas. Governmental resources dedicated to veteran homelessness should be supported, and obtaining accurate prevalence estimates are important to tracking progress over time.

  6. Different faces of discrimination: perceived discrimination among homeless adults with mental illness in healthcare settings.

    Science.gov (United States)

    Skosireva, Anna; O'Campo, Patricia; Zerger, Suzanne; Chambers, Catharine; Gapka, Susan; Stergiopoulos, Vicky

    2014-09-07

    Research on discrimination in healthcare settings has primarily focused on health implications of race-based discrimination among ethno-racial minority groups. Little is known about discrimination experiences of other marginalized populations, particularly groups facing multiple disadvantages who may be subjected to other/multiple forms of discrimination. (1) To examine the prevalence of perceived discrimination due to homelessness/poverty, mental illness/alcohol/drug related problems, and race/ethnicity/skin color while seeking healthcare in the past year among racially diverse homeless adults with mental illness; (2) To identify whether perceiving certain types of discrimination is associated with increased likelihood of perceiving other kinds of discrimination; and (3) To examine association of these perceived discrimination experiences with socio-demographic characteristics, self-reported measures of psychiatric symptomatology and substance use, and Emergency Department utilization. We used baseline data from the Toronto site of the At Home/Chez Soi randomized controlled trial of Housing First for homeless adults with mental illness (n = 550). Bivariate statistics and multivariable logistic regression models were used for the analysis. Perceived discrimination related to homelessness/poverty (30.4%) and mental illness/alcohol/substance use (32.5%) is prevalent among ethnically diverse homeless adults with mental illness in healthcare settings. Only 15% of the total participants reported discrimination due to race/ethnicity/skin color. After controlling for relevant confounders and presence of psychosis, all types of discrimination in healthcare settings were associated with more frequent ED use, a greater - 3 - severity of lifetime substance abuse, and mental health problems. Perceiving discrimination of one type was associated with increased likelihood of perceiving other kinds of discrimination. Understanding the experience of discrimination in healthcare

  7. Experience of primary care among homeless individuals with mental health conditions.

    Directory of Open Access Journals (Sweden)

    Joya G Chrystal

    Full Text Available The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA, one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366 were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005, with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score. Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons' needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers.

  8. Predictors of HIV-risk sexual behavior: examining lifetime sexual and physical abuse histories in relation to substance use and psychiatric problem severity among ex-offenders.

    Science.gov (United States)

    Majer, John M; Rodriguez, Jaclyn; Bloomer, Craig; Jason, Leonard A

    2014-01-01

    Lifetime histories of sexual and physical abuse have been associated with increased HIV-risk sexual behavior, and some studies have identified other variables associated with these relationships. However, there is a dearth of literature that has critically examined abuse histories and HIV-risk sexual behavior in relation to these other variables. Predictors of HIV-risk sexual behavior were analyzed among a sample of ex-offenders who were completing inpatient substance dependence treatment to identify factors related to increases in HIV-risk sexual behavior beyond that of abuse histories. Hierarchical linear regression was conducted to examine sociodemographic characteristics, recent substance use, and current psychiatric problem severity in addition to lifetime histories of sexual/physical abuse in a cross-sectional design. Gender, substance use, and psychiatric problem severity predicted increases in HIV-risk sexual behavior beyond what was predicted by abuse histories. Proportionately more women than men reported abuse histories. In addition, significantly more unprotected sexual than safer sexual practices were observed, but differences in these practices based on lifetime abuse histories and gender were not significant. Findings suggest recent substance use and current psychiatric problem severity are greater risk factors for HIV-risk sexual behavior than lifetime abuse histories among persons who have substance use disorders.

  9. Prep/Tech: Volume 1, No. 1, Youth on homelessness

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    PREP/TECH is a skill development, academic enrichment program of U. of Toledo in Toledo OH and The Engineers Foundation of Ohio; it addresses the mathematics, science, language, and intellectual needs of about 100 African-American and Hispanic-American 7th, 8th, and 9th graders in Toledo. This summer, after 3 weeks of classes, the 80 students returned for a second 3 week session and were divided into two groups, one studying the growing problem of homelessness in America. This group researched and published a pamphlet on homelessness. This report is divided into: myths, causes, descriptions, and solutions. Finally, a brief account is given of the homelessness project.

  10. National Center on Family Homelessness

    Science.gov (United States)

    ... You are here Home National Center on Family Homelessness Center A staggering 2.5 million children are ... raise awareness of the current state of child homelessness in the United States, documents the number of ...

  11. National Coalition for Homeless Veterans

    Science.gov (United States)

    ... Continues Support of National Campaign to End Veteran Homelessness Nov. 14, 2017 This Veterans Day, Harbor Freight ... support of the national campaign to end veteran homelessness through generous contributions to the National Coalition for ...

  12. The homeless mentally ill and community-based care: changing a mindset.

    Science.gov (United States)

    Martin, M A

    1990-10-01

    The care of persons with severe, persistent and disabling mental illness has received increasing attention during the past ten years. This focus is due, to some extent, to the increased visibility of a subset of this population, the large number of individuals with psychiatric problems who have become homeless. These men and women, who are without homes or in temporary residences, present a sophisticated array of needs and a multiplicity of problems which have rendered most communities impotent to provide appropriate and adequate rehabilitative services. To date, there is no "perfect" community-based system of care for these men and women. What exists is a hodge-podge of shelter, outreach and drop-in center services. Most of these provide little more than a bed (or a chair) to sleep on, a hot meal and refuge from inclement weather. This article discusses some of the issues and assumptions that inhibit and foster the development and provision of a comprehensive system of community-based care for persons with serious and persistent mental disorders who have become homeless. A framework, useful in reconceptualizing the clients, the services and the interaction between them is presented.

  13. Outsiders Within: Claiming Discursive Space at National Homelessness Conferences in Canada

    Directory of Open Access Journals (Sweden)

    Emily Paradis

    2016-10-01

    Full Text Available Homelessness in Canada is a large and growing problem affecting more than 235,000 men, women, youth, and families per year, in urban, suburban, rural and Northern communities. Though it is produced by economic and policy drivers including colonization, income insecurity, and state withdrawal from housing provision, policies on homelessness tend to focus on service provision rather than addressing root causes. This article reviews activist, advocacy, service and policy responses to homelessness in Canada, and in particular, homeless sector conferences. Taking as its starting-point a demonstration at a 2014 national conference on homelessness, it examines these conferences as important sites of governance in which service organizations collaborate in the development and delivery of policy. Conferences’ normative culture, and their discursive construction of homelessness as a technical problem, tend to leave unchallenged the prevailing economic, social, political and institutional arrangements that produce homelessness. Recent interventions by people facing homelessness and their allies, though, have claimed discursive space at national homelessness conferences for outsider perspectives and demands. These interventions open possibilities for new alliances, analyses, and tactics that are necessary for ending homelessness.

  14. No Homeless Child Left behind

    Science.gov (United States)

    Saxberg, David

    2011-01-01

    Although it is difficult to determine the precise number of homeless children, the National Coalition for the Homeless reports that there are more than 1.3 million children lacking a permanent residence on any given night. Further, 39 percent of the homeless population was comprised of children under the age of 18 in July 2009, the most recent…

  15. Homeless and Policy – Part I

    Centers for Disease Control (CDC) Podcasts

    2010-11-19

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts policy and what public health professionals can do about it.  Created: 11/19/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) and National Center for Environmental Health (NCEH).   Date Released: 11/19/2010.

  16. Homeless and Policy – Part II

    Centers for Disease Control (CDC) Podcasts

    2010-11-19

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts policy and what public health professionals can do about it.  Created: 11/19/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) and National Center for Environmental Health (NCEH).   Date Released: 11/19/2010.

  17. Homelessness and Health – Part I

    Centers for Disease Control (CDC) Podcasts

    2010-11-19

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts health and what public health professionals can do about it.  Created: 11/19/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) and National Center for Environmental Health (NCEH).   Date Released: 11/19/2010.

  18. Homelessness and Health – Part II

    Centers for Disease Control (CDC) Podcasts

    2010-11-19

    Homelessness in the 21st century is an ongoing problem, increasing due to the country's recent economic downturn, especially in urban areas. This podcast discusses how homelessness impacts health and what public health professionals can do about it.  Created: 11/19/2010 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) and National Center for Environmental Health (NCEH).   Date Released: 11/19/2010.

  19. The association of military discharge variables with smoking status among homeless Veterans.

    Science.gov (United States)

    Hammett, Patrick; Fu, Steven S; Lando, Harry A; Owen, Greg; Okuyemi, Kolawale S

    2015-12-01

    There is a dearth of research examining the health correlates of tobacco use within the homeless population, particularly with respect to homeless Veterans. An aim of the present study was to compare homeless Veteran and homeless non-Veteran smokers across a series of socio-demographic and health variables, and to determine whether any of these variables were independently associated with Veteran status. A subsequent aim was to compare the socio-demographic and health profiles of Veteran smokers and Veteran nonsmokers, and to determine whether any of these variables were independently associated with current smoking. Data were obtained from the 2009 Homelessness in Minnesota survey conducted by the Wilder Research Foundation. The final sample included 4750 homeless individuals living throughout Minnesota. The prevalence of smoking was greater among homeless Veterans (74%) than homeless non-Veterans (70%). The prevalence of physical and mental health problems was higher among homeless Veteran smokers than homeless non-Veteran smokers, although these variables were not independently associated with Veteran status after controlling for socio-demographics. Analyses of the homeless Veteran sample indicated that receipt of Veterans' benefits, type of discharge, and alcohol and/or chemical dependence were independently associated with current smoking. Homeless Veteran smokers exhibit heightened rates of physical and mental health problems compared to homeless non-Veteran smokers. Military service and discharge characteristics may contribute to this high smoking prevalence. Future efforts should focus on increasing Veterans' access to and knowledge of Veterans' health resources, and on developing innovative strategies to boost cessation in this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Primary Psychiatric Diseases

    Directory of Open Access Journals (Sweden)

    Sibel Mercan

    2010-07-01

    Full Text Available The etiology of these dermatological diseases is entirely psychiatric origin. These patients show overconcern to their skin or self inflicted dermatoses unconsciously instead of facing with their real problems. In this group, delusions, dermatitis artefacta, trichotillomania, body dysmorphic disorder can be seen. They use denial as defence mechanism to their real psychiatric problems and prefer to apply dermatology instead of psychiatry. Dermatologist should be very careful before asking psychiatric consultation. Denial mechanism help patients to overcome agressive impulses like suicide or prevent further psychiatric damage like psychosis. Dermatologist should see these patients with short and frequent intervals with a good empathic approach. This will help to progress a powerful patient doctor relationship which will lead to a psychiatric evaluation.

  1. Healthcare experiences of the homeless.

    Science.gov (United States)

    Nickasch, Bonnie; Marnocha, Suzanne K

    2009-01-01

    To explore the healthcare experiences of homeless individuals and inform providers of the barriers created by the situation of homelessness. This was a qualitative research study using a grounded theory approach. The sample included homeless individuals older than 18 years living in northeastern Wisconsin. This research provided rich insight into the healthcare experiences of the homeless. Five key conclusions were made: (a) the great majority of homeless people have an external locus of control; (b) most homeless individuals lack the necessary resources to meet their physical needs of shelter, air, water, and food; (c) most homeless individuals lack the financial resources to seek adequate health care; (d) access to resources is limited because of poor transportation, telephones, and mail; and (e) all those interviewed felt that healthcare providers lack compassion for the homeless. Healthcare providers can use the concepts discovered in this study to help improve their skills and comfort level when working with homeless individuals. A decrease in acute illnesses and an increase in the effective management of chronic disease resulting in fewer long-term complications and medical costs because of these unnecessary complications could be seen. Healthcare professionals may also volunteer to become more involved with the care of the homeless if they are confident in their skills. Improving the health of the homeless in the community will result in improvements in the overall health of the community.

  2. Characteristics and service use of homeless veterans and nonveterans residing in a low-demand emergency shelter.

    Science.gov (United States)

    Petrovich, James C; Pollio, David E; North, Carol S

    2014-06-01

    This study examined use of U.S. Department of Veterans Affairs (VA) and non-VA services and predictors of service use among veterans and nonveterans who resided in a low-demand emergency shelter. Equal numbers (N=110) of veterans and nonveterans recruited between January and June 2008 at a low-demand emergency shelter were interviewed about demographic characteristics, histories of military service and homelessness, general medical and mental functioning, current alcohol and drug problems and substance use, and use of medical, psychiatric, and substance abuse services. The Behavioral Model for Vulnerable Populations was used to identify need-based, enabling, and predisposing variables for analysis. Both groups reported high rates of arrest and incarceration, very low incomes, extensive histories of homelessness, and a similar need for services. However, significantly more veterans than nonveterans used psychiatric services, nonemergency medical services, and inpatient substance use services. Similar proportions of veterans and nonveterans used public non-VA health care services. Need-based variables appropriately predicted service use, but veterans and individuals with insurance were also more likely to access services. The veterans and nonveterans residing in a low-demand shelter faced several barriers to escaping homelessness. Both groups made similar use of non-VA services, but veterans used more services overall because of their access to VA services. The predictive power of insurance indicated that veterans may experience barriers to care despite the availability of VA services. The presence of veterans in this low-demand shelter may represent evidence of barriers to veteran and other public housing services.

  3. Cocreating with the homeless?

    DEFF Research Database (Denmark)

    Hansen, Brian Benjamin; Gemal, Carsten Høy

    2014-01-01

    The article is based on the case of a group of homeless people who in the fall of 2013 occupied a central site in the Danish town of Aarhus. The authors argue that this specific case is an ideal object of investigation for casting light on a new situation in the field of public administration...... the case of the homeless, the authors argue that participatory citizenship should not only be viewed as “added value” to the field of public administration, but rather as emerging within a dynamic and conflict-ridden field between citizens and administration where new types of value are potentially created...

  4. Homeless in Galilee

    OpenAIRE

    Robert L. Brawley

    2011-01-01

    This article has located Jesus’ saying about homelessness in the context of the Roman Empire as it was experienced in Galilee. Homelessness is part of a broader picture that translates into loss of access to the resources of the land. The thesis is that in light of a theology of land resulting from the development of Abrahamic covenant traditions and the prophetic hope expressed especially in Isaiah, Ezekiel and Psalm 37, Jesus proclaimed God’s kingdom as God’s rule over heaven and earth, whi...

  5. [Mental Disorder and Self-Rated Health Among Homeless People in Zurich - First Epidemiological Data from Switzerland].

    Science.gov (United States)

    Briner, David; Jäger, Matthias; Kawohl, Wolfram; Baumgartner-Nietlisbach, Gabriela

    2017-09-01

    Objective This study aims to assess psychiatric morbidity and self-rated health (SRH) of homeless people in Zurich, Switzerland. Methods Cross-sectional study of N = 338 homeless people, assessement of psychiatric disorders (ICD-10), level of functioning (GAF, HoNOS), self-rated health. Comparison of SRH among homeless people with a sample of Zurich (N = 956) and Swiss (N = 21 579) population. Results 96 % of the homeless people had at least one psychiatric disorder, most of them drug- (60.9 %) or alcohol-dependence (41.5 %). Homeless people had a far lower SRH than the Zurich population. Higher impairment in HoNOS was associated with lower levels of SRH. Low SRH was associated with help care seeking (OR = 1.9, p < 0.001) and medication (OR = 1.5, p = 0.006). Conclusions The prevalence of psychiatric disorders is far higher among homeless people compared to the general population in Zurich. Implications for providing help at the intersection of social and health care are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Health care utilization and costs after entry into an outreach program for homeless mentally ill veterans.

    Science.gov (United States)

    Rosenheck, R; Gallup, P; Frisman, L K

    1993-12-01

    This study evaluated the impact of a Department of Veterans Affairs outreach and residential treatment program for homeless mentally ill veterans on utilization and cost of health care services provided by the VA. Veterans at nine program sites (N = 1,748) were assessed with a standard intake instrument. Services provided by the outreach program were documented in quarterly clinical reports and in residential treatment discharge summaries. Data on nonprogram VA health service utilization and health care costs were obtained from national VA data bases. Changes in use of services and cost of services from the year before initial contact with the program to the year after were analyzed by t test. Multivariate analyses were used to examine the relationship of these changes to indicators of clinical need and to participation in the outreach program. Although utilization of inpatient service did not increase after veterans' initial contact with the program, use of domiciliary and outpatient services increased substantially. Total annual costs to the VA also increased by 35 percent, from $6,414 to $8,699 per veteran per year. Both clinical need and participation in the program were associated with increased use of health services and increased cost. Veterans with concomitant psychiatric and substance abuse problems used fewer health care services than others. Specialized programs to improve the access of homeless mentally ill persons to health care services appear to be effective, but costly. Dually diagnosed persons seem especially difficult to engage in treatment.

  7. Development and Implementation of an Academic-Community Partnership to Enhance Care among Homeless Persons

    Directory of Open Access Journals (Sweden)

    Sharon B.S. Gatewood

    2011-01-01

    Full Text Available An academic-community partnership between a Health Care for the Homeless (HCH clinic and a school of pharmacy was created in 2005 to provide medication education and identify medication related problems. The urban community based HCH clinic in the Richmond, VA area provides primary health care to the homeless, uninsured and underinsured. The center also offers eye care, dental care, mental health and psychiatric care, substance abuse services, case management, laundry and shower facilities, and mail services at no charge to those in need. Pharmacist services are provided in the mental health and medical clinics. A satisfaction survey showed that the providers and staff (n = 13 in the clinic were very satisfied with the integration of pharmacist services. The quality and safety of medication use has improved as a result of the academic-community collaborative. Education and research initiatives have also resulted from the collaborative. This manuscript describes the implementation, outcomes and benefits of the partnership for both the HCH clinic and the school of pharmacy. Type: Clinical Experience

  8. A wraparound treatment engagement intervention for homeless veterans with co-occurring disorders.

    Science.gov (United States)

    Smelson, David A; Kline, Anna; Kuhn, John; Rodrigues, Stephanie; O'Connor, Kathryn; Fisher, William; Sawh, Leon; Kane, Vincent

    2013-05-01

    This article reports the results of a low-intensity wraparound intervention, Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking (MISSION), to augment Treatment as Usual (TAU) and engage and retain homeless veterans with a co-occurring disorder (COD) in care. Using a quasi-experimental design, 333 homeless veterans were enrolled, 218 who received MISSION along with TAU and 115 who received TAU alone. Group assignment was based on MISSION treatment slot availability at time of enrollment. Compared with TAU alone, individuals receiving MISSION demonstrated greater outpatient session attendance within the 30 days before the 12-month follow up assessment and a larger decline from baseline in the number of psychiatric hospitalization nights. Individuals in the MISSION and TAU-only groups both showed statistically significant improvements in substance use and related problems at 12 months, with those in MISSION less likely to drink to intoxication and experience serious tension or anxiety. Although this study confirmed that compared with TAU alone, MISSION along with TAU is effective in augmenting usual care and engaging and retaining homeless veterans in treatment, some caution is warranted as this study did not involve random assignment. These results, however, are similar to a recent study involving a briefer version of the intervention which included random assignment. Based on these findings, MISSION is being further studied in the joint Department of Housing and Urban Development (HUD) - Department of Veterans Affairs (VA) Supportive Housing (HUD-VASH) program, which offers rapid housing placement and case management to aid in housing maintenance. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  9. Homeless Families in the Netherlands: Intervention Policies and Practices

    Directory of Open Access Journals (Sweden)

    Catelijne Akkermans

    2011-07-01

    Full Text Available The demographics of the homeless population in many countries are currently shifting, and this cannot be explained by the different welfare systems to be found in these countries. Nevertheless, there is some evidence that the homelessness policies of some countries are converging, and we observe a combination of decentralisation, housing first, and a taylor-made, individualised approach. However, what is interesting is the question as to what extent these policies are based on a punitive dimension or on a justice dimension. This aspect is little discussed in the Netherlands where policies to combat homelessness are intended to put an end to public nuisance and to get the homeless off the street. Research into evicted families demonstrates that combining elements of (mild coercion with efforts to solve homelessness leads to problems in at least three domains: the motivation of homeless families to accept help and support, the quality of life in the individualised approach, and the matter of registration. These problems need investigating, also from an international perspective.

  10. An Inside Look at Homeless Youths' Social Networks: Perceptions of Substance Use Norms.

    Science.gov (United States)

    Melander, Lisa A; Tyler, Kimberly A; Schmitz, Rachel M

    2016-01-02

    Substance use among homeless young people is a pervasive problem, and there have been many efforts to understand more about the dynamics of this health compromising behavior. The current study examined perceived substance use norms within homeless youths' social networks utilizing in-depth interviews. The sample included 19 homeless individuals aged 16 to 21. Four elements of substance use within networks emerged: substance use choices, drug use safety issues, encouragement and/or discouragement, and appropriate situations in which substance use is condoned. These findings provide unique insight into the norms associated with drug and alcohol use within homeless youths' social networks.

  11. An Inside Look at Homeless Youths’ Social Networks: Perceptions of Substance Use Norms1

    Science.gov (United States)

    Melander, Lisa A.; Tyler, Kimberly A.; Schmitz, Rachel M.

    2016-01-01

    Substance use among homeless young people is a pervasive problem, and there have been many efforts to understand more about the dynamics of this health compromising behavior. The current study examined perceived substance use norms within homeless youths’ social networks utilizing in-depth interviews. The sample included 19 homeless individuals aged 16 to 21. Four elements of substance use within networks emerged: substance use choices, drug use safety issues, encouragement and/or discouragement, and appropriate situations in which substance use is condoned. These findings provide unique insight into the norms associated with drug and alcohol use within homeless youths’ social networks. PMID:26989340

  12. Foot Conditions among Homeless Persons: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Matthew J To

    Full Text Available Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons.A literature search was conducted on MEDLINE (1966-2016, EMBASE (1947-2016, and CINAHL (1982-2016 and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist.Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes.Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and addressing social factors that lead to

  13. Foot Conditions among Homeless Persons: A Systematic Review

    Science.gov (United States)

    To, Matthew J.; Brothers, Thomas D.; Van Zoost, Colin

    2016-01-01

    Introduction Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons. Methods A literature search was conducted on MEDLINE (1966–2016), EMBASE (1947–2016), and CINAHL (1982–2016) and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist. Results Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes. Discussion Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and

  14. Homeless & hungry: the evidence from Liverpool.

    Science.gov (United States)

    Stitt, S; Griffiths, G; Grant, D

    1994-01-01

    Much research has established the link between low incomes and poor nutritional standards. A research team from the Centre for Consumer Education & Research at Liverpool John Moores' University recently found that 30% of all families with children in Britain today are spending less on food than what is required to achieve a dietary which adheres, at minimum cost, to the Department of Health's Dietary Recommended Values (DRVs). But very little, if any, research has investigated the nutritional implications of a particularly extreme form of material deprivation--homelessness. This pilot study therefore sets out to study the dietaries of a number of homeless families in Liverpool--homeless as defined by living in Bed & Breakfast accommodation. Not only do such families have to contend with dependency upon welfare benefits when purchasing their foodstuffs; they also have to labour under inadequate cooking facilities. The study has involved these families keeping a dietary diary of all food and drink consumed. This information has then been analysed for its nutrient composition, using the Microdiet computer programme at Liverpool JMU. The results will show that, in every single case, the dietaries of these homeless families fall substantially short of the government's own nutritional guidelines and are, without doubt, unhealthy in the extreme. This paper is thus an examination of the nature and extent of the problem, using the science of nutrition and dietetics: not a policy prescription (although this is obvious) not a policy analysis. A study of the dietary implications of homelessness for 100 individuals (the largest ever undertaken) on Merseyside will be undertaken between September 1993 and June 1994.

  15. The role of self-esteem in the development of psychiatric problems: a three-year prospective study in a clinical sample of adolescents.

    Science.gov (United States)

    Henriksen, Ingvild Oxås; Ranøyen, Ingunn; Indredavik, Marit Sæbø; Stenseng, Frode

    2017-01-01

    Self-esteem is fundamentally linked to mental health, but its' role in trajectories of psychiatric problems is unclear. In particular, few studies have addressed the role of self-esteem in the development of attention problems. Hence, we examined the role of global self-esteem in the development of symptoms of anxiety/depression and attention problems, simultaneously, in a clinical sample of adolescents while accounting for gender, therapy, and medication. Longitudinal data were obtained from a sample of 201 adolescents-aged 13-18-referred to the Department of Child and Adolescent Psychiatry in Trondheim, Norway. In the baseline study, self-esteem, and symptoms of anxiety/depression and attention problems were measured by means of self-report. Participants were reassessed 3 years later, with a participation rate of 77% in the clinical sample. Analyses showed that high self-esteem at baseline predicted fewer symptoms of both anxiety/depression and attention problems 3 years later after controlling for prior symptom levels, gender, therapy (or not), and medication. Results highlight the relevance of global self-esteem in the clinical practice, not only with regard to emotional problems, but also to attention problems. Implications for clinicians, parents, and others are discussed.

  16. Policy, Behavior, and Research: Changing Schooling for Homeless Children and Youth.

    Science.gov (United States)

    First, Patricia F.; Oakley, Joye L.

    1993-01-01

    Considers state and national policies directed toward the homeless. Problems with policies for immunization and vaccination requirements, transportation, parent participation, domestic violence, and home schooling are discussed. Alternative solutions that may be more conducive to the education of the homeless are offered. (SLD)

  17. Homelessness and Work Experience: Two Years in Saint Paul. Final Report.

    Science.gov (United States)

    Davis, Dennis R.

    A study explored the role of work experience in addressing problems of homeless people in Saint Paul (Minnesota) during the 1989-91 grant cycles of the McKinney Job Training for the Homeless Demonstration Program. The program included a number of elements: outreach, intake, assessment and enrollment, orientation, work experience, basic…

  18. Homeless in Chicago: The Special Case of Pregnant Teenagers and Young Parents.

    Science.gov (United States)

    Knauss, Jenny; Nelson, Krista

    This report from the Illinois Caucus on Teenage Pregnancy concerns the plight of an estimated 7,000 homeless teenagers in the state who are either pregnant or are teenage mothers. The scope of the homeless youth problem in Illinois is defined in the introduction. A section on dimensions of need focuses on the "feminization of…

  19. A strengths based method for homeless youth: effectiveness and fidelity of Houvast

    NARCIS (Netherlands)

    Krabbenborg, M.A.M.; Boersma, S.N.; Wolf, J.R.L.M.

    2013-01-01

    BACKGROUND: While homelessness among youth is a serious problem, there is little information about evidence-based interventions for homeless youth. In cooperation with professionals and youths, Wolf (2012) developed Houvast (Dutch for 'grip'): a strengths based method grounded in scientific and

  20. Recruitment and Retention of Homeless Youth in a Substance Use and HIV-Risk Reduction Program

    Science.gov (United States)

    Garvey, Rick; Pedersen, Eric R.; D'Amico, Elizabeth J.; Ewing, Brett A.; Tucker, Joan S.

    2018-01-01

    Conducting intervention studies with homeless populations can be difficult, particularly in terms of retaining participants across multiple sessions and locating them for subsequent follow-up assessments. Homeless youth are even more challenging to engage due to substance use, mental health problems, wariness of authority figures, and frequent…

  1. A Status Report on Hunger and Homelessness in America's Cities, 2002: A 25-City Survey.

    Science.gov (United States)

    Lowe, Eugene T.

    To assess the status of hunger and homelessness in U.S. cities during 2002, 25 major cities completed surveys regarding demand for emergency food assistance and emergency shelter and capacity of local agencies to meet the demand; causes of hunger and homelessness and demographics of populations experiencing these problems; exemplary programs or…

  2. Prevalence of Mental Illness among Homeless People in Hong Kong.

    Directory of Open Access Journals (Sweden)

    Larina Chi-Lap Yim

    Full Text Available This study examined the prevalence and correlates of mental illness in homeless people in Hong Kong and explored the barriers preventing their access to health care. Ninety-seven Cantonese-speaking Chinese who were homeless during the study period were selected at random from the records of the three organisations serving the homeless population. The response rate was 69%. Seventeen subjects could not give valid consent due to their poor mental state, so their responses were excluded from the data analysis. A psychiatrist administered the Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I and the Mini -Mental State Examination. Consensus diagnoses for subjects who could not complete the SCID-I were established by three independent psychiatrists.The point prevalence of mental illness was 56%. Seventy-one percent of the subjects had a lifetime history of mental illness, 30% had a mood disorder, 25% had an alcohol use disorder, 25% had a substance use disorder, 10% had a psychotic disorder, 10% had an anxiety disorder and 6% had dementia. Forty-one percent of the subjects with mental illness had undergone a previous psychiatric assessment. Only 13% of the subjects with mental illness were receiving psychiatric care at the time of interview. The prevalence of psychotic disorders, dementia and the rate of under treatment are hugely underestimated, as a significant proportion (18% of the subjects initially selected were too ill to give consent to join the study.The low treatment rate and the presence of this severely ill and unreached group of homeless people reflect the fact that the current mode of service delivery is failing to support the most severely ill homeless individuals.

  3. Alcohol, poverty and social exclusion: Alcohol consumption among the homeless and those at risk of social exclusion in Madrid.

    Science.gov (United States)

    Panadero, Sonia; Vázquez, José Juan; Martín, Rosa María

    2016-06-14

    The work analyzes different aspects related to alcohol consumption among homeless people and people at risk of social exclusion. The data was gathered from a representative sample of homeless people in Madrid (n = 188) and a sample of people at risk of social exclusion (n = 164) matched in sex, age, and origin (Spaniards vs. foreigners). The results showed that homeless people present a greater consumption of alcohol and have experienced more problems derived from its consumption than people at risk of social exclusion. Most of the homeless people who had alcohol-related problems had had them prior to their homelessness, and they stated they had poorer health and had experienced a greater number of homelessness episodes. Despite the relevance of problems related to alcohol among our sample, only a small percentage of the sample had participated in treatment programs for alcohol consumption.

  4. Homeless Individuals Approaching the End of Life: Symptoms and Attitudes.

    Science.gov (United States)

    Tobey, Matthew; Manasson, Julia; Decarlo, Kristen; Ciraldo-Maryniuk, Katrina; Gaeta, Jessie M; Wilson, Erica

    2017-04-01

    Over a million individuals in the United States experience homelessness annually and homeless individuals die at a higher rate than domiciled peers. Homeless individuals often have unique experiences at the end of life (EOL). This study examined the symptoms experienced by homeless individuals nearing the EOL and explored social background, attitudes, and experiences. Investigators conducted surveys of homeless individuals approaching the EOL at a medical respite home. Eligibility required a serious medical condition and for the patient's medical provider to answer "no" to the question "Would you be surprised if this patient were not alive in one year?" Interviews explored symptoms using the Memorial Symptom Assessment Survey. Symptoms were compared with those of relevant comparator groups in other studies. Participants (n = 20) were young to face the EOL (median age = 58) and suffered high rates of substance use disorders (n = 18; 90%) and psychiatric diagnoses (n = 16; 80%). Symptom frequency was high, especially as regarded pain and psychological symptoms. Previous experience with death among family and peers was universal (n = 20; 100%). Mistrust of others' decisions about the EOL was common, as was concern about receiving too little (n = 11; 55%) or too much (n = 8; 40%) care at the EOL. The frequency of symptoms was higher than in three comparator studies and those studies' subgroups (P < 0.01 for each comparison). Homeless individuals may experience a high frequency of pain and other symptoms as they approach the EOL. Care for such individuals may require a tailored approach. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  5. Military sexual assault and homeless women veterans: clinical correlates and treatment preferences.

    Science.gov (United States)

    Decker, Suzanne E; Rosenheck, Robert A; Tsai, Jack; Hoff, Rani; Harpaz-Rotem, Ilan

    2013-01-01

    Both homeless women and women who have experienced military sexual assault (MSA) are at high risk of serious psychological sequelae. However, little is known about the combined impact of MSA and current homelessness on psychological distress, or about distinctive treatment preferences among homeless female veterans affected by MSA. This observational study compared clinical symptoms, pre-military experiences, and treatment preferences among 509 female veterans with and without MSA who enrolled in 11 VA Homeless Women Veterans Programs. Over one third of participants (41.1%) reported MSA. In multivariate analyses, homeless female veterans who reported MSA endorsed greater severity of PTSD and other psychiatric symptoms. Those who had experienced MSA were more likely to report interest in treatment, and treatment focused on safety was reported as especially attractive. Among homeless female veterans, MSA is associated with greater mental health symptoms and greater interest in safety-focused treatment. Services targeting the needs of homeless MSA survivors should be encouraged. Published by Elsevier Inc.

  6. The 'Arc of Prosperity' Revisited: Homelessness Policy Change in North Western Europe

    Directory of Open Access Journals (Sweden)

    Isobel Anderson

    2016-10-01

    Full Text Available This paper compares continuity and change in homelessness policy in Ireland, Scotland and Norway with a particular focus on the period of post-crisis austerity measures (2008–2016. The analytical approach draws on institutional theory and the notion of path dependency, which has rarely been applied to comparative homelessness research. The paper compares welfare and housing systems in the three countries prior to presenting a detailed analysis of the conceptualisation and measurement of homelessness; the institutions which address homelessness; and the evidence of change in the post-2008 period. The analysis demonstrates that challenges remain in comparing the nature of homelessness and policy responses across nation states, even where they have a number of similar characteristics, and despite some EU influence towards homelessness policy convergence. Similarly, national-level homelessness policy change could not be interpreted as entirely a result of the external shock of the 2008 general financial crisis, as existing national policy goals and programmes were also influential. Overall, embedded national frameworks and institutions were resilient, but sufficiently flexible to deliver longer term policy shifts in response to the changing nature of the homelessness problem and national policy goals. Institutionalism and path dependency were found to be useful in developing the comparative analysis of homelessness policy change and could be fruitfully applied in future longitudinal, empirical research across a wider range of countries.

  7. Use of outpatient mental health services by homeless veterans after hurricanes.

    Science.gov (United States)

    Brown, Lisa M; Barnett, Scott; Hickling, Edward; Frahm, Kathryn; Campbell, Robert R; Olney, Ronald; Schinka, John A; Casey, Roger

    2013-05-01

    Little is known about the impact of hurricanes on people who are homeless at the time a disaster occurs. Although researchers have extensively studied the psychosocial consequences of disaster produced homelessness on the general population, efforts focused on understanding how homeless people fare have been limited to a few media reports and the gray literature. In the event of a hurricane, homeless veterans may be at increased risk for negative outcomes because of their cumulative vulnerabilities. Health care statistics consistently document that homeless veterans experience higher rates of medical, emotional, substance abuse, legal, and financial problems compared with the general population. This study used the 2004 to 2006 Veterans Health Administration (VHA) Outpatient Medical Dataset to examine the effects of hurricanes on use of outpatient mental health services by homeless veterans. Homeless veterans residing in hurricane-affected counties were significantly more likely to participate in group psychotherapy (32.4% vs. 13.4%, p homeless programs and the provision of VHA mental health services to homeless veterans postdisaster. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  8. Housing assistance and case management: improving access to substance use disorder treatment for homeless veterans.

    Science.gov (United States)

    Winn, Jaime L; Shealy, Suzanne E; Kropp, Gary J; Felkins-Dohm, Donna; Gonzales-Nolas, Cheryl; Francis, Elie

    2013-05-01

    The problem of waiting list attrition in addiction treatment programs is widespread, and homeless and marginally housed individuals are particularly susceptible. This naturalistic, retrospective study describes an intervention (Transitional Supportive Housing and Case Management) that effectively promoted treatment admission for this high-risk group above and beyond that which could be explained by certain pretreatment factors. The clinical records of 211 military veterans referred to intensive outpatient addiction treatment were reviewed for factors related to treatment program admission, including 3 interventions designed to prevent waiting list attrition. Chi-square tests evaluated univariate predictors of treatment entry, and a hierarchical binary logistic regression evaluated several variables simultaneously. Results showed that fewer than 50% of wait-listed patients achieved treatment admission. Univariate predictors of treatment entry were not having a current partner, having a legal problem, and having had past substance use disorder treatment. The logistic regression showed that patients who received the intervention were 4.5 times more likely to enter the treatment program, and individuals with a current legal problem were 2.5 times more likely to enter treatment. Participation in a weekly support group and/or contact with a psychiatric nurse practitioner did not increase the likelihood of program admission. It may be possible to enhance treatment entry for the homeless and marginally housed by providing case management and housing services. Future research is needed to determine how the individual-level factors predicting treatment entry in this study can be used to tailor other interventions to further address the problem of waiting list attrition. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  9. Coming of age on the streets: survival sex among homeless young women in Hollywood.

    Science.gov (United States)

    Warf, Curren W; Clark, Leslie F; Desai, Mona; Rabinovitz, Susan J; Agahi, Golnaz; Calvo, Richard; Hoffmann, Jenny

    2013-12-01

    This study examined childhood physical or sexual abuse, involvement in dependency or delinquency systems, psychiatric hospitalization, and suicide as possible risk factors for survival sex among homeless young women. Homeless young women were found to have similarly high rates of childhood sexual abuse, dependency and delinquency systems involvement, and psychiatric hospitalization. Homeless young women involved in survival sex disclosed higher rates of attempted suicide and reported marginally higher rates of childhood physical abuse. Analysis of qualitative data showed that those engaged in survival sex were motivated primarily by desperation to meet basic needs including a place to stay, food and money, and one third mentioned that peers commonly were influential in decisions to engage in survival sex. Others were influenced by coercion (10%) or pursuit of drugs (10%). Young women engaged in survival sex generally experienced regret and shame about their experience. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  10. Homelessness in France: Labour market implications

    Directory of Open Access Journals (Sweden)

    Arup Mitra

    2011-01-01

    Full Text Available This paper analyses homelessness in France with regard to three major mutually interacting sets of factors: labour-market strains, illegal migration and institutional inadequacy. Macroeconomic challenges have resulted in the loss of jobs and subsequent labour-market hardships, and these have tended to affect those without adequate skills. As a result, labour-market problems together with a lack of social capital and adequate housing at affordable prices, accompanied by insufficient institutional support, has resulted in increased homelessness. All of this indicates that there should be active government intervention in the housing market in order to create space for the relatively weaker section of the population in the growth process, which is often unequal. Another important issue is how to create jobs with positive growth in real wages because, without adequate purchasing power, simply providing housing would mean transferring poverty from one space to another.

  11. Homeless in Galilee

    Directory of Open Access Journals (Sweden)

    Robert L. Brawley

    2011-04-01

    Full Text Available This article has located Jesus’ saying about homelessness in the context of the Roman Empire as it was experienced in Galilee. Homelessness is part of a broader picture that translates into loss of access to the resources of the land. The thesis is that in light of a theology of land resulting from the development of Abrahamic covenant traditions and the prophetic hope expressed especially in Isaiah, Ezekiel and Psalm 37, Jesus proclaimed God’s kingdom as God’s rule over heaven and earth, which implicates restoration of equitable access to the resources of the earth. The Lord’s Prayer, presumptions about the water of Jacob’s well in John 4 and the parable of the unjust steward in Luke 16 are used to demonstrate understandings of violations of equitable access according to Abrahamic covenant traditions and the hope for the restoration thereof.

  12. Gender Differences in Predictors of Suicidal Thoughts and Attempts Among Homeless Veterans that Abuse Substances

    Science.gov (United States)

    Benda, Brent B.

    2005-01-01

    This study of 315 male and 310 female homeless military veterans in a V.A. inpatient program designed to treat substance abusers, many of whom also suffer psychiatric disorders, was designed to examine gender differences in factors associated with the odds of having suicidal thoughts, and of attempting suicide, in comparison to being nonsuicidal.…

  13. The variation in family background amongst young homeless shelter users in Denmark

    DEFF Research Database (Denmark)

    Benjaminsen, Lars

    2016-01-01

    This article analyses variation in the family background of young homeless people in a cohort of young Danes. The study is based on administrative data for individuals who were 18 years old in 2007 and their parents. Homelessness is measured by shelter use over a five-year period. Data also cover...... of their parents having mental illness or substance abuse problems. These young people develop psychosocial problems and become homeless without strong predictors from their family background. Amongst the young shelter users from families with severe social problems a higher share are in the Not in Education...

  14. Sources of psychological pain and suicidal thoughts among homeless adults.

    Science.gov (United States)

    Coohey, Carol; Easton, Scott D; Kong, Jooyoung; Bockenstedt, Julie K W

    2015-06-01

    Homeless adults experience problems in multiple areas of their lives. It was hypothesized that adults who were troubled by problems in more areas of their lives would be more likely to report suicidal thoughts. The sample included 457 homeless men and women who resided in three emergency shelters. The number of sources of psychological pain, past suicide attempts, and being a man predicted current suicidal thoughts, but being diagnosed with a depressive disorder did not. Shelter workers should ask adults whether they have attempted suicide in the past and how troubled they are by each area of their lives. © 2014 The American Association of Suicidology.

  15. Long stay patients in a psychiatric hospital in Lagos, Nigeria

    African Journals Online (AJOL)

    Introduction. In psychiatric practice, some mentally ill patients spend their life in continuous or prolonged hospitalization; that is, as long stay patients.1,2 This is due among other reasons to severe mental illness with poor symptom control, substance dependence, homelessness and abandonment by the patients' relatives.3 ...

  16. Can Better National Policy End Family Homelessness?

    Science.gov (United States)

    Roman, Nan

    2010-01-01

    An understanding of the close link between federal policy and family homelessness is critical for ensuring that one day no child in the United States is homeless. This article discusses the nature of family homelessness, the national policy framework that exists to help vulnerable families, the homeless assistance system that federal policy has…

  17. HCV screening in a cohort of HIV infected and uninfected homeless and marginally housed women in San Francisco, California

    Directory of Open Access Journals (Sweden)

    Kimberly Page

    2017-02-01

    Full Text Available Abstract Background Hepatitis C virus (HCV screening has taken on new importance as a result of updated guidelines and new curative therapies. Relatively few studies have assessed HCV infection in homeless populations, and a minority include women. We assessed prevalence and correlates of HCV exposure in a cohort of homeless and unstably housed women in San Francisco, and estimated the proportion undiagnosed. Methods A probability sample of 246 women were recruited at free meal programs, homeless shelters, and low-cost single room occupancy hotels in San Francisco; women with HIV were oversampled. At baseline, anti-HCV status was assessed using an enzyme immunoassay, and results compared in both HIV-positive and negative women. Exposures were assessed by self-report. Logistic regression was used to assess factors independently associated th HCV exposure. Results Among 246 women 45.9% were anti-HCV positive, of whom 61.1% were HIV coinfected; 27.4% of positives reported no prior screening. Most (72% women were in the ‘baby-boomer’ birth cohort; 19% reported recent injection drug use (IDU. Factors independently associated with anti-HCV positivity were: being born in 1965 or earlier (AOR 3.94; 95%CI: 1.88, 8.26, IDU history (AOR 4.0; 95%CI: 1.68, 9.55, and number of psychiatric diagnoses (AOR 1.16; 95%CI: 1.08, 1.25. Conclusions Results fill an important gap in information regarding HCV among homeless women, and confirm the need for enhanced screening in this population where a high proportion are baby-boomers and have a history of drug use and psychiatric problems. Due to their age and risk profile, there is a high probability that women in this study have been infected for decades, and thus have significant liver disease. The association with mental illness and HCV suggests that in addition increased screening, augmenting mental health care and support may enhance treatment success.

  18. Youth Homelessness and Individualised Subjectivity

    Science.gov (United States)

    Farrugia, David

    2011-01-01

    This article aims to contribute to understandings of youth homelessness and subjectivity by analysing identity construction in terms of young people's negotiation of the structural and institutional environment of youth homelessness. I suggest that while existing literature on this topic concentrates mainly on micro-social encounters, the…

  19. Youth Homelessness: Early Intervention & Prevention.

    Science.gov (United States)

    Chamberlain, Chris; MacKenzie, David

    The issue of youth homelessness in Australia is examined in the context of relevant social and educational policies. The exploration is based on 8 years of research into the situation of homeless youth in Australia involving several studies, including a study of school students in 9 communities and field visits to 100 schools. In 1994, researchers…

  20. Coming home: health status and homelessness risk of older pre-release prisoners.

    Science.gov (United States)

    Williams, Brie A; McGuire, James; Lindsay, Rebecca G; Baillargeon, Jacques; Cenzer, Irena Stijacic; Lee, Sei J; Kushel, Margot

    2010-10-01

    Older adults comprise an increasing proportion of the prison and homeless populations. While older age is associated with adverse post-release health events and incarceration is a risk factor for homelessness, the health status and homelessness risk of older pre-release prisoners are unknown. Moreover, most post-release services are geared towards veterans; it is unknown whether the needs of non-veterans differ from those of veterans. To assess health status and risk of homelessness of older pre-release prisoners, and to compare veterans with non-veterans. Cross-sectional study of 360 prisoners (≥ 55 years of age) within 2 years of release from prison using data from the 2004 Survey of Inmates in State and Federal Correctional Facilities. Veteran status, health status (based on self-report), and risk of homelessness (homelessness before arrest). Mean age was 61 years; 93.8% were men and 56.5% were white. Nearly 40% were veterans, of whom 77.2% reported likely VA service eligibility. Veterans were more likely to be white and to have obtained a high school diploma or GED. Overall, 79.1% reported a medical condition and 13.6% reported a serious mental illness. There was little difference in health status between veterans and non-veterans. Although 1 in 12 prisoners reported a risk factor for homelessness, the risk factors did not differ according to veteran status. Older pre-release prisoners had a high burden of medical and mental illness and were at risk for post-release homelessness regardless of veteran status. Reentry programs linking pre-release older prisoners to medical and psychiatric services and to homelessness prevention programs are needed for both veterans and non-veterans.

  1. Health risks of homeless adolescents. Implications for holistic nursing.

    Science.gov (United States)

    Rew, L

    1996-12-01

    Although the exact number of homeless adolescents is unknown, it is estimated that this population may exceed 2 million. Literally living on the streets, homeless youth are at risk for a variety of physical, psychosocial, and spiritual health problems. Many engage in "survival sex," exchanging sexual favors for necessities of food, clothing, and shelter. Such risky sexual behaviors make them vulnerable to sexually transmitted diseases, including human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), and unintended pregnancies. Many have serious, diagnosable mental health problems, whereas others suffer various consequences of substance abuse. There is a need for comprehensive and holistic health care services, for which the majority of homeless youth have very limited access. Holistic nursing can provide creative interventions for thus vulnerable population.

  2. Strengths perspective among the homeless adolescents: A systematic review

    Directory of Open Access Journals (Sweden)

    Janmejaya Samal

    2017-01-01

    Full Text Available Background: Earlier, the scholars of family studies have primarily focused on the problems and weaknesses of the families. However, during these days, there is a shift from problems to strength-based perspective. Methodology: Search of literature was carried out through internet-based Google Scholar search engine. Of the 112 titles obtained 21 titles fit the criteria of the study objectives, of which 9 full-text articles were finally selected for the purpose of this review. Results: In this review, nine full-text articles were reviewed. Nine of these researches investigated different facets of strengths perspective among the homeless adolescents. Chronologically, nine of these reviewed studies delineated the following thematic facets of strengths perspective among the homeless adolescents. These include personal strength and informal resources, personal strength in high-risk environment, strengths perspective during the transition of adolescence to adulthood, personal and social strengths that refrained the homeless adolescents form intravenous drug use, resilience and self-esteem, religion as an important strength, “hope” as a way of living among the homeless adolescents, coping strategies of street-involved youth, and usage of internet and social media as an important strength among homeless adolescents. Conclusion: Strengths perspective helps the youth to become a master of their own lives and helps to deal with all the adversities in life.

  3. Predictors of Mortality in Older Homeless Veterans.

    Science.gov (United States)

    Schinka, John A; Curtiss, Glenn; Leventhal, Katherine; Bossarte, Robert M; Lapcevic, William; Casey, Roger

    2017-10-01

    In this analysis of a cohort of older homeless veterans, we examined psychosocial, health, housing, and employment characteristics to identify predictors of mortality. Our sample of 3,620 older veterans entered Veteran Affairs homeless programs in years 2000-2003. Fifteen variables from a structured interview described this sample and served as predictors. National Death Index data for years 2000-2011 were used to ascertain death. Survival table analyses were conducted to estimate and plot cumulative survival functions. To determine predictors and estimate hazard functions, Cox proportional hazards regression analysis was conducted. Five variables (presence of a serious health issue, hospitalization for alcohol abuse, alcohol dependency, unemployment for 3 years, and age 60+) were associated with increased risk of death; three (non-White, drug dependency, and dental problems) were associated with reduced risk. A risk score, based on total unit-weighted risk for all eight predictors, was used to identify three groups that were found to differ significantly in mortality. These analyses underline the jeopardy faced by older homeless veterans in terms of early death. We were able to identify several variables associated with mortality; more importantly, we were able to show that a risk score based on status for these variables was significantly related to survival.

  4. Five dimensions of faith and spiritually of older African American women transitioning out of homelessness.

    Science.gov (United States)

    Washington, Olivia G M; Moxley, David P; Garriott, Lois; Weinberger, Jennifer P

    2009-12-01

    Homelessness among older African American women is emerging as a serious social problem. The increasing cost of living, diminishing community resources, and shrinking retirement benefits, as well as reduced social services are resulting in greater numbers of older minority women becoming homeless. This investigation explores the relevance of faith and spirituality to an advocacy assessment designed to help participants resolve issues that operate as barriers to their leaving and staying out of homelessness. A substudy of a larger research and development project was undertaken, in which qualitative interview methods were used to illuminate the role of faith and spirituality resources in the lives of 84 older homeless African American women. Comparative thematic analysis of illustrative cases was undertaken to better understand the role of faith and spirituality in the women's lives and in how they used faith and spirituality in coping with homelessness. Five dimensions of faith and spirituality, (a) identity and beliefs; (b) affiliation and membership; (c) involvement; (d) practices; and (e) benefits, served as promising resources in understanding life spaces of homeless minority women and identified promising advocacy strategies. Two cases describe the realities of homelessness for older minority women endeavoring to transition out of homelessness and illustrate how faith and spirituality can buffer stress, facilitate coping, and sustain motivation. How older homeless African American women use their faith and spiritual resources to cope with demands of homelessness, challenges of transition, and recovery from the multiple traumas resulting from being homeless makes the assessment of faith and spirituality an important part of the advocacy process.

  5. When health insurance is not a factor: national comparison of homeless and nonhomeless US veterans who use Veterans Affairs Emergency Departments.

    Science.gov (United States)

    Tsai, Jack; Doran, Kelly M; Rosenheck, Robert A

    2013-12-01

    We examined the proportion of homeless veterans among users of Veterans Affairs (VA) emergency departments (EDs) and compared sociodemographic and clinical characteristics of homeless and nonhomeless VA emergency department users nationally. We used national VA administrative data from fiscal year 2010 for a cross-sectional study comparing homeless (n = 64,091) and nonhomeless (n = 866,621) ED users on sociodemographics, medical and psychiatric diagnoses, and other clinical characteristics. Homeless veterans had 4 times the odds of using EDs than nonhomeless veterans. Multivariate analyses found few differences between homeless and nonhomeless ED users on the medical conditions examined, but homeless ED users were more likely to have been diagnosed with a drug use disorder (odds ratio [OR] = 4.12; 95% confidence interval [CI] = 3.97, 4.27), alcohol use disorder (OR = 3.67; 95% CI = 3.55, 3.79), or schizophrenia (OR = 3.44; 95% CI = 3.25, 3.64) in the past year. In a national integrated health care system with no specific requirements for health insurance, the major differences found between homeless and nonhomeless ED users were high rates of psychiatric and substance abuse diagnoses. EDs may be an important location for specialized homeless outreach (or "in" reach) services to address mental health and addictive disorders.

  6. Psychiatric morbidity among inmates of center for destitutes: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Raghavendra B Nayak

    2015-01-01

    Full Text Available Context: One percent of the population in India is homeless (destitutes which include beggars, commercial sex workers, homeless mentally ill, elderly women with dependent children, street children, and persons with disability. Psychiatric disorders are generally seen to be common among homeless individuals. The data are limited regarding psychiatric morbidity and its prevalence in this populace in Indian context. Aim: The aim was to study the prevalence of psychiatric morbidity among the inmates of a center for destitutes. Settings and Design: Cross-sectional study. Materials and Methods: The study included all the residents (n = 50 of a center of destitutes. Psychiatric evaluation was done by qualified practicing psychiatrist. Brief Psychiatric Rating Scale and Global Assessment of Functioning instruments were used to assess the severity of psychiatric symptoms and general functioning of the individuals with mental disorders. Statistical Analysis Used: SPSS version 13 was used for statistical analysis. Results: All residents (n = 50 of center of destitutes were evaluated for psychiatric co-morbidity. 42 (84% inmates were suffering from psychiatric disorders. Most common psychiatric disorder among them was psychotic disorders in 19 (38%, followed by affective disorders, mainly depression in 16 (32%, somatoform disorders in 5 (10%, and anxiety disorders in 2 (4%. No significant gender differences were noted (P = 0.335. Substance abuse was present in 22 (44% of the inmates. A significant negative correlation between psychiatric symptoms and functioning of the subject was seen, (P < 0.001. Conclusion: Psychiatric disorders and in particular substance abuse, are common among the homeless people who stay in the center of destitutes. Psychiatric disorders are likely to be the cause significant functional impairment.

  7. Out on the Street: A Public Health and Policy Agenda for Lesbian, Gay, Bisexual, and Transgender Youth Who Are Homeless

    Science.gov (United States)

    Keuroghlian, Alex S.; Shtasel, Derri; Bassuk, Ellen L.

    2014-01-01

    A disproportionate number of lesbian, gay, bisexual and transgender (LGBT) youth experience homelessness each year in the United States. LGBT youth who are homeless have particularly high rates of mental health and substance use problems, suicidal acts, violent victimization, and a range of HIV risk behaviors. Given the intense needs of LGBT youth experiencing homelessness, it is imperative that we understand their unique experiences and develop responsive practices and policies. The range and severity of health risks vary across subgroups of all homeless LGBT youth, and since the population is nonhomogeneous their particular needs must be identified and addressed. Thus the purpose of this article is to review the causes of homelessness among LGBT youth, discuss the mental health and victimization risks faced by this population, address differences among homeless LGBT subgoups, and recommend effective interventions and best practices. We conclude by discussing promising future research and public policy directions. PMID:24826829

  8. Predictors of homelessness among vulnerably housed adults in 3 Canadian cities: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Matthew J. To

    2016-10-01

    Full Text Available Abstract Background Homelessness is a major concern in many urban communities across North America. Since vulnerably housed individuals are at risk of experiencing homelessness, it is important to identify predictive factors linked to subsequent homelessness in this population. The objectives of this study were to determine the probability of experiencing homelessness among vulnerably housed adults over three years and factors associated with higher risk of homelessness. Methods Vulnerably housed adults were recruited in three Canadian cities. Data on demographic characteristics, chronic health conditions, and drug use problems were collected through structured interviews. Housing history was obtained at baseline and annual follow-up interviews. Generalized estimating equations were used to characterize associations between candidate predictors and subsequent experiences of homelessness during each follow-up year. Results Among 561 participants, the prevalence of homelessness was 29.2 % over three years. Male gender (AOR = 1.59, 95 % CI: 1.14–2.21 and severe drug use problems (AOR = 1.98, 95 % CI: 1.22–3.20 were independently associated with experiencing homelessness during the follow-up period. Having ≥3 chronic conditions (AOR = 0.55, 95 % CI: 0.33–0.94 and reporting higher housing quality (AOR = 0.99, 95 % CI: 0.97–1.00 were protective against homelessness. Conclusions Vulnerably housed individuals are at high risk for experiencing homelessness. The study has public health implications, highlighting the need for enhanced access to addiction treatment and improved housing quality for this population.

  9. Predictors of homelessness among vulnerably housed adults in 3 Canadian cities: a prospective cohort study.

    Science.gov (United States)

    To, Matthew J; Palepu, Anita; Aubry, Tim; Nisenbaum, Rosane; Gogosis, Evie; Gadermann, Anne; Cherner, Rebecca; Farrell, Susan; Misir, Vachan; Hwang, Stephen W

    2016-10-03

    Homelessness is a major concern in many urban communities across North America. Since vulnerably housed individuals are at risk of experiencing homelessness, it is important to identify predictive factors linked to subsequent homelessness in this population. The objectives of this study were to determine the probability of experiencing homelessness among vulnerably housed adults over three years and factors associated with higher risk of homelessness. Vulnerably housed adults were recruited in three Canadian cities. Data on demographic characteristics, chronic health conditions, and drug use problems were collected through structured interviews. Housing history was obtained at baseline and annual follow-up interviews. Generalized estimating equations were used to characterize associations between candidate predictors and subsequent experiences of homelessness during each follow-up year. Among 561 participants, the prevalence of homelessness was 29.2 % over three years. Male gender (AOR = 1.59, 95 % CI: 1.14-2.21) and severe drug use problems (AOR = 1.98, 95 % CI: 1.22-3.20) were independently associated with experiencing homelessness during the follow-up period. Having ≥3 chronic conditions (AOR = 0.55, 95 % CI: 0.33-0.94) and reporting higher housing quality (AOR = 0.99, 95 % CI: 0.97-1.00) were protective against homelessness. Vulnerably housed individuals are at high risk for experiencing homelessness. The study has public health implications, highlighting the need for enhanced access to addiction treatment and improved housing quality for this population.

  10. The social context of homeless men's substance use.

    Science.gov (United States)

    Rhoades, Harmony; Wenzel, Suzanne L; Golinelli, Daniela; Tucker, Joan S; Kennedy, David P; Green, Harold D; Zhou, Annie

    2011-11-01

    Homeless men may be at particular risk for the negative health effects of substance use. This cross-sectional study investigates the individual and personal network risk factors associated with substance use in this vulnerable population. Participants were a representative probability sample of 305 heterosexually active homeless men interviewed from meal programs in the Skid Row region of Los Angeles, CA. Interviews assessed individual, personal network, and substance use characteristics. Logistic regression examined individual and personal network predictors of the three most prevalent substances. In the past 6 months, the three most prevalent substances were marijuana (56%), crack (40%), and alcohol to intoxication (38%). The mental health status of homeless men was associated with substance use, with PTSD more common among those who used crack. Riskier networks (comprised of a larger proportion of drug users) were associated with marijuana use, and normative social ties (family, employed and school/work contacts) were associated with a decreased likelihood of crack use. Mental health problems and riskier personal networks are associated with homeless men's substance use. These findings underscore the importance of interventions that focus on improving mental health, mitigating the drug-using norms of personal networks, and helping men to maintain contact with normative, low-risk alters. Mental health care and peer-based, network interventions to reduce substance use should be a priority for heterosexually active homeless men. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Infectious Diseases in the Homeless

    Centers for Disease Control (CDC) Podcasts

    2008-08-26

    In this podcast, Ted Pestorius speaks with Dr. Marian McDonald, Associate Director for Minority and Women’s Health at CDC about an article in September 2008 issue of Emerging Infectious Diseases on infectious diseases in the homeless. There are an estimated 100 million homeless people worldwide today, and this number is likely to grow. The homeless population is vulnerable to many diseases, including HIV, hepatitis, and tuberculosis. Dr. McDonald discusses why this population is so vulnerable.  Created: 8/26/2008 by Emerging Infectious Diseases.   Date Released: 8/27/2008.

  12. Medication non-adherence in the homeless population in an Intermountain West city

    Directory of Open Access Journals (Sweden)

    Elizabeth J. Unni

    2014-01-01

    Full Text Available Background: Homelessness happens when people or household are unable to acquire and/or maintain housing they can afford. Approximately 17% of homeless individuals are also chronically ill. Studies have often not objectively measured medication non- adherence among the homeless population, probably due to lack of consistent pharmacy records. This study proposed to objectively estimate medication non-adherence to chronic medications among the homeless population in Salt Lake City, Utah. Methods: A retrospective study design was used based on the pharmacy records from the Fourth Street Pharmacy based on four classes of chronic medications - asthma, diabetes, statins, and psychiatric medications. Data was collected between November 1, 2010 and February 28, 2011 on the variables: date of original prescription, number of refills on the original prescription, date of 1st, 2nd, 3rd, and 4th fills, age, gender, and race. Primary non-adherence and medication refill non-adherence based on Continuous Measure of Medication Gaps were calculated. Results: The medication refill non-adherence rate was 38.8% with asthma medications, 38.5% with diabetic medications, 27.2% with statins, and 47.1% with psychiatric medications. The primary non-adherence rate varied from zero percent to 20%. Conclusion: The study concluded that this population has comparable non-adherence rates with asthma, diabetes, cholesterol lowering, and certain psychiatric medications than the general population.   Type: Original Research

  13. Health implications of chronic homelessness: lived experiences of ...

    African Journals Online (AJOL)

    The study concludes that the relationship between adult homelessness in Johannesburg inner city and the rapid spread of HIV and AIDS is a compelling problem requiring local insights and global perspectives in the quest to provide collaborative sustainable development and innovative health resource management.

  14. 75 FR 14633 - Homeless Veterans' Reintegration Into Employment

    Science.gov (United States)

    2010-03-26

    ... Solicitation for Grant Applications. The full announcement is posted on http://www.grants.gov . Funding Opportunity Number: SGA 10-01. Key Dates: The closing date for receipt of applications is 30 days after... address the complex problems facing homeless veterans. The full Solicitation for Grant Application is...

  15. 76 FR 33788 - Homeless Veterans' Reintegration Into Employment

    Science.gov (United States)

    2011-06-09

    ... Solicitation for Grant Applications. The full announcement is posted on http://www.grants.gov . Funding Opportunity Number: SGA 11-01. Key Dates: The closing date for receipt of applications is 30 DAYS AFTER... service delivery systems that will address the complex problems facing homeless veterans. The full...

  16. Homelessness and drug misuse in developing countries: A mathematical approach

    Science.gov (United States)

    Bhunu, C. P.

    2014-06-01

    Homelessness and drug-misuse are known to exist like siamese twins. We present a model to capture the dynamics in the growth in the number of homeless (street kids and street adults) and drug misusers. The reproduction numbers of the model are determined and analyzed. Results from this study suggests that adult peer pressure plays a more significant role in the growth of drug-misuse and the number of street kids. This result suggests that in resource constrained settings intervention strategies should be tailor made to target adults whose behaviour influence others to misuse drugs and abuse children. Furthermore, numerical simulations show that homelessness and drug-misuse positively enhances, the growth of each other. Thus, to effectively control these two social problems require strategies targeting both of them.

  17. Burden of mental disorders and unmet needs among street homeless people in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Fekadu, Abebaw; Hanlon, Charlotte; Gebre-Eyesus, Emebet; Agedew, Melkamu; Solomon, Haddis; Teferra, Solomon; Gebre-Eyesus, Tsehaysina; Baheretibeb, Yonas; Medhin, Girmay; Shibre, Teshome; Workneh, Abraham; Tegegn, Teketel; Ketema, Alehegn; Timms, Philip; Thornicroft, Graham; Prince, Martin

    2014-08-20

    The impact of mental disorders among homeless people is likely to be substantial in low income countries because of underdeveloped social welfare and health systems. As a first step towards advocacy and provision of care, we conducted a study to determine the burden of psychotic disorders and associated unmet needs, as well as the prevalence of mental distress, suicidality, and alcohol use disorder among homeless people in Addis Ababa, the capital of Ethiopia. A cross-sectional survey was conducted among street homeless adults. Trained community nurses screened for potential psychosis and administered standardized measures of mental distress, alcohol use disorder and suicidality. Psychiatric nurses then carried out confirmatory diagnostic interviews of psychosis and administered a locally adapted version of the Camberwell Assessment of Needs Short Appraisal Schedule. We assessed 217 street homeless adults, about 90% of whom had experienced some form of mental or alcohol use disorder: 41.0% had psychosis, 60.0% had hazardous or dependent alcohol use, and 14.8% reported attempting suicide in the previous month. Homeless people with psychosis had extensive unmet needs with 80% to 100% reporting unmet needs across 26 domains. Nearly 30% had physical disability (visual and sensory impairment and impaired mobility). Only 10.0% of those with psychosis had ever received treatment for their illness. Most had lived on the streets for over 2 years, and alcohol use disorder was positively associated with chronicity of homelessness. Psychoses and other mental and behavioural disorders affect most people who are street homeless in Addis Ababa. Any programme to improve the condition of homeless people should include treatment for mental and alcohol use disorders. The findings have significant implications for advocacy and intervention programmes, particularly in similar low income settings.

  18. A prospective trial of customized adherence enhancement plus long-acting injectable antipsychotic medication in homeless or recently homeless individuals with schizophrenia or schizoaffective disorder

    Science.gov (United States)

    Sajatovic, Martha; Levin, Jennifer; Ramirez, Luis F.; Hahn, David Y.; Tatsuoka, Curtis; Bialko, Christopher S.; Cassidy, Kristin A.; Fuentes-Casiano, Edna; Williams, Tiffany D.

    2014-01-01

    Background Treatment non-adherence in people with schizophrenia is associated with relapse and homelessness. Building upon the usefulness of long-acting medication, and our work in psychosocial interventions to enhance adherence, we conducted a prospective uncontrolled trial of customized adherence enhancement (CAE) plus long-acting injectable antipsychotic (LAI) using haloperidol decanoate in 30 homeless or recently homeless individuals with schizophrenia and schizoaffective disorder. Methods Participants received monthly CAE and LAI (CAE-L) for 6 months. Primary outcomes were adherence as measured by the Tablets Routine Questionnaire (TRQ) and housing status. Secondary outcomes included psychiatric symptoms, functioning, side effects, and hospitalizations. Results Mean age of participants was 41.8 years (SD 8.6), mainly minorities (90% African-American) and mainly single/never married (70%). Most (97%) had past or current substance abuse, and had been incarcerated (97%). Ten individuals (33%) terminated the study prematurely. CAE-L was associated with good adherence to LAI (76% at 6 months) and dramatic improvement in oral medication adherence, which changed from missing 46% of medication at study enrollment to missing only 10% at study end (p = 0.03). There were significant improvements in psychiatric symptoms (pschizoaffective disorder. Additional research is needed on effective and practical approaches to improving health outcomes for homeless people with serious mental illness. PMID:24434094

  19. Prospective trial of customized adherence enhancement plus long-acting injectable antipsychotic medication in homeless or recently homeless individuals with schizophrenia or schizoaffective disorder.

    Science.gov (United States)

    Sajatovic, Martha; Levin, Jennifer; Ramirez, Luis F; Hahn, David Y; Tatsuoka, Curtis; Bialko, Christopher S; Cassidy, Kristin A; Fuentes-Casiano, Edna; Williams, Tiffany D

    2013-12-01

    Treatment nonadherence in people with schizophrenia is associated with relapse and homelessness. Building on the usefulness of long-acting medication and our work in psychosocial interventions to enhance adherence, we conducted a prospective uncontrolled trial of customized adherence enhancement (CAE) plus long-acting injectable antipsychotic (LAI) using haloperidol decanoate in 30 homeless or recently homeless individuals with DSM-IV-defined schizophrenia or schizoaffective disorder. Participants received monthly CAE and LAI (CAE-L) for 6 months. Primary outcomes were adherence, as measured by the Tablets Routine Questionnaire, and housing status. Secondary outcomes included psychiatric symptoms, functioning, side effects, and hospitalizations. The study was conducted from July 2010 to December 2012. The mean age of participants was 41.8 years (SD = 8.6); they were mainly minorities (90%, n = 27 African-American) and mainly single/never married (70%, n = 21). Most (97%, n = 29) had past or current substance abuse and had been incarcerated (97%, n = 29). Ten individuals (33%) terminated the study prematurely. CAE-L was associated with good adherence to LAI (at 6 months, 76%) and dramatic improvement in oral medication adherence, which changed from missing 46% of medication at study enrollment to missing only 10% at study end (P = .03). There were significant improvements in psychiatric symptoms (P health outcomes for homeless people with serious mental illness. ClinicalTrials.gov identifier: NCT01152697. © Copyright 2013 Physicians Postgraduate Press, Inc.

  20. Traumatic brain injury among people who are homeless: a systematic review

    Directory of Open Access Journals (Sweden)

    Topolovec-Vranic Jane

    2012-12-01

    Full Text Available Abstract Background Homelessness and poverty are important social problems, and reducing the prevalence of homelessness and the incidence of injury and illness among people who are homeless would have significant financial, societal, and individual implications. Recent research has identified high rates of traumatic brain injury (TBI among this population, but to date there has not been a review of the literature on this topic. The objective of this systematic review was to review the current state of the literature on TBI and homelessness in order to identify knowledge gaps and direct future research. Methods A systematic literature search was conducted in PsycINFO (1887–2012, Embase (1947–2012, and MEDLINE/Pubmed (1966–2012 to identify all published research studies on TBI and homelessness. Data on setting, sampling, outcome measures, and rate of TBI were extracted from these studies. Results Eight research studies were identified. The rate of TBI among samples of persons who were homeless varied across studies, ranging from 8%-53%. Across the studies there was generally little information to adequately describe the research setting, sample sizes were small and consisted mainly of adult males, demographic information was not well described, and validated screening tools were rarely used. The methodological quality of the studies included was generally moderate and there was little information to illustrate that the studies were adequately powered or that study samples were representative of the source population. There was also an absence of qualitative studies in the literature. Conclusions The rate of TBI is higher among persons who are homeless as compared to the general population. Both descriptive and interventional studies of individuals who are homeless should include a psychometrically sound measure of history of TBI and related disability. Education of caregivers of persons who are at risk of becoming, or are homeless, should

  1. [Characteristics and health status of homeless women born in France and abroad: Results of Insee-Ined 2012 survey].

    Science.gov (United States)

    Gomes do Espirito Santo, M-E; Perrine, A-L; Bonaldi, C; Guseva-Canu, I

    2018-02-08

    French national surveys among the homeless population in 2001 and 2012 provided a general description of the homeless beneficiaries of medical and social aids. However, given the increasing number of women in this population, mostly born abroad and accompanied by their children, a descriptive study of homeless women according to the fact of being born in France or abroad was conducted. A probability sample of 1470 French-speaking homeless women was recruited for the Insee-Ined 2012 survey. Socio-demographic characteristics, life trajectories, work and employment over the last 12 months, perceived health, reported morbidity, use of care and medical coverage have been described, comparing homeless women born abroad with those born in France. Homeless women are young (median age=34 y.), often single (55%), without a partner (71%) and often accompanied by children (52%). The vast majority (60%) reported no salary during the previous 12 months. Housing conditions were less precarious in women born in France, but these women had a more difficult life history, a more unfavorable perception of their health status, and a higher frequency of chronic health problems. Homeless women born abroad seemed to have more precarious conditions of life and more difficulties to access aids and medical coverage. Overall, despite a relatively good availability of medical insurance, homeless women, regardless of the place of birth, often reported health problems, which were not treated. This study suggests that homeless women often have to deal with chronic health problems that are not treated. Homeless women born abroad are characterized by more precarious living conditions that women born in France. Although younger, with an overall favorable perception of their health and declaring less often an addiction, their general state of health appears to be as fragile as for women born in France. Actions towards homeless women should be implemented to promote their access to care. Copyright

  2. Effects of the Good Behavior Game on the Behavioral, Emotional, and Social Problems of Children With Psychiatric Disorders in Special Education Settings

    NARCIS (Netherlands)

    Breeman, Linda D.; van Lier, Pol A C; Wubbels, Theo; Verhulst, Frank C.; van der Ende, Jan; Maras, Athanasios; Struiksma, A. J Chris; Hopman, Juliette A B; Tick, Nouchka T.

    2016-01-01

    Teaching children with psychiatric disorders can be a challenging task. The purpose of this study was to examine the impact of the Good Behavior Game (GBG) in children with psychiatric disorders, and their teachers, in special education. Teachers were trained by licensed school consultants to

  3. Effects of the Good Behavior Game on the behavioral, emotional, and social problems of children with psychiatric disorders in special education settings

    NARCIS (Netherlands)

    Breeman, L.D.; Van Lier, Pol; Wubbels, T.; Verhulst, Frank C.; van der Ende, Jan; Maras, Athanasios; Struiksma, Chris; Hopman, J.A.B.; Tick, Nouchka

    Teaching children with psychiatric disorders can be a challenging task. The purpose of this study was to examine the impact of the Good Behavior Game (GBG) in children with psychiatric disorders, and their teachers, in special education. Teachers were trained by licensed school consultants to

  4. Effects of the Good Behavior Game on the Behavioral, Emotional, and Social Problems of Children with Psychiatric Disorders in Special Education Settings

    Science.gov (United States)

    Breeman, Linda D.; van Lier, Pol A. C.; Wubbels, Theo; Verhulst, Frank C.; van der Ende, Jan; Maras, Athanasios; Struiksma, A. J. Chris; Hopman, Juliette A. B.; Tick, Nouchka T.

    2016-01-01

    Teaching children with psychiatric disorders can be a challenging task. The purpose of this study was to examine the impact of the Good Behavior Game (GBG) in children with psychiatric disorders, and their teachers, in special education. Teachers were trained by licensed school consultants to implement positive behavior support strategies to…

  5. Are childhood abuse and neglect related to age of first homelessness episode among currently homeless adults?

    Science.gov (United States)

    Mar, Marissa Y; Linden, Isabelle A; Torchalla, Iris; Li, Kathy; Krausz, Michael

    2014-01-01

    This study investigates 500 homeless adults and the associations between childhood maltreatment types and the age of first reported homelessness episode. Those first experiencing homelessness in youth (age 24 years or younger; 46%) were compared with those first experiencing homelessness at a later age (older than age 24 years). In individual models, physical abuse, emotional abuse, and emotional neglect were associated with first experiencing homelessness during youth (p homeless during youth (p homeless earlier in life and support the need for early interventions with at-risk families.

  6. Providing housing and care to elderly homeless men and women in Australia.

    Science.gov (United States)

    Lipmann, Bryan

    2003-01-01

    People who are unemployed and who lack the resources to buy adequate food, shelter, or basic health care services face an endless struggle to survive. It is frequently a degrading and humiliating experience. The elderly homeless, who are often frail and sick, are particularly disadvantaged in this struggle. Yet resources are often available to welfare providers to care for the aged homeless. All that is needed is a willingness for providers and government agencies to acknowledge the existence of homelessness among the elderly and be prepared to alleviate the problem.

  7. Retention of Homeless Smokers in the Power to Quit Study.

    Science.gov (United States)

    Richards, Christina M; Sharif, Faduma; Eischen, Sara; Thomas, Janet; Wang, Qi; Guo, Hongfei; Luo, Xianghua; Okuyemi, Kolawole

    2015-09-01

    Concerns about retention are a major barrier to conducting studies enrolling homeless individuals. Since smoking is a major problem in homeless communities and research on effective methods of promoting smoking cessation is needed, we describe strategies used to increase retention and participant characteristics associated with retention in smoking cessation study enrolling homeless adults. The parent study was a 2-group randomized controlled trial with 26-week follow-up enrolling 430 homeless smokers from emergency shelters and transitional housing units in Minneapolis/Saint Paul, MN, USA. Multiple strategies were used to increase retention, including conducting visits at convenient locations for participants, collecting several forms of contact information from participants, using a schedule that was flexible and included frequent low-intensity visits, and providing incentives. Participant demographics as well as characteristics related to tobacco and drug use and health status were analyzed for associations with retention using univariate and multivariate analysis. Overall retention was 75% at 26 weeks. Factors associated with increased retention included greater age; having healthcare coverage; history of multiple homeless episodes, lower stress level; and higher PHQ-9 (Patient Health Questionnaire-9) score. A history of excessive drinking and drug use were associated with decreased retention. It is possible to successfully retain homeless individuals in a smoking cessation study if the study is designed with participants' needs in mind. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Comparison of outcomes of homeless female and male veterans in transitional housing.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A; McGuire, James F

    2012-12-01

    Homelessness among female veterans is of national concern, but there have been few studies of how they differ from male veterans or whether they have different outcomes. This study compared 59 female and 1,181 male participants in a multi-site study of three VA-funded transitional housing programs over a 1-year period following completion of an episode of treatment. At baseline, female participants were younger, reported more psychiatric symptoms, had shorter histories of homelessness,were less likely to have substance use disorders, and were less likely to be working than males. After controlling for these baseline differences, there were no overall gender differences in outcomes measures of housing, employment,substance use, physical and mental health, or quality of life. These results suggest homeless female veterans have different characteristics than male veterans, but benefit equally from transitional housing.

  9. Psychiatric Aspects of Infertility

    Directory of Open Access Journals (Sweden)

    Hacer Sezgin

    2014-06-01

    Full Text Available Infertility can be defined as a crisis with cultural, religious, and class related aspects, which coexists with medical, psychiatric, psychological, and social problems. Relation between psychiatric and psychological factors stem from a mutual interaction of both. Family is an important institution in maintaining human existence and raising individuals in line with society's expectations. Fertility and reproduction are seen as universal functions unique to women with raising children as the expected result of the family institution. Incidence of infertility has increased recently and can become a life crisis for a couple. Even though not being able to have a child affects both sexes emotionally, women feel greater amounts of stress, pressure, anxiety, and depression.Consequences of infertility arise from short and long-term devastating effects on both individual's physical and mental health, and marital system. Many studies focus on infertility related psychological and psychiatric disorders (depression, anxiety, grief, marital conflict, gender differences, relation between the causes of infertility and psychopathology, the effects of psychiatric evaluation and intervention -when necessaryon the course of infertility treatment, pregnancy rates, and childbirth. The most important underlying causes of high levels of stress and anxiety that infertile women experience are the loss of maternity, reproduction, sense of self, and genetic continuity. In this review article is to investigate the relationship between medically unexplained symptoms and psychiatric symptoms. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 165-185

  10. What differentiates homeless persons who died by suicide from other suicides in Australia? A comparative analysis using a unique mortality register.

    Science.gov (United States)

    Arnautovska, U; Sveticic, J; De Leo, D

    2014-04-01

    To study the incidence of suicide by homeless persons over a 20-year period, and identify demographic and clinical characteristics that distinguish these cases from those in non-homeless persons. A comparative analysis of homeless and non-homeless persons who died by suicide between 1990 and 2009 in Queensland, Australia. Ninety-two persons (82 males and 10 females) were identified from the Queensland Suicide Register as being homeless at the time of death. Suicide rates were calculated for the second decade only due to the lack of population numbers of homeless persons in the first decade. Homeless persons had almost twice higher suicide rate than non-homeless counterparts. They were more often male, of young age, single/never married, non-Indigenous, unemployed, had at least one physical illness or other stressful life event prior to death, had drug and alcohol abuse problems, and also were more likely to have evidence for an untreated mental illness. Regression analysis showed that being unemployed, having a history of legal problems and not being diagnosed with mental illness were strongly associated with suicide among homeless persons. This study is the first in Australia, and the second study internationally, to examine the characteristics of homeless people who died by suicide. Although based on a relatively small sample, the present work nonetheless carries practical implications for the development of targeted suicide prevention strategies in this peculiar population of individuals.

  11. Psychiatric Genomics

    DEFF Research Database (Denmark)

    Sullivan, Patrick F; Agrawal, Arpana; Bulik, Cynthia M

    2018-01-01

    into biologically, clinically, and therapeutically meaningful insights. The emerging findings suggest that we are entering a phase of accelerated genetic discovery for multiple psychiatric disorders. These findings are likely to elucidate the genetic portions of these truly complex traits, and this knowledge can...... then be mined for its relevance for improved therapeutics and its impact on psychiatric practice within a precision medicine framework. [AJP at 175: Remembering Our Past As We Envision Our Future November 1946: The Genetic Theory of Schizophrenia Franz Kallmann's influential twin study of schizophrenia in 691...

  12. Newly Homeless Youth Typically Return Home

    OpenAIRE

    Milburn, Norweeta G.; Rosenthal, Doreen; Rotheram-Borus, Mary Jane; Mallett, Shelley; Batterham, Philip; Rice, Eric; Solorio, Rosa

    2007-01-01

    165 newly homeless adolescents from Melbourne, Australia and 261 from Los Angeles, United States were surveyed and followed for two years. Most newly homeless adolescents returned home (70% U.S., 47% Australia) for significant amounts of time (39% U.S., 17% Australia more than 12 months) within two years of becoming homeless.

  13. The Second Student-Run Homeless Shelter

    Science.gov (United States)

    Seider, Scott C.

    2012-01-01

    From 1983-2011, the Harvard Square Homeless Shelter (HSHS) in Cambridge, Massachusetts, was the only student-run homeless shelter in the United States. However, college students at Villanova, Temple, Drexel, the University of Pennsylvania, and Swarthmore drew upon the HSHS model to open their own student-run homeless shelter in Philadelphia,…

  14. 78 FR 21256 - Shelter for the Homeless

    Science.gov (United States)

    2013-04-10

    ... of the Secretary 32 CFR Part 226 RIN 0790-AI88 Shelter for the Homeless AGENCY: Office of the Under... Defense Shelter for the Homeless Program. This direct final rule makes nonsubstantive changes to the... the Homeless Program. DoD expects no opposition to the changes and no significant adverse comments...

  15. Approaches to psychiatric nosology: A viewpoint

    National Research Council Canada - National Science Library

    Avasthi, Ajit; Sarkar, Siddharth; Grover, Sandeep

    2014-01-01

    Psychiatric nosology is required for communication among clinicians and researchers, understanding etiology, testing treatment efficacy, knowing the prevalence of the problems and disorders, health...

  16. [Examination of the clinical, familial and personal characteristics on homelessness of at-risk adolescents].

    Science.gov (United States)

    Robert, Marie; Fournier, Louise; Pauzé, Robert

    2003-01-01

    Our research pertains to juveniles coming under the responsibility of the Centres jeunesse du Quebec (delinquency and youth protection regional services). Some of these teenagers fled their family and made use of their social network to cope with residential instability. These youths were then in a situation of "hidden homelessness", sleeping neither in the streets nor at shelters. Two objectives are pursued: 1) a comparison of youth's and parent's evaluations of significant dimensions of their family life, and 2) an identification of the adolescents' characteristics (clinical, familial and individual) related to their "hidden homelessness". Using bivariate analysis, a group of adolescents who had experienced homelessness was paired (on sex, age and urban or rural areas of origin) to a sample of non-homeless youths. The analysis uses both adolescents and parent/caretaker reports on measures of family characteristics and adolescent self-reports on measures of clinical and personal characteristics. Our results show 1) that, in general, adolescents report a higher level of parental maltreatment and more problems related to the family dynamics and their relationship with their parents than their parents do; 2) that hidden homelessness of distressed youths is generally associated with the same familial risk factors as the ones identified by the studies concerning street youths; 3) in contrast to some other comparative studies, the homeless adolescents in our study did not differ from the non-homeless youths as to the importance of the depressive diagnostic and the use of hard drugs.

  17. A Comparison of Homeless Male Veterans in Metropolitan and Micropolitan Areas in Nebraska: A Methodological Caveat.

    Science.gov (United States)

    Tsai, Jack; Ramaswamy, Sriram; Bhatia, Subhash C; Rosenheck, Robert A

    2015-12-01

    This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff conducted structured interviews with homeless veterans. Results showed that compared to homeless veterans in metropolitans, those in micropolitans were more likely to be White, unmarried, living in transitional settings, and were far more transient but reported greater social support and housing satisfaction. Veterans in micropolitans also reported more medical problems, diagnoses of anxiety and personality disorders, and unexpectedly, were more likely to report using various health services and less travel time for services. Together, these findings suggest access to homeless and health services for veterans in micropolitan areas may be facilitated through Veterans Affairs facilities and community providers that work in close proximity to one another. Many homeless veterans in these areas are transient, making them a difficult population to study and serve. Innovative ways to provide outreach to homeless veterans in micropolitan and more rural areas are needed.

  18. The prevalence of mental illness in homeless children: a systematic review and meta-analysis.

    Science.gov (United States)

    Bassuk, Ellen L; Richard, Molly K; Tsertsvadze, Alexander

    2015-02-01

    The numbers of children experiencing homelessness have increased. To develop responsive interventions, we must understand their mental health/behavioral needs. The purpose of this systematic review was to update the evidence base by identifying, appraising, and summarizing studies on the prevalence of mental health issues among homeless children, comparing these individuals to low-income-housed children, and discussing research, practice, and policy implications. We searched 3 electronic databases and included empirical studies investigating the prevalence of mental illness in homeless children in the United States (1990-2014). Retrieved publications were screened, data extracted, and study quality appraised by independent reviewers. Evidence synthesis was based on qualitative and quantitative analyses. Prevalence odds ratios (OR) of individual studies were pooled using an inverse-variance random effects model. Twelve studies were included and reviewed. Overall, 10% to 26% of homeless preschoolers had mental health problems requiring clinical evaluation. This proportion increased to 24% to 40% among homeless school-age children, a rate 2 to 4 times higher than poor children aged 6 to 11 years in the National Survey of America's Families. According to our meta-analyses, the difference in prevalence measured by Child Behavior Checklist (CBCL) Total Problems (T score ≥60-64) was not significantly different between homeless and housed preschool children (OR = 1.49; 95% CI = 0.97-2.28). School-age homeless children compared to housed children were significantly more likely to have a mental health problem as defined by the CBCL Total Problems subscale (T score ≥60; OR = 1.78; 95% CI = 1.19-2.66). Evidence-based mental health interventions for children experiencing homelessness are long overdue. Universal screening, treatment plan development, and support of adaptive systems that focus on positive parenting and children's self-regulation are essential. Copyright

  19. Characteristics and Use of Services Among Literally Homeless and Unstably Housed U.S. Veterans With Custody of Minor Children.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; Kane, Vincent

    2015-10-01

    The study examined the number of homeless veterans with minor children in their custody ("children in custody"), compared sociodemographic and clinical characteristics among homeless veterans with and without children in custody, and observed differences in referral and admission patterns among veterans with and without children in custody for a variety of U.S. Department of Veterans Affairs (VA) programs for homeless veterans. Data were obtained from the VA Homeless Operations Management and Evaluation System for 89,142 literally homeless and unstably housed veterans. Sociodemographic, housing, health, and psychosocial characteristics of veterans were analyzed. Among literally homeless veterans, 9% of men and 30% of women had children in custody; among unstably housed veterans, 18% of men and 45% of women had children in custody. Both male and female veterans with children in custody were younger and less likely to have chronic general medical conditions and psychiatric disorders compared with other veterans, but, notably, 11% of homeless veterans with children in custody had psychotic disorders. Veterans with children in custody were more likely than other veterans to be referred and admitted to the VA's permanent supported housing program, and women were more likely than men to be admitted to the program. A substantial proportion of homeless veterans served by the VA have severe mental illness and children in custody, which raises concerns about the parenting environment for their children. Particular focus should be directed at VA's supported-housing program, and the practical and ethical implications of serving homeless parents and their children need to be considered.

  20. Adherence to antipsychotic medication among homeless adults in Vancouver, Canada: a 15-year retrospective cohort study.

    Science.gov (United States)

    Rezansoff, Stefanie N; Moniruzzaman, A; Fazel, S; Procyshyn, R; Somers, J M

    2016-12-01

    The purpose of this study was to investigate the level of adherence to antipsychotic prescription medication in a well-defined homeless cohort over a 15-year period. We hypothesized that adherence would be well below the recommended threshold for clinical effectiveness (80 %), and that it would be strongly associated with modifiable risk factors in the social environment in which homeless people live. Linked baseline data (including comprehensive population-level administrative prescription records) were examined in a subpopulation of participants from two pragmatic-randomized trials that investigated Housing First for homeless and mentally ill adults. Adherence to antipsychotic medication was operationalized using the medication possession ratio. Multivariable logistic regression was used to estimate effect sizes between socio-demographic, homelessness-related and illness factors, and medication possession ratio. Among the 290 participants who met inclusion criteria for the current analysis, adherence to antipsychotic prescription was significantly associated with: history of psychiatric hospitalization; receipt of primary medical services; long-acting injectable antipsychotic formulations; and duration of homelessness. Mean medication possession ratio in the pre-randomization period was 0.41. Socio-demographic characteristics previously correlated with antipsychotic non-adherence were not significantly related to medication possession ratio. This is the first study to quantify the very low level of adherence to antipsychotic medication among homeless people over an extended observation period of 15 years. Each of the four factors found to be significantly associated with adherence presents opportunities for intervention. Strategies to end homelessness for this population may represent the greatest opportunity to improve adherence to antipsychotic medication.

  1. Profiles and Trends in Danish Homelessness

    DEFF Research Database (Denmark)

    Christensen, Ivan; Koch-Nielsen, Inger

    Due to an increased visibility in homelessness from the late 80s and onwards many political initiatives have been taken to reduce homelessness and to improve the situation for the homeless. The aim of this article is to try to describe the development in homelessness in Denmark since the late 80s...... in homelessness. The composition of the group has changed, as the proportion of young and elderly seems to have decreased and the proportion of the middle-aged to have increased. There is probably an increase in the proportion of ethnic minorities, whereas a change in the gender composition is difficult to verify...

  2. Long-term homelessness in men with a psychosis: Limitation of services.

    Science.gov (United States)

    Burns, Adam; Robins, Alan; Hodge, Mark; Holmes, Alex

    2009-04-01

    A proportion of persistently homeless men with psychosis are unable to function in the community, despite intensive outreach. The present study aimed to (i) develop a method to measure the number of homeless clients with a psychosis who are unable to maintain basic levels of function, despite the application of intensive community treatment; and (ii) determine if the proportion of these men had increased in an Australian inner urban setting over a 5-year period. Criteria were developed and validated to define this group. A review of records of clients engaged in homeless settings was conducted in order to compare the proportion of men with these features in 2000 and 2005. In 2005, 23% met the criterion of long-term homelessness with poor function, despite intensive outreach, as compared with 17% in 2000 (P = 0.62). The 2005 cohort was more likely to have attempted intensive community psychiatric treatment (P = 0.04). We conclude that a proportion of homeless men with a psychosis in Australia do not achieve basic function, despite access to intensive outreach. The proportion of these men did not change between 2000 and 2005. These men require additional specialized services, including access to long-term supported housing.

  3. Children in homeless families in Melbourne: health status and use of health services.

    Science.gov (United States)

    Efron, D; Sewell, J R; Horn, M; Jewell, F

    To determine the prevalence of health and behaviour problems in a sample of children in homeless families and of psychological problems in their parents, and to assess the use of health services by homeless families. A cross-sectional, questionnaire-based prevalence survey. Supported accommodation provided by a welfare service in Melbourne between May 1994 and June 1995. 51 children from 31 families soon after housing crises. More than one-third of all children had total behaviour problems scores in the "deviant" range (i.e., requiring mental health referral). Intellectual disability/developmental delay, skin problems, vision problems, recurrent headache, and asthma or other breathing problems were more prevalent in these homeless children than in a large Australian normative population. Their mothers scored higher than a large normative sample on the mental health questionnaire, most markedly for "anxiety-insomnia", "severe depression" and total score. Cost of treatment and transport difficulties were seen as barriers to using health care services. Australian health-care practitioners should be aware of the health and health service access problems of children in homeless families, and work to minimise their physical, emotional, developmental and academic disadvantages. Psychological support services should be available for homeless families, particularly for mothers.

  4. Obsessive-compulsive symptoms are associated with psychiatric comorbidities, behavioral and clinical problems: a population-based study of Brazilian school children.

    Science.gov (United States)

    Alvarenga, Pedro G; do Rosario, Maria C; Cesar, Raony C; Manfro, Gisele G; Moriyama, Tais S; Bloch, Michael H; Shavitt, Roseli G; Hoexter, Marcelo Q; Coughlin, Catherine G; Leckman, James F; Miguel, Euripedes C

    2016-02-01

    Pediatric-onset obsessive-compulsive disorder (OCD) is underdiagnosed, and many affected children are untreated. The present study seeks to evaluate the presence and the clinical impact of OCD and obsessive-compulsive symptoms (OCS) in a large sample of school-age children. In Phase I, we performed an initial screening using the Family History Screen (FHS). In Phase II, we identified an "at-risk" sample, as well as a randomly selected group of children. A total of 2,512 children (6-12 years old) were assessed using the FHS, the Development and Well-Being Assessment (DAWBA), the Strengths and Difficulties Questionnaire (SDQ), and the Child Behavior Checklist (CBCL). Data analyses included descriptive and multivariate analytical techniques. 2,512 children (mean age: 8.86 ± 1.84 years; 55.0% male) were categorized into one of the three diagnostic groups: OCD (n = 77), OCS (n = 488), and unaffected controls (n = 1,947). There were no significant socio-demographic differences (age, gender, socioeconomic status) across groups. The OCS group resembled the OCD on overall impairment, including school problems and delinquent behaviors. However, the OCD group did have significantly higher rates of several comorbid psychiatric disorders, including separation anxiety, generalized anxiety, and major depressive disorder, than OCS or unaffected controls. Moreover, the OCD group also scored higher than the SDQ, as well as on each of CBCL items rated by the parent. Our findings suggest that there is a psychopathological continuum between OCS and OCD in school-aged children. The presence of OCS is associated with functional impairment, which needs further investigation in longitudinal studies.

  5. Characteristics of homeless adults with serious mental illness served by a state mental health transitional shelter.

    Science.gov (United States)

    Viron, Mark; Bello, Iruma; Freudenreich, Oliver; Shtasel, Derri

    2014-07-01

    Specialized transitional shelters are available in various cities to provide assistance to homeless individuals with serious mental illness. Little is known about the population using such shelters. The authors conducted a retrospective chart review to collect demographic, social, and clinical data of residents in a state-operated mental health transitional shelter in Massachusetts. A total of 74 subjects were included. Schizophrenia-spectrum disorders were present in 67.6 % of the sample and mood disorders in 35.1 %. Substance use disorders were documented in 44.6 %. Chronic medical illness (mostly hypertension, dyslipidemia, asthma, and diabetes) was found in 82.4 %. The co-occurrence of a psychiatric and substance use disorder and chronic medical illness was found in 36.5 %. The majority (75.7 %) of patients had a history of legal charges. Homeless individuals with serious mental illness served by specialized transitional shelters represent a population with complex psychiatric, medical and social needs.

  6. Gender, coping strategies, homelessness stressors, and income generation among homeless young adults in three cities.

    Science.gov (United States)

    Ferguson, Kristin M; Bender, Kimberly; Thompson, Sanna J

    2015-06-01

    This study examined gender differences among homeless young adults' coping strategies and homelessness stressors as they relate to legal (e.g., full-time employment, selling personal possessions, selling blood/plasma) and illegal economic activity (e.g., selling drugs, theft, prostitution). A sample of 601 homeless young adults was recruited from 3 cities (Los Angeles, CA [n = 200], Austin, TX [n = 200], and Denver, CO [n = 201]) to participate in semi-structured interviews from March 2010 to July 2011. Risk and resilience correlates of legal and illegal economic activity were analyzed using six Ordinary Least Squares regression models with the full sample and with the female and male sub-samples. In the full sample, three variables (i.e., avoidant coping, problem-focused coping, and mania) were associated with legal income generation whereas eight variables (i.e., social coping, age, arrest history, transience, peer substance use, antisocial personality disorder [ASPD], substance use disorder [SUD], and major depressive episode [MDE]) were associated with illegal economic activity. In the female sub-sample, three variables (i.e., problem-focused coping, race/ethnicity, and transience) were correlated with legal income generation whereas six variables (i.e., problem-focused coping, social coping, age, arrest history, peer substance use, and ASPD) were correlated with illegal economic activity. Among males, the model depicting legal income generation was not significant yet seven variables (i.e., social coping, age, transience, peer substance use, ASPD, SUD, and MDE) were associated with illegal economic activity. Understanding gender differences in coping strategies and economic activity might help customize interventions aimed at safe and legal income generation for this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. A cross-sectional examination of the mental health of homeless mothers: does the relationship between mothering and mental health vary by duration of homelessness?

    Science.gov (United States)

    Zabkiewicz, Denise M; Patterson, Michelle; Wright, Alexandra

    2014-01-01

    Objectives This study draws on baseline data from the At Home/Chez Soi demonstration project to examine the association between parenting status and mental health among homeless women and whether the association varies by duration of homelessness. Setting Structured interviews were conducted with participants in five cities across Canada including Moncton, Montreal, Toronto, Vancouver and Winnipeg. Participants Eligibility criteria included those with legal adult status, with a mental illness, and who lacked a regular, fixed shelter. All 713 women who participated in the larger project were selected for inclusion in this analysis. Measures The mental health conditions of interest include depression, post-traumatic stress disorder (PTSD), alcohol dependence and substance dependence. Results The relationship between parenting status and depression, as well as PTSD, varied by duration of homelessness. Among women who had been homeless for less than 2 years, no relationship was found between parenting status and depression, or PTSD. However, among women who had been homeless for 2 or more years, the odds of depression was twice as high among parenting women compared with others (aOR=2.05, p≤0.05). A similar relationship was found between parenting status and PTSD (aOR=2.03, p≤0.05). The odds of substance dependence was found to be 2.62 times greater among parenting women compared with others and this relationship did not vary by duration of homelessness (aOR=2.62; 95% CI 1.86 to 3.69). No relationship was found between parenting and alcohol dependence. Conclusions Overall, the findings from this study suggest that there is a relationship between long-term homelessness and mothers’ risk of poor mental health. Given the multiple demands mothers face, a failure to recognise their unique needs is likely to contribute to intergenerational legacies of homelessness and mental health problems. Trial registration number World Health Organization's International Clinical

  8. Bartonella quintana in Homeless Persons

    Centers for Disease Control (CDC) Podcasts

    2009-06-30

    In this podcast, Dr. Marina Eremeeva discusses an article about Bartonella quintana in homeless populations in San Francisco. Bartonella quintana is a bacterium that is transmitted by human body lice. Findings by the article’s authors suggest that Bartonella quintana may be transmitted by head lice. This could mean that populations other than homeless populations, such as school children, might be at increased risk for Bartonella quintana.  Created: 6/30/2009 by Emerging Infectious Diseases.   Date Released: 6/30/2009.

  9. Is there a role for pharmacists in multidisciplinary health-care teams at community outreach events for the homeless?

    Science.gov (United States)

    Chan, Vincent; Patounas, Marea; Dornbusch, Debbie; Tran, Hung; Watson, Patricia

    2015-01-01

    Homelessness is a significant public health problem. It is well-documented that people experiencing homelessness exhibit more serious illnesses and have poorer health than the general population. The provision of services and interventions by health-care professionals, including pharmacists, may make a simple yet important contribution to improved health outcomes in those experiencing homelessness, but evidence of roles and interventions is limited and variable. In Australia, the Queensland University of Technology Health Clinic connects with the homeless community by taking part in community outreach events. This paper provides details of one such event, as well as the roles, interventions and experiences of pharmacists. Participation and inclusion of pharmacists in a multidisciplinary health-care team approach at homeless outreach events should be supported and encouraged.

  10. Perceptions of homelessness in older homeless veterans, VA homeless program staff liaisons, and housing intervention providers.

    Science.gov (United States)

    Molinari, Victor A; Brown, Lisa M; Frahm, Kathryn A; Schinka, John A; Casey, Roger

    2013-05-01

    To understand the needs and challenges encountered by older homeless veterans. We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers. Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs. Major themes for VA staff liaison/housing intervention providers: 1) belief that the transitional housing program has made a positive change; 2) need for individualized criteria to address the unique needs of veterans; 3) distinct differences between older and younger homeless veterans; 4) outreach services; 5) permanent housing issues; and 6) coordination of services. Compared with younger veterans, older veterans have less social support, greater employment and health challenges, and, perhaps greater motivation to change.

  11. Psychopharmacologic Services for Homeless Veterans: Comparing Psychotropic Prescription Fills Among Homeless and Non-Homeless Veterans with Serious Mental Illness.

    Science.gov (United States)

    Hermes, Eric; Rosenheck, Robert

    2016-02-01

    Using national Veterans Health Administration (VHA) administrative data, this study evaluated differences in psychotropic medication use between homeless and non-homeless adults with serious mental illness (SMI) who used VHA services in 2010. The adjusted mean number of psychotropic prescription fills associated with homeless individuals were identified using regression models adjusted for socio-demographics, diagnoses, and use of health services. Of the 876,989 individuals with SMI using VHA services, 7.2 % were homeless at some time during 2010. In bivariate analysis, homeless individuals filled more psychotropic medication prescriptions compared with non-homeless individuals. However, after adjusting for potentially confounding variables, homeless individuals were found to have filled 16.2 % fewer prescriptions than non-homeless individuals when all psychotropics were analyzed together (F = 6947.1, p < .001) and for most individual classes of psychotropics. Greater use of residential/inpatient mental health services by the homeless was the most important single factor associated with filling more psychotropic prescriptions than non-homeless individuals.

  12. [Qualitative methods in psychiatric research].

    Science.gov (United States)

    Sikorski, Claudia; Glaesmer, Heide

    2011-01-01

    This article addresses the usage of qualitative methods in psychiatric research and presents the qualitative approach in more detail. Recent original empirical work of a German psychiatric journal was systematically reviewed. Methods used to collect and analyse the information are detailed. One third of the articles used a solely qualitative research design. One further article applied a combination of quantitative and qualitative approaches. Three kinds of the qualitative interviews were used (in depth, narrative and problem-focussed interview). Additionally, focus groups (group discussions) and qualitative content analysis were applied by studies. Qualitative approaches are an integral part of psychiatric research. Further work should assure to use adequate sampling strategies.

  13. A Theory of Mental Health and Optimal Service Delivery for Homeless Children.

    Science.gov (United States)

    Marcal, Katherine E

    2017-08-01

    Homeless children are a vulnerable group with high risk for developing mental health disorders. The pathways to disorders among homeless children have not been fully elucidated, with significant logistical and measurement issues challenging accurate and thorough assessment of need. The environments of homeless children are uniquely chaotic, marked by frequent moves, family structure changes, household and neighborhood disorder, parenting distress, and lack of continuous services. Despite high rates of service use, mental health outcomes remain poor. This paper reviews the literature on homeless children's mental health, as well as prior theoretical explorations. Finally, the paper proposes a theoretical model that explains elevated rates of mental health problems among homeless children as consequences of harmful stress reactions triggered by chronic household instability along with repeated service disruptions. This model draws upon existing conceptual frameworks of child development, family poverty, health services utilization, and the biology of stress to clarify the role of environmental chaos in the development of child emotional and behavioral problems. Potential strategies to mitigate the risk for mental health disorders among homeless children and future research directions are discussed.

  14. Self-reported oral health of a metropolitan homeless population in Australia: comparisons with population-level data.

    Science.gov (United States)

    Parker, E J; Jamieson, L M; Steffens, M A; Cathro, P; Logan, R M

    2011-09-01

    There is limited information on self-perceived oral health of homeless populations. This study quantified self-reported oral health among a metropolitan homeless adult population and compared against a representative sample of the metropolitan adult population obtained from the National Survey of Adult Oral Health. A total of 248 homeless participants (age range 17-78 years, 79% male) completed a self-report questionnaire. Data for an age-matched, representative sample of metropolitan-dwelling adults were obtained from Australia's second National Survey of Adult Oral Health. Percentage responses and 95% confidence intervals were calculated, with non-overlapping 95% confidence intervals used to identify statistically significant differences between the two groups. Homeless adults reported poorer oral health than their age-matched general population counterparts. Twice as many homeless adults reported visiting a dentist more than a year ago and that their usual reason for dental attendance was for a dental problem. The proportion of homeless adults with a perceived need for fillings or extractions was also twice that of their age-matched general population counterparts. Three times as many homeless adults rated their oral health as 'fair' or 'poor'. A significantly greater proportion of homeless adults in an Australian metropolitan location reported poorer oral health compared with the general metropolitan adult population. © 2011 Australian Dental Association.

  15. Military sexual trauma among homeless veterans.

    Science.gov (United States)

    Pavao, Joanne; Turchik, Jessica A; Hyun, Jenny K; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

    2013-07-01

    Military sexual trauma (MST) is the Veteran Health Administration's (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. To estimate the prevalence of MST, examine the association between MST and mental health conditions, and describe mental health utilization among homeless women and men. National, cross-sectional study of 126,598 homeless Veterans who used VHA outpatient care in fiscal year 2010. All variables were obtained from VHA administrative databases, including MST screening status, ICD-9-CM codes to determine mental health diagnoses, and VHA utilization. Of homeless Veterans in VHA, 39.7 % of females and 3.3 % of males experienced MST. Homeless Veterans who experienced MST demonstrated a significantly higher likelihood of almost all mental health conditions examined as compared to other homeless women and men, including depression, posttraumatic stress disorder, other anxiety disorders, substance use disorders, bipolar disorders, personality disorders, suicide, and, among men only, schizophrenia and psychotic disorders. Nearly all homeless Veterans had at least one mental health visit and Veterans who experienced MST utilized significantly more mental health visits compared to Veterans who did not experience MST. A substantial proportion of homeless Veterans using VHA services have experienced MST, and those who experienced MST had increased odds of mental health diagnoses. Homeless Veterans who had experienced MST had higher intensity of mental health care utilization and high rates of MST-related mental health care. This study highlights the importance of trauma-informed care among homeless Veterans and the success of VHA homeless

  16. Predictors of Frequent Emergency Room Visits among a Homeless Population.

    Directory of Open Access Journals (Sweden)

    Kinna Thakarar

    Full Text Available Homelessness, HIV, and substance use are interwoven problems. Furthermore, homeless individuals are frequent users of emergency services. The main purpose of this study was to identify risk factors for frequent emergency room (ER visits and to examine the effects of housing status and HIV serostatus on ER utilization. The second purpose was to identify risk factors for frequent ER visits in patients with a history of illicit drug use.A retrospective analysis was performed on 412 patients enrolled in a Boston-based health care for the homeless program (HCH. This study population was selected as a 2:1 HIV seronegative versus HIV seropositive match based on age, sex, and housing status. A subgroup analysis was performed on 287 patients with history of illicit drug use. Chart data were analyzed to compare demographics, health characteristics, and health service utilization. Results were stratified by housing status. Logistic models using generalized estimating equations were used to predict frequent ER visits.In homeless patients, hepatitis C was the only predictor of frequent ER visits (OR 4.49, p<0.01. HIV seropositivity was not predictive of frequent ER visits. In patients with history of illicit drug use, mental health (OR 2.53, 95% CI 1.07-5.95 and hepatitis C (OR 2.85, 95% CI 1.37-5.93 were predictors of frequent ER use. HIV seropositivity did not predict ER use (OR 0.45, 95% CI 0.21 - 0.97.In a HCH population, hepatitis C predicted frequent ER visits in homeless patients. HIV seropositivity did not predict frequent ER visits, likely because HIV seropositive HCH patients are engaged in care. In patients with history of illicit drug use, hepatitis C and mental health disorders predicted frequent ER visits. Supportive housing for patients with mental health disorders and hepatitis C may help prevent unnecessary ER visits in this population.

  17. Latent homeless risk profiles of a national sample of homeless veterans and their relation to program referral and admission patterns

    National Research Council Canada - National Science Library

    Tsai, Jack; Kasprow, Wesley J; Rosenheck, Robert A

    2013-01-01

    ...) homeless service programs. We examined data from the VA's new Homeless Operations Management and Evaluation System on 120,852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors...

  18. Universal screening for homelessness and risk for homelessness in the Veterans Health Administration.

    Science.gov (United States)

    Montgomery, Ann Elizabeth; Fargo, Jamison D; Byrne, Thomas H; Kane, Vincent R; Culhane, Dennis P

    2013-12-01

    We examined data for all veterans who completed the Veterans Health Administration's national homelessness screening instrument between October 1, 2012, and January 10, 2013. Among veterans who were not engaged with the US Department of Veterans Affairs homeless system and presented for primary care services, the prevalence of recent housing instability or homelessness was 0.9% and homelessness risk was 1.2%. Future research will refine outreach strategies, targeting of prevention resources, and development of novel interventions.

  19. Elderly Homeless Veterans in Los Angeles: Chronicity and precipitants of homelessness

    OpenAIRE

    van den Berk-Clark, Carissa; McGuire, James

    2013-01-01

    We interviewed 33 chronically and 26 acutely homeless veterans aged 65 and over about their health and mental health, education and employment experience, social support, service needs and other precipitants of homelessness. Chronically homeless elderly veterans were more likely to have lower levels of education, had greater numbers and longer durations of prior homelessness, fewer social contacts providing instrumental support, and were more likely to report financial barriers to procuring h...

  20. Disproportionate Exposure to Early-Life Adversity and Sexual Orientation Disparities in Psychiatric Morbidity

    Science.gov (United States)

    McLaughlin, Katie A.; Hatzenbuehler, Mark L.; Xuan, Ziming; Conron, Kerith J.

    2012-01-01

    Objectives: Lesbian, gay, and bisexual (LGB) populations exhibit elevated rates of psychiatric disorders compared to heterosexuals, and these disparities emerge early in the life course. We examined the role of exposure to early-life victimization and adversity--including physical and sexual abuse, homelessness, and intimate partner violence--in…

  1. When should governments increase the supply of psychiatric beds?

    Science.gov (United States)

    Allison, S; Bastiampillai, T; Licinio, J; Fuller, D A; Bidargaddi, N; Sharfstein, S S

    2017-07-11

    Low numbers of hospital-based psychiatric beds create problems for people with severe mental illness (SMI), when they face extended emergency department (ED) waits, higher thresholds for admission to an acute bed, and short revolving-door stays with high rates of rehospitalisation. Limited access to inpatient treatment has been associated with higher suicide risk, premature mortality, homelessness, violent crime and incarceration. Ultimately, people with SMI can be transinstitutionalised to the criminal justice system. In the USA, for example, prisons have replaced mental hospitals as the largest institutions housing people with SMI. There is no international consensus on the safe minimum numbers of acute, forensic and rehabilitation beds needed to reduce these risks. As a consequence, Organisation for Economic Cooperation and Development (OECD) countries have wide variations in the mix of hospital beds with an average of 71 beds per 100 000 population. Policymakers face difficult choices with few studies to guide decisions on supplying beds. The UK Royal College of Psychiatrists offered a policy framework, which was adapted for Australia. The government of the State of South Australia increased the supplies of crisis, acute and forensic beds to meet a mandatory target to safely reduce mental health boarding in the EDs.Molecular Psychiatry advance online publication, 11 July 2017; doi:10.1038/mp.2017.139.

  2. Is Substance Use Associated with Perpetration and Victimization of Physically Violent Behavior and Property Offences among Homeless Youth? A Systematic Review of International Studies

    Science.gov (United States)

    Heerde, Jessica A.; Hemphill, Sheryl A.

    2015-01-01

    Background: Substance use is a commonly reported problem associated with numerous adverse outcomes among homeless youth. Homelessness is reportedly a covariate to perpetration of, and victimization from, physically violent behavior and property offences. Of particular importance in both the perpetration of, and victimization from these behaviors,…

  3. How to provide for the primary health care needs of homeless people: what do homeless people in Leicester think?

    OpenAIRE

    Hewett, N C

    1999-01-01

    The best means of improving access to primary health care for homeless people remains controversial, but the debate may be informed by the opinions of homeless people. A questionnaire asked users of a homeless drop-in centre to choose between the options of facilitated access to mainstream primary health care or special provision for homeless people. While both models of care were endorsed, 84% of homeless people preferred a special homeless service.

  4. Homelessness Outcome Reporting Normative Framework: Systems-Level Evaluation of Progress in Ending Homelessness

    Science.gov (United States)

    Austen, Tyrone; Pauly, Bernie

    2012-01-01

    Homelessness is a serious and growing issue. Evaluations of systemic-level changes are needed to determine progress in reducing or ending homelessness. The report card methodology is one means of systems-level assessment. Rather than solely establishing an enumeration, homelessness report cards can capture pertinent information about structural…

  5. Unaccompanied Homeless Youth: Intersections of Homelessness, School Experiences and Educational Policy

    Science.gov (United States)

    Aviles de Bradley, Ann M.

    2011-01-01

    School districts are faced with the challenge of how best to serve the needs of a growing homeless student population. As the numbers of homeless children and youth continue to rise, it is imperative for educators and others to understand the experiences of unaccompanied homeless youth. A qualitative research project was undertaken to obtain the…

  6. On the Way Up? : Exploring homelessness and stable housing among homeless people in the Netherlands

    NARCIS (Netherlands)

    B. van Straaten (Barbara)

    2016-01-01

    markdownabstractAround 31,000 people in the Netherlands were literally homeless in 2015. This thesis focused on the situation of homeless people in the Netherlands and into developments in their situation over time. More insight into the situation of homeless people and into developments over time

  7. Homelessness and Housing Insecurity Among Former Prisoners

    Directory of Open Access Journals (Sweden)

    Claire W. Herbert

    2015-11-01

    Full Text Available The United States has experienced dramatic increases in both incarceration rates and the population of insecurely housed or homeless persons since the 1980s. These marginalized populations have strong overlaps, with many people being poor, minority, and from an urban area. That a relationship between homelessness, housing insecurity, and incarceration exists is clear, but the extent and nature of this relationship is not yet adequately understood. We use longitudinal, administrative data on Michigan parolees released in 2003 to examine returning prisoners’ experiences with housing insecurity and homelessness. Our analysis finds relatively low rates of outright homelessness among former prisoners, but very high rates of housing insecurity, much of which is linked to features of community supervision, such as intermediate sanctions, returns to prison, and absconding. We identify risk factors for housing insecurity, including mental illness, substance use, prior incarceration, and homelessness, as well as protective “buffers” against insecurity and homelessness, including earnings and social supports.

  8. Case Study Methodology and Homelessness Research

    Directory of Open Access Journals (Sweden)

    Jill Pable

    2013-10-01

    Full Text Available This paper describes the potential suitability of case study methodology for inquiry with the homeless population. It references a research study that uses case study research method to build theory. This study's topic is the lived experience of destitute individuals who reside in homeless shelters, and explores the homeless shelter built environment's potential influence on resident satisfaction and recovery. Case study methodology may be appropriate because it explores real-life contextual issues that characterize homelessness and can also accommodate the wide range of homeless person demographics that make this group difficult to study in a generalized fashion. Further, case study method accommodates the need within research in this area to understand individualized treatments as a potential solution for homelessness.

  9. Risk factors for homelessness among women veterans.

    Science.gov (United States)

    Washington, Donna L; Yano, Elizabeth M; McGuire, James; Hines, Vivian; Lee, Martin; Gelberg, Lillian

    2010-02-01

    Women veterans are three to four times more likely than non-veteran women to become homeless. However, their risk factors for homelessness have not been defined. Case-control study of non-institutionalized homeless women veterans (n533) and age-matched housed women veterans (n=165). Health, health care, and factors associated with homelessness were assessed using multiple logistic regression with a Monte Carlo algorithm to estimate exact standard errors of the model coefficients and p-values. Characteristics associated with homelessness were sexual assault during military service, being unemployed, being disabled, having worse overall health, and screening positive for an anxiety disorder or post-traumatic stress disorder. Protective factors were being a college graduate or married. Efforts to assess housed women veterans' risk factors for homelessness should be integrated into clinical care programs within and outside the Veterans Administration. Programs that work to ameliorate risk factors may prevent these women's living situations from deteriorating over time.

  10. Nutritional deficiencies in homeless persons with problematic drinking: a systematic review.

    Science.gov (United States)

    Ijaz, Sharea; Jackson, Joni; Thorley, Helen; Porter, Katie; Fleming, Clare; Richards, Alison; Bonner, Adrian; Savović, Jelena

    2017-05-05

    A significant proportion of homeless people drink alcohol excessively and this can lead to malnutrition and consequent medical problems. The aim of this review was to assess the evidence on the range of nutritional deficiencies in the homeless problem-drinking populations. We conducted a comprehensive search of nine scientific literature databases and 13 grey literature sources. We included studies of any design that included homeless population with problem-drinking and reported measures of nutritional deficiencies in urine or blood. Study selection and data extraction was done by one reviewer and checked by another. Data on malnutrition profile were summarized narratively. We found nine studies reporting nutritional deficiencies in homeless populations with problem-drinking. The oldest study was from the 1950s and the most recent from 2013. The following nutrients were reported across studies: vitamins B1, B2, B6, B9, B12, C, A, and E; haemoglobin; and albumin. The most common deficiencies reported were of vitamin B1 (prevalence of deficiency was 0, 2, 6, 45, and 51% in five studies) and vitamin C (29, 84, and 95% in three studies). None of the studies were assessed to be at a low risk of bias. The limited, low quality and relatively old evidence suggests that homeless people who drink heavily may be deficient in vitamin C, thiamine, and other nutrients. New, well conducted studies are needed in order to optimally inform public health interventions aimed at improving deficiencies in this population. PROSPERO CRD42015024247.

  11. Health and Self-Regulation among School-Age Children Experiencing Family Homelessness

    Directory of Open Access Journals (Sweden)

    Andrew J. Barnes

    2017-08-01

    Full Text Available Children in homeless families have high levels of adversity and are at risk for behavior problems and chronic health conditions, however little is known about the relationship between cognitive-emotional self-regulation and health among school-aged homeless children. Children (n = 86; mean age 10.5 living in shelters were assessed for health, family stress/adversity, emotional-behavioral regulation, nonverbal intellectual abilities, and executive function. Vision problems were the most prevalent health condition, followed by chronic respiratory conditions. Cumulative risk, child executive function, and self-regulation problems in children were uniquely related to child physical health. Homeless children experience problems with cognitive, emotional, and behavioral regulation as well as physical health, occurring in a context of high psychosocial risk. Several aspects of children’s self-regulation predict physical health in 9- to 11-year-old homeless children. Health promotion efforts in homeless families should address individual differences in children’s self-regulation as a resilience factor.

  12. Sustaining dignity? food insecurity in homeless young people in urban Australia.

    Science.gov (United States)

    Crawford, Belinda; Yamazaki, Rowena; Franke, Elise; Amanatidis, Sue; Ravulo, Jioji; Steinbeck, Kate; Ritchie, Jan; Torvaldsen, Siranda

    2014-08-01

    Food insecurity is recognised as an increasing problem in disadvantaged and marginalised groups. The aim of this study was to investigate issues associated with food insecurity and nutrition in young people experiencing, or at risk of, homelessness in metropolitan Australia. Eight focus group discussions were conducted with 48 young people (aged between 15 and 25 years) in specialist homelessness services in central and south-western Sydney. Participants described daily experiences of food insecurity, persistent hunger and poverty. Structural barriers to food security and nutrition were identified and included poverty and reduced physical access to fresh foods. Participants also described a desire to save time, for convenience and to be socially connected. Despite the hardships and the chaos of youth homelessness, the groups were defined by their strength of character, resilience and hope for the future. Homeless young people within central and south-western Sydney report varying degrees of food insecurity, despite being supported by specialist youth homelessness services. SO WHAT? A collaborative, multistrategic approach with youth participation is required to further enhance the capacity of youth services to improve food security, food access and the availability of nutritious foods for homeless young people. A greater focus on advocacy and policy action is also required to bring food security and nutrition to the forefront of national efforts to improve the health and welfare of disadvantaged groups.

  13. Homeless adults engagement in art: first steps towards identity, recovery and social inclusion.

    Science.gov (United States)

    Thomas, Yvonne; Gray, Marion; McGinty, Sue; Ebringer, Sally

    2011-12-01

    The Australian policy on homelessness identifies participation in structured activities as the first step towards social inclusion and increasing the likelihood of permanently leaving a homeless lifestyle. Art interventions increase interpersonal function and social participation and provide a means of expression and transformation with people who are homeless. This study explores the value of an art programme provided by a non-government agency for homeless adults. Qualitative methods including participant observation and purposive interviews were analysed inductively and thematically to gain an understanding of the participants' experience of art and its value. Interviews with stakeholders provided additional information and triangulation of the data. The study demonstrates that art occupations provide a starting point for participation in community and a positive experience that encourages the construction of new identities, routines and roles. Furthermore, art provides an alternative from the problems associated with homelessness, mental health and substance abuse and allows for public recognition and social inclusion. Health professionals should work towards the social inclusion of homeless people through providing occupational opportunities for participation in safe settings as a first step to community engagement. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

  14. Alcohol and drug use disorders among homeless veterans: prevalence and association with supported housing outcomes.

    Science.gov (United States)

    Tsai, Jack; Kasprow, Wesley J; Rosenheck, Robert A

    2014-02-01

    This study examines the prevalence of alcohol and drug disorders among homeless veterans entering the Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program and its association with both housing and clinical outcomes. A total of 29,143 homeless veterans were categorized as either having: no substance use disorder, only an alcohol use disorder, only a drug use disorder, or both alcohol and drug use disorders. Veterans were compared on housing and clinical status prior to admission to HUD-VASH and a smaller sample of 14,086 HUD-VASH clients were compared on their outcomes 6 months after program entry. Prior to HUD-VASH, 60% of program entrants had a substance use disorder and 54% of those with a substance use disorder had both alcohol and drug use disorders. Homeless veterans with both alcohol and drug use disorders had more extensive homeless histories than others, and those with any substance use disorder stayed more nights in transitional housing or residential treatment in the previous month. After six months in HUD-VASH, clients with substance use disorders continued to report more problems with substance use, even after adjusting for baseline differences, but there were no differences in housing outcomes. These findings suggest that despite strong associations between substance use disorders and homelessness, the HUD-VASH program is able to successfully house homeless veterans with substance use disorders although additional services may be needed to address their substance abuse after they become housed. Published by Elsevier Ltd.

  15. Network collaboration of organizations for homeless individuals in the Montreal region

    Directory of Open Access Journals (Sweden)

    Marie-Josée Fleury

    2014-02-01

    Full Text Available Introduction: We know little about the intensity and determinants of interorganisational collaboration within the homeless network. This study describes the characteristics and relationships (along with the variables predicting their degree of interorganisational collaboration of 68 organisations of such a network in Montreal (Quebec, Canada. Theory and methods: Data were collected primarily through a self-administered questionnaire. Descriptive analyses were conducted followed by social network and multivariate analyses. Results: The Montreal homeless network has a high density (50.5% and a decentralised structure and maintains a mostly informal collaboration with the public and cross-sectorial sectors. The network density showed more frequent contacts among four types of organisations which could point to the existence of cliques. Four variables predicted interorganisational collaboration: organisation type, number of services offered, volume of referrals and satisfaction with the relationships with public organisations. Conclusions and discussion: The Montreal homeless network seems adequate to address non-complex homelessness problems. Considering, however, that most homeless individuals present chronic and complex profiles, it appears necessary to have a more formal and better integrated network of homeless organisations, particularly in the health and social service sectors, in order to improve services.

  16. Network collaboration of organizations for homeless individuals in the Montreal region

    Directory of Open Access Journals (Sweden)

    Marie-Josée Fleury

    2014-02-01

    Full Text Available Introduction: We know little about the intensity and determinants of interorganisational collaboration within the homeless network. This study describes the characteristics and relationships (along with the variables predicting their degree of interorganisational collaboration of 68 organisations of such a network in Montreal (Quebec, Canada.Theory and methods: Data were collected primarily through a self-administered questionnaire. Descriptive analyses were conducted followed by social network and multivariate analyses.Results: The Montreal homeless network has a high density (50.5% and a decentralised structure and maintains a mostly informal collaboration with the public and cross-sectorial sectors. The network density showed more frequent contacts among four types of organisations which could point to the existence of cliques. Four variables predicted interorganisational collaboration: organisation type, number of services offered, volume of referrals and satisfaction with the relationships with public organisations.Conclusions and discussion: The Montreal homeless network seems adequate to address non-complex homelessness problems. Considering, however, that most homeless individuals present chronic and complex profiles, it appears necessary to have a more formal and better integrated network of homeless organisations, particularly in the health and social service sectors, in order to improve services.

  17. Network collaboration of organisations for homeless individuals in the Montreal region.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Lesage, Alain; Ma, Nan; Ngui, André Ngamini

    2014-01-01

    We know little about the intensity and determinants of interorganisational collaboration within the homeless network. This study describes the characteristics and relationships (along with the variables predicting their degree of interorganisational collaboration) of 68 organisations of such a network in Montreal (Quebec, Canada). Data were collected primarily through a self-administered questionnaire. Descriptive analyses were conducted followed by social network and multivariate analyses. The Montreal homeless network has a high density (50.5%) and a decentralised structure and maintains a mostly informal collaboration with the public and cross-sectorial sectors. The network density showed more frequent contacts among four types of organisations which could point to the existence of cliques. Four variables predicted interorganisational collaboration: organisation type, number of services offered, volume of referrals and satisfaction with the relationships with public organisations. The Montreal homeless network seems adequate to address non-complex homelessness problems. Considering, however, that most homeless individuals present chronic and complex profiles, it appears necessary to have a more formal and better integrated network of homeless organisations, particularly in the health and social service sectors, in order to improve services.

  18. Improving health status of homeless patients at a nurse-managed clinic in the Midwest USA.

    Science.gov (United States)

    Savage, Christine L; Lindsell, Christopher J; Gillespie, Gordon L; Lee, Roberta J; Corbin, Adele

    2008-09-01

    Homeless adults have a higher rate of morbidity and mortality than their housed counterparts. Improving the health of homeless adults is a complex problem because of the overlay of individual risk factors, social issues and lack of economic resources. Due to the increased morbidity and mortality rate in homeless adults, it is imperative to develop interventions with demonstrated efficacy that result in improved health outcomes. The purpose of this pre-post pilot study was to compare pre- and post-test scores on specific health outcomes in a group of homeless adults receiving a nurse intervention when utilising a nurse-managed clinic located in the urban core of a Midwestern city in the USA. Between September of 2004 and January 2006, 43 homeless adults completed a health survey at baseline and 2 months later that included measures of health-related quality of life (HRQOL), substance use and health resource use. There was a significant improvement on the post-test scores including substance use, perceived quality and availability of health care, and on two domains of HRQOL: mental health and vitality. This study provides evidence that a nursing intervention can result in improved health outcomes for adult homeless persons.

  19. Exploring the potential of technology-based mental health services for homeless youth: A qualitative study.

    Science.gov (United States)

    Adkins, Elizabeth C; Zalta, Alyson K; Boley, Randy A; Glover, Angela; Karnik, Niranjan S; Schueller, Stephen M

    2017-05-01

    Homelessness has serious consequences for youth that heighten the need for mental health services; however, these individuals face significant barriers to access. New models of intervention delivery are required to improve the dissemination of mental health interventions that tailor these services to the unique challenges faced by homeless youth. The purpose of this study was to better understand homeless youths' use of technology, mental health experiences and needs, and willingness to engage with technology-supported mental health interventions to help guide the development of future youth-facing technology-supported interventions. Five focus groups were conducted with 24 homeless youth (62.5% female) in an urban shelter. Youth were 18- to 20-years-old with current periods of homelessness ranging from 6 days to 4 years. Transcripts of these focus groups were coded to identify themes. Homeless youth reported using mobile phones frequently for communication, music, and social media. They indicated a lack of trust and a history of poor relationships with mental health providers despite recognizing the need for general support as well as help for specific mental health problems. Although initial feelings toward technology that share information with a provider were mixed, they reported an acceptance of tracking and sharing information under certain circumstances. Based on these results, we provide recommendations for the development of mental health interventions for this population focusing on technology-based treatment options. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Homelessness and stakeholders' involvement in the Grand Duchy of Luxembourg: a qualitative study.

    Science.gov (United States)

    Stona, Anne-Claire; Berrang, Charles; Santerre, Honorine; Georges, Nathalie; Chimenti, Rosa; Kneip, René; Fond-Harmant, Laurence

    2016-02-01

    In 2013, between 150 and 200 people per night in the Grand Duchy of Luxembourg are estimated roofless. Abilities to respond to emergencies in the GDL are perceptibly decreased due to longer stays in emergency shelters. This study aimed to analyse the needs of long-term homeless (LTH) individuals and to put forward professional recommendations to improve support and care for homeless individuals. A local, cross-sectional, qualitative study carried out between February and September 2013 in the GDL. Semi-structured interviews and focus groups were conducted with homeless people living in Caritas housing facilities permanently over a period of 2 years or temporarily over a period of 3 years, as well as Caritas professionals and Luxembourgish psychiatrists. They mainly focused on the homeless person's life pathways, needs and expectations, and difficulties encountered. Twenty-two homeless persons, 13 professionals from Caritas and three Luxembourgish psychiatrists participated. Homeless persons' needs and expectations consist of the following: (i) seeking freedom and peacefulness, (ii) having their own space, being independent and (iii) living like everyone else. Professionals mainly complained about difficulties for supporting LTH persons and the lack of collaboration with Luxembourg stakeholders from social and psychiatric departments. This study has found that the current approach is not appropriate for the management of LTHness in the country. This study recommends changes within the Caritas facilities and outside, on the basis of three concepts: (i) a decent home as an essential need, (ii) respect of freedom of choice and (iii) a housing-first model. © 2015 John Wiley & Sons Ltd.

  1. Psychiatric aspects of induced abortion.

    Science.gov (United States)

    Stotland, Nada L

    2011-08-01

    Approximately one third of the women in the United States have an abortion during their lives. In the year 2008, 1.21 million abortions were performed in the United States (Jones and Koolstra, Perspect Sex Reprod Health 43:41-50, 2011). The psychiatric outcomes of abortion are scientifically well established (Adler et al., Science 248:41-43, 1990). Despite assertions to the contrary, there is no evidence that abortion causes psychiatric problems (Dagg, Am J Psychiatry 148:578-585, 1991). Those studies that report psychiatric sequelae suffer from severe methodological defects (Lagakos, N Engl J Med 354:1667-1669, 2006). Methodologically sound studies have demonstrated that there is a very low incidence of frank psychiatric illness after an abortion; women experience a wide variety of feelings over time, including, for some, transient sadness and grieving. However, the circumstances that lead a woman to terminate a pregnancy, including previous and/or ongoing psychiatric illness, are independently stressful and increase the likelihood of psychiatric illness over the already high baseline incidence and prevalence of mood and anxiety disorders among women of childbearing age. For optimal psychological outcomes, women, including adolescents, need to make autonomous and supported decisions about problem pregnancies. Clinicians can help patients facing these decisions and those who are working through feelings about having had abortions in the past.

  2. Risk Factors for Homelessness Among US Veterans

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A.

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171

  3. Risk factors for homelessness among US veterans.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  4. Actors, observers, and causal attributions of homelessness: Differences in attribution for the causes of homelessness among domiciled and homeless people in Madrid

    OpenAIRE

    Vázquez, José Juan; Panadero, Sonia; Zúñiga, Claudia

    2017-01-01

    The study analyzes the differences in causal attributions of homelessness and attributions of responsibility among the members of three groups: Homeless Group, consisting of a representative sample of homeless people in Madrid, Spain (n= 188), Domiciled Service-Users Group, consisting of people at risk of homelessness (n=164), and Domiciled Non Service-Users Group, consisting of people at no imminent risk of homelessness (n=180). The Domiciled Service-Users Group and Domiciled Non Service-Use...

  5. End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care.

    Science.gov (United States)

    Shulman, Caroline; Hudson, Briony F; Low, Joseph; Hewett, Nigel; Daley, Julian; Kennedy, Peter; Davis, Sarah; Brophy, Niamh; Howard, Diana; Vivat, Bella; Stone, Patrick

    2017-06-01

    Being homeless or vulnerably housed is associated with death at a young age, frequently related to medical problems complicated by drug or alcohol dependence. Homeless people experience high symptom burden at the end of life, yet palliative care service use is limited. To explore the views and experiences of current and formerly homeless people, frontline homelessness staff (from hostels, day centres and outreach teams) and health- and social-care providers, regarding challenges to supporting homeless people with advanced ill health, and to make suggestions for improving care. Thematic analysis of data collected using focus groups and interviews. Single homeless people ( n = 28), formerly homeless people ( n = 10), health- and social-care providers ( n = 48), hostel staff ( n = 30) and outreach staff ( n = 10). This research documents growing concern that many homeless people are dying in unsupported, unacceptable situations. It highlights the complexities of identifying who is palliative and lack of appropriate places of care for people who are homeless with high support needs, particularly in combination with substance misuse issues. Due to the lack of alternatives, homeless people with advanced ill health often remain in hostels. Conflict between the recovery-focused nature of many services and the realities of health and illness for often young homeless people result in a lack of person-centred care. Greater multidisciplinary working, extended in-reach into hostels from health and social services and training for all professional groups along with more access to appropriate supported accommodation are required to improve care for homeless people with advanced ill health.

  6. Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review

    Directory of Open Access Journals (Sweden)

    Kouyoumdjian Fiona

    2011-08-01

    Full Text Available Abstract Background Research on interventions to positively impact health and housing status of people who are homeless has received substantially increased attention over the past 5 years. This rapid review examines recent evidence regarding interventions that have been shown to improve the health of homeless people, with particular focus on the effect of these interventions on housing status. Methods A total of 1,546 articles were identified by a structured search of five electronic databases, a hand search of grey literature and relevant journals, and contact with experts. Two reviewers independently screened the first 10% of titles and abstracts for relevance. Inter-rater reliability was high and as a result only one reviewer screened the remaining titles and abstracts. Articles were included if they were published between January 2004 and December 2009 and examined the effectiveness of an intervention to improve the health or healthcare utilization of people who were homeless, marginally housed, or at risk of homelessness. Two reviewers independently scored all relevant articles for quality. Results Eighty-four relevant studies were identified; none were of strong quality while ten were rated of moderate quality. For homeless people with mental illness, provision of housing upon hospital discharge was effective in improving sustained housing. For homeless people with substance abuse issues or concurrent disorders, provision of housing was associated with decreased substance use, relapses from periods of substance abstinence, and health services utilization, and increased housing tenure. Abstinent dependent housing was more effective in supporting housing status, substance abstinence, and improved psychiatric outcomes than non-abstinence dependent housing or no housing. Provision of housing also improved health outcomes among homeless populations with HIV. Health promotion programs can decrease risk behaviours among homeless populations

  7. The initiation of homeless youth into the street economy.

    Science.gov (United States)

    Gwadz, Marya Viorst; Gostnell, Karla; Smolenski, Carol; Willis, Brian; Nish, David; Nolan, Theresa C; Tharaken, Maya; Ritchie, Amanda S

    2009-04-01

    Homeless youth (HY) who lack employment in the formal economy typically turn to the street economy (e.g., prostitution, drug selling) for survival. Guided by the theory of social control, the present paper explores factors influencing HY's initiation into the street economy. Eighty HY (ages 15-23) were recruited from four community-based organizations. All participated in structured interviews and 25% participated in qualitative interviews. Almost all HY had participated in the street (81%) and formal economies (69%). Five main factors simultaneously influenced initiation into the street economy: social control/bonds, barriers to the formal economy (e.g., homelessness, educational deficits, mental health problems, incarceration, stigma), tangible and social/emotional benefits of the street economy, severe economic need, and the active recruitment of HY into the street economy by others. Qualitative and quantitative data sources were congruent. Intervention efforts are needed at multiple levels of influence to promote HY's success in the formal economy.

  8. The influence of maternal optimality and infant temperament on parenting stress at 12 months among mothers with substance abuse and psychiatric problems.

    Science.gov (United States)

    Siqveland, Torill S; Olafsen, Kåre S; Moe, Vibeke

    2013-10-01

    The present prospective longitudinal study aimed to investigate the long-term impact of maternal optimality assessed during pregnancy on parenting stress at infant age 12 months. In this study the concept of optimality was utilized to investigate maternal variations regarding resources during pregnancy in relation to later parenting stress, among three different groups of mothers that were recruited from substance abuse treatment, psychiatric outpatient treatment and well-baby clinics respectively. The influence of infant temperament on parenting stress was also examined. All mothers were interviewed during pregnancy. At 12 months, infant temperament (Colorado Childhood Temperament Inventory; Rowe & Plomin, 1977) and stress in the parent and child domain (Parenting Stress Index; Abidin, 1955) were assessed. Results demonstrated higher levels of parenting stress among mothers in the clinical groups, compared to the non-clinical group. Furthermore, it was the maternal psychiatric optimality index in combination with child temperament characteristics (child emotionality) that contributed uniquely to stress in the parent domain, while stress in the child domain was significantly associated only with child temperament characteristics (both child emotionality and soothability). The association between maternal psychiatric optimality assessed in pregnancy, infant temperament and parenting stress when the infants were 12 months old, points to the importance of simultaneously addressing the mothers' own psychological distress, and to support positive mother-infant interactions. Each woman's individual optimality profile may be used to display needs of follow-up in order to prevent enduring effects of non-optimality on parenting stress. © 2013 The Scandinavian Psychological Associations.

  9. Analyzing the impact of social factors on homelessness: a fuzzy cognitive map approach.

    Science.gov (United States)

    Mago, Vijay K; Morden, Hilary K; Fritz, Charles; Wu, Tiankuang; Namazi, Sara; Geranmayeh, Parastoo; Chattopadhyay, Rakhi; Dabbaghian, Vahid

    2013-08-23

    The forces which affect homelessness are complex and often interactive in nature. Social forces such as addictions, family breakdown, and mental illness are compounded by structural forces such as lack of available low-cost housing, poor economic conditions, and insufficient mental health services. Together these factors impact levels of homelessness through their dynamic relations. Historic models, which are static in nature, have only been marginally successful in capturing these relationships. Fuzzy Logic (FL) and fuzzy cognitive maps (FCMs) are particularly suited to the modeling of complex social problems, such as homelessness, due to their inherent ability to model intricate, interactive systems often described in vague conceptual terms and then organize them into a specific, concrete form (i.e., the FCM) which can be readily understood by social scientists and others. Using FL we converted information, taken from recently published, peer reviewed articles, for a select group of factors related to homelessness and then calculated the strength of influence (weights) for pairs of factors. We then used these weighted relationships in a FCM to test the effects of increasing or decreasing individual or groups of factors. Results of these trials were explainable according to current empirical knowledge related to homelessness. Prior graphic maps of homelessness have been of limited use due to the dynamic nature of the concepts related to homelessness. The FCM technique captures greater degrees of dynamism and complexity than static models, allowing relevant concepts to be manipulated and interacted. This, in turn, allows for a much more realistic picture of homelessness. Through network analysis of the FCM we determined that Education exerts the greatest force in the model and hence impacts the dynamism and complexity of a social problem such as homelessness. The FCM built to model the complex social system of homelessness reasonably represented reality for the

  10. Evaluating the impact of dental care on housing intervention program outcomes among homeless veterans.

    Science.gov (United States)

    Nunez, Elizabeth; Gibson, Gretchen; Jones, Judith A; Schinka, John A

    2013-12-01

    In this retrospective longitudinal cohort study, we examined the impact of dental care on outcomes among homeless veterans discharged from a Department of Veterans Affairs (VA) transitional housing intervention program. Our sample consisted of 9870 veterans who were admitted into a VA homeless intervention program during 2008 and 2009, 4482 of whom received dental care during treatment and 5388 of whom did not. Primary outcomes of interest were program completion, employment or stable financial status on discharge, and transition to permanent housing. We calculated descriptive statistics and compared the 2 study groups with respect to demographic characteristics, medical and psychiatric history (including alcohol and substance use), work and financial support, and treatment outcomes. Veterans who received dental care were 30% more likely than those who did not to complete the program, 14% more likely to be employed or financially stable, and 15% more likely to have obtained residential housing. Provision of dental care has a substantial positive impact on outcomes among homeless veterans participating in housing intervention programs. This suggests that homeless programs need to weigh the benefits and cost of dental care in program planning and implementation.

  11. Self-harm among the homeless population in Ireland: A national registry-based study of incidence and associated factors.

    Science.gov (United States)

    Barrett, Peter; Griffin, Eve; Corcoran, Paul; O'Mahony, Mary T; Arensman, Ella

    2017-12-27

    Self-harm is a strong predictor of future suicide, but little is known about self-harm among the homeless population. The study aim was to estimate the incidence of self-harm among the homeless population and to assess factors associated with self-harm. Data on self-harm presentations to 34 hospital emergency departments in Ireland were collected by the National Self-Harm Registry Ireland (NSHRI). Index presentations between 2010 and 2014 were included for the homeless and fixed residence populations. Incidence rates of self-harm were calculated using NSHRI data and census estimates. Factors associated with self-harm and repeated self-harm were analysed by multivariable-adjusted logistic regression. The age-standardised incidence rate of self-harm was 30 times higher among the homeless (5572 presentations per 100,000) compared with those with a fixed residence (187 presentations per 100,000). Homeless people had significantly higher odds of being male (OR 1.86, 95%CI 1.56-2.23), presenting with self-cutting (vs. overdose, OR 2.15, 95%CI 1.74-2.66) and having psychiatric admission (vs. general admission, OR 2.43, 95%CI 1.66-3.57). Homeless people had higher odds of self-harm repetition within 12 months (vs. fixed residence, OR 1.46, 95%CI 1.21-1.77). The odds of repetition were significantly increased among homeless who engaged in self-cutting (vs. overdose, OR 1.76, 95%CI 1.17-2.65) and did not receive psychiatric review at index presentation (vs. reviewed, OR 1.54, 95%CI 1.05-2.26). The study only reflects self-harm presenting to hospital, and assumes no change in homelessness status after index presentation. Residual confounding may affect the results. There is a disproportionate burden of self-harm among the homeless. Targeted preventive actions are warranted. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Enhanced Methodologies to Enumerate Persons Experiencing Homelessness in a Large Urban Area.

    Science.gov (United States)

    Troisi, Catherine L; D'Andrea, Ritalinda; Grier, Gary; Williams, Stephen

    2015-10-01

    Homelessness is a public health problem, and persons experiencing homelessness are a vulnerable population. Estimates of the number of persons experiencing homelessness inform funding allocations and services planning and directly determine the ability of a community to intervene effectively in homelessness. The point-in-time (PIT) count presents a logistical problem in large urban areas, particularly those covering a vast geographical area. Working together, academia, local government, and community organizations improved the methodology for the count. Specific enhancements include use of incident command system (ICS), increased number of staging areas/teams, specialized outreach and Special Weapons and Tactics teams, and day-after surveying to collect demographic information. This collaboration and enhanced methodology resulted in a more accurate estimate of the number of persons experiencing homelessness and allowed comparison of findings for 4 years. While initial results showed an increase due to improved counting, the number of persons experiencing homelessness counted for the subsequent years showed significant decrease during the same time period as a "housing first" campaign was implemented. The collaboration also built capacity in each sector: The health department used ICS as a training opportunity; the academics enhanced their community health efforts; the service sector was taught and implemented more rigorous quantitative methods; and the community was exposed to public health as a pragmatic and effective discipline. Improvements made to increase the reliability of the PIT count can be adapted for use in other jurisdictions, leading to improved counts and better evaluation of progress in ending homelessness. © The Author(s) 2015.

  13. Housing First or no housing? Housing and homelessness at the end of alcohol and drug treatment.

    Science.gov (United States)

    Dyb, Evelyn

    2016-10-01

    The rate of alcohol and drug dependency is high among homeless persons in Norway as well as in other Western societies. National homeless surveys also show a certain correlation between discharge from institutions and homelessness. However, the rate of homelessness versus the rate with fixed abode at the end of specialised alcohol and drug treatment has not been examined using quantitative methods. A cross-sectional survey was conducted in alcohol and drug treatment units in the national health services and private clinics. The survey investigates the housing outcome at the end of treatment compared to the situation at the start of treatment using an individual questionnaire for patients ending treatment in a specific time window. Housing outcome is measured by the odds ratio of having a fixed abode at the end of treatment in relation to main intoxicating substance, type of treatment (in- and outpatient), completing versus cutting short the treatment, housing situation at the start of treatment, socioeconomic capital, mental health problems, individual plan, medical assisted treatment, and a set of background variables. The housing versus homeless situation hardly changes during the treatment period. In both a bivariate analysis and a simple multivariate model, principal intoxicating substance is the strongest predictor of having a fixed abode both before and after treatment. However, a more sophisticated analysis indicates that socioeconomic resources and social capital play along with the preferred intoxicating substance as predictors of having permanent housing. After more than a decade of a housing-led national homeless policy, and wide embracement of Housing First approaches in the European Union, homeless persons entering specialised alcohol and drug treatment are likely to return to the streets and hostels at the end of treatment. Access to housing after treatment is very limited for those lacking resources to solve their housing problem without assistance

  14. High burden of homelessness among sexual-minority adolescents: findings from a representative Massachusetts high school sample.

    Science.gov (United States)

    Corliss, Heather L; Goodenow, Carol S; Nichols, Lauren; Austin, S Bryn

    2011-09-01

    We compared the prevalence of current homelessness among adolescents reporting a minority sexual orientation (lesbian/gay, bisexual, unsure, or heterosexual with same-sex sexual partners) with that among exclusively heterosexual adolescents. We combined data from the 2005 and 2007 Massachusetts Youth Risk Behavior Survey, a representative sample of public school students in grades 9 though 12 (n = 6317). Approximately 25% of lesbian/gay, 15% of bisexual, and 3% of exclusively heterosexual Massachusetts public high school students were homeless. Sexual-minority males and females had an odds of reporting current homelessness that was between 4 and 13 times that of their exclusively heterosexual peers. Sexual-minority youths' greater likelihood of being homeless was driven by their increased risk of living separately from their parents or guardians. Youth homelessness is linked with numerous threats such as violence, substance use, and mental health problems. Although discrimination and victimization related to minority sexual orientation status are believed to be important causal factors, research is needed to improve our understanding of the risks and protective factors for homelessness and to determine effective strategies to prevent homelessness in this population.

  15. Homelessness in the U.S.: A Historical Analysis

    Science.gov (United States)

    Murphy, Joseph; Tobin, Kerri

    2014-01-01

    In this article, the authors examine homelessness across time and examine, in an introductory way, homelessness today. The authors start by examining important themes that ribbon homelessness in America over the last 300 years. Next, they provide a period analysis of homelessness from the birth of the country through the late 1970s. In the last…

  16. 76 FR 76917 - Homeless Management Information Systems Requirements

    Science.gov (United States)

    2011-12-09

    ... Shelter Grants program to broaden its existing emergency shelter and homelessness prevention activities... assistance for persons at risk of homelessness over time, to produce an unduplicated count of homeless persons for each Continuum of Care; to understand the extent and nature of homelessness locally...

  17. Working to End Family Homelessness. Annual Report

    Science.gov (United States)

    National Center on Family Homelessness (NJ1), 2012

    2012-01-01

    The National Center on Family Homelessness is determined to end family homelessness. Sheltering families provides a temporary safe haven. Connecting families to permanent housing, essential services, and critical supports can change their lives forever. Through research the Center learns what families need to rebound from the housing, economic,…

  18. Homeless in Galilee | Brawley | HTS Teologiese Studies ...

    African Journals Online (AJOL)

    This article has located Jesus' saying about homelessness in the context of the Roman Empire as it was experienced in Galilee. Homelessness is part of a broader picture that translates into loss of access to the resources of the land. The thesis is that in light of a theology of land resulting from the development of Abrahamic ...

  19. Young Children and Families Experiencing Homelessness

    Science.gov (United States)

    Wilson, Allison B.; Squires, Jane

    2014-01-01

    The increasing prevalence of homelessness among young children and families in the United States is described, as is the developmental impact on young children and cost to society. Although services are mandated for this population under the McKinney­-Vento Act, Education of Homeless Children and Youth Program, and the Individuals With…

  20. HIV and the urban homeless in Johannesburg

    African Journals Online (AJOL)

    2012-11-02

    Nov 2, 2012 ... confirmatory test was used in the case of discordant results. We. Background. There are few data on HIV prevalence and risk factors among inner-city homeless and marginally housed individuals in South Africa. Methods. We recruited 136 adults from a Johannesburg inner-city homeless clinic; mean age ...

  1. Providing Lifelines for Our Nation's Homeless Youth

    Science.gov (United States)

    Duffield, Barbara

    2013-01-01

    This article discusses educational challenges for homeless children and explains how districts can and must meet their needs. According to the U.S. Department of Education Federal Data Collection, 1,065,794 homeless children and youth were enrolled in public schools for the school year 2010-2011, the highest number on record. After listing…

  2. Intervention Strategies with the Homeless Population

    Science.gov (United States)

    Dykeman, Bruce F.

    2011-01-01

    A literature review describing psychological and sociological factors of homelessness. Methods of estimating the frequency of homelessness are described, along with recent point-in-time and period-of-time estimates. Models of service delivery are reviewed. A biopsychosocial model of intervention is proposed that describes stages of intervention…

  3. Psychiatric sequelae of traumatic brain injury: Retrospective ...

    African Journals Online (AJOL)

    2011-12-23

    Dec 23, 2011 ... Objective: Traumatic brain injury (TBI) is a public health problem and is associated with many complications. However little is known about the psychiatric sequelae of TBI in Nigeria. This study described the pattern and determinants of psychiatric sequelae among subjects with TBI. Materials and Methods: ...

  4. Perceived sleep quality of psychiatric patients

    NARCIS (Netherlands)

    de Niet, G. J. (Gerrit); Tiemens, B. G. (Bea); Lendemeijer, H. H. G. M. (Bert); Hutschemaekers, G. J. M. (Giel)

    This paper aims at acquiring knowledge about the quality of sleep of adult and elderly psychiatric patients who receive clinical or outpatient nursing care, and identifying key factors in perceiving a sleep problem. To do so, a sample of 1699 psychiatric patients were asked whether they perceived a

  5. Homelessness and Aging Out of Foster Care: A National Comparison of Child Welfare-Involved Adolescents.

    Science.gov (United States)

    Fowler, Patrick J; Marcal, Katherine E; Zhang, Jinjin; Day, Orin; Landsverk, John

    2017-06-01

    The present study represents the first large-scale, prospective comparison to test whether aging out of foster care contributes to homelessness risk in emerging adulthood. A nationally representative sample of adolescents investigated by the child welfare system in 2008 to 2009 from the second cohort of the National Survey of Child and Adolescent Well-being Study (NSCAW II) reported experiences of housing problems at 18- and 36-month follow-ups. Latent class analyses identified subtypes of housing problems, including literal homelessness, housing instability, and stable housing. Regressions predicted subgroup membership based on aging out experiences, receipt of foster care services, and youth and county characteristics. Youth who reunified after out-of-home placement in adolescence exhibited the lowest probability of literal homelessness, while youth who aged out experienced similar rates of literal homelessness as youth investigated by child welfare but never placed out of home. No differences existed between groups on prevalence of unstable housing. Exposure to independent living services and extended foster care did not relate with homelessness prevention. Findings emphasize the developmental importance of families in promoting housing stability in the transition to adulthood, while questioning child welfare current focus on preparing foster youth to live.

  6. Do homeless veterans have the same needs and outcomes as non-veterans?

    Science.gov (United States)

    Tsai, Jack; Mares, Alvin S; Rosenheck, Robert A

    2012-01-01

    Although veterans have been found to be at increased risk for homelessness as compared to non-veterans, it is not clear whether those who are homeless have more severe health problems or poorer outcomes in community-based supported housing. This observational study compared 162 chronically homeless veterans to 388 non-veterans enrolled in a national-supported housing initiative over a 1-year period. Results showed that veterans tended to be older, were more likely to be in the Vietnam era age group, to be male, and were more likely to have completed high school than other chronically homeless adults. There were no differences between veterans and non-veterans on housing or clinical status at baseline or at follow-up, but both groups showed significant improvement over time. These findings suggest that the greater risk of homelessness among veterans does not translate into more severe problems or treatment outcomes. Supported housing programs are similarly effective for veterans and non-veterans.

  7. Health disparities in the Native Hawaiian homeless.

    Science.gov (United States)

    Yamane, David P; Oeser, Steffen G; Omori, Jill

    2010-06-01

    While it is well accepted that Native Hawaiians have poor health statistics compared to other ethnic groups in Hawaii, it is not well documented if these disparities persist when comparing Native Hawaiian homeless individuals to the general homeless population. This paper examines the Native Hawaiian homeless population living in three shelters on the island of Oahu, to determine if there are significant differences in the frequency of diseases between the Native Hawaiian and non-Native Hawaiian homeless. A retrospective data collection was performed using records from the Hawaii Homeless Outreach and Medical Education (H.O.M.E.) project. Data from 1182 patients was collected as of 12/05/09. Information collected included patient demographics, frequency of self reported diseases, family history of diseases, risk factors, prevalence of chronic diseases, and most common complaints. The data from Native Hawaiians and non-Native Hawaiians were examined for differences and a 1-tail Fisher exact analysis was done to confirm significance. The data reveals that the Native Hawaiian homeless population is afflicted more frequently with asthma and hypertension compared to other ethnic groups. While diabetes constituted more visits to the clinics for Native Hawaiians compared to the non-Native Hawaiians, there was no significant difference in patient reported prevalence of diabetes. The Native Hawaiian homeless also had increased rates of risky behaviors demonstrated by higher past use of marijuana and methamphetamines. Interestingly, there was a lower use of alcohol in the Native Hawaiian homeless and no significant difference between Native Hawaiians and non-native Hawaiians in current use of illicit drugs, which may represent a hopeful change in behaviors. These troubling statistics show that some of the health disparities seen in the general Native Hawaiian population persist despite the global impoverished state of all homeless. Hopefully, these results will aid

  8. Psychiatric conditions associated with bullying.

    Science.gov (United States)

    Kumpulainen, Kirsti

    2008-01-01

    Bullying is a complex phenomenon moderated not only by the personal characteristics and behavioral traits of the individual but also by family rearing practices, as well as by situational factors such as the frequency and type of bullying. The phenomenon is also affected by group processes among the individuals present during the event. Bullying is a distressing experience that is often continuous over years and predicts both concurrent and future psychiatric symptoms and disorders, even in adulthood. At young ages, attention-deficit hyperactivity disorder and depression, as well as anxiety, are prevalent concurrently with bullying among the children involved. Later in young adulthood, male victims are at risk for anxiety, male bullies for personality disorders, and male bully-victims for both personality disorders and anxiety, and the risk is especially increased if the child is disturbed when involved in bullying at school age. Rarely does any single behavior predict future problems as clearly as bullying does, and additional assessment of psychiatric problems is always warranted, if the child is involved in bullying as a bully, victim or bully-victim. Based on our current knowledge, school-based interventions regulating the behavior of the child, increasing pro-social skills and promoting peer relationships are recommended for those without concurrent psychiatric disturbance, but those displaying psychiatric symptoms and disorders should be referred for psychiatric consultation and intervention.

  9. Nurse-led primary health care for homeless men: a multimethods descriptive study.

    Science.gov (United States)

    Roche, M A; Duffield, C; Smith, J; Kelly, D; Cook, R; Bichel-Findlay, J; Saunders, C; Carter, D J

    2017-12-21

    To explore the primary healthcare needs and health service use of homeless men in inner Sydney. People experiencing homelessness have greater health needs than the general population and place high demands on tertiary care, which is expensive and may not be the optimum service for their needs. Accessible, approachable and affordable primary healthcare services could improve the health of homeless persons and potentially decrease costs to the healthcare system. A multimethod design using a cross-sectional survey (n = 40) and administrative data (n = 2 707 daily summaries) collected from a nurse-led primary healthcare clinic for homeless men in Sydney. Survey respondents were aged 27-76 years. Health problems reflected multimorbidity, with mental health issues present in almost all respondents. The majority had attended the clinic more than 20 times in the past year and said the services, treatments and referrals helped them avoid the emergency department. Administrative data indicated that medication administration was the most frequent service provided. Referrals to other health services doubled over the 7-year period. Multiple morbidities, particularly mental health issues, are associated with homelessness. A proactive approach by nurses including preventative services appeared to overcome barriers to health service use. This nurse-led primary healthcare clinic highlights the importance of providing services to homeless men with multiple comorbidities. Respect and trust in addition to easy access to health services appear to be important facilitators of health service use. A greater number of primary health services that collaborate with specialist services, including nurse-led clinics, may facilitate health care for persons who are homeless, reducing the burden on acute services. © 2017 International Council of Nurses.

  10. [Impact of personality disorders in a sample of 212 homeless drug users].

    Science.gov (United States)

    Combaluzier, S; Gouvernet, B; Bernoussi, A

    2009-10-01

    The impact of the mental disorders (axis I and II, according to DSM IV) on psychosocial problems (axis IV) is now a well-known fact, notably when substance abuse disorders are encountered on axis I. This leads to the conclusion that personality disorders increase the risk of substance abuse, that substance abuse increases the risk of homelessness, that dual diagnosis has a high impact on homelessness and underlines interactions between personality disorders (PD), drug abuse (DA) and homelessness. The aim of this paper is also to study these interactions. We will process the classical epidemiological measures, which have already produced interesting findings on other substance-linked disorders. We will study the multiplicative interaction (I(AB)) and the etiological fraction (EFi) linked to interaction, which evaluate the effects of two factors on another. According to the authors, the I(AB) determines whether the co-occurrence of two risk factors in a group induces more cases than each factor acting together; also if the I(AB) is greater than 1 it is possible to estimate the EFi, that proportionally measures the number of cases of the third factor that can be attributed to the co-occurrence. We will also study the interactions of homelessness and PD on DA, of the PD and DA on homelessness, and of this association DA and homelessness on PD. The data we will use in the paper deal with the prevalence of PD in general, drug users (n=226), homeless (n=999) and homeless drug abusers (n=212). The two last data are extracted from the same population and have been collected through clinical interviews, and the diagnosis follows the DSM criteria. They are comparable to Kokkevi et al.'s sample regarding the drug (heroin), the mean age (28 years for Kokkevi et al., 27 years in our sample), and the geographic origin of the populations (Mediterranean basin). The repartition of PD differs significantly (0.001) in the homeless population and the homeless drug abusers (chi(2

  11. Psychiatric emergencies (part II): psychiatric disorders coexisting with organic diseases.

    Science.gov (United States)

    Testa, A; Giannuzzi, R; Sollazzo, F; Petrongolo, L; Bernardini, L; Dain, S

    2013-02-01

    In this Part II psychiatric disorders coexisting with organic diseases are discussed. "Comorbidity phenomenon" defines the not univocal interrelation between medical illnesses and psychiatric disorders, each other negatively influencing morbidity and mortality. Most severe psychiatric disorders, such as schizophrenia, bipolar disorder and depression, show increased prevalence of cardiovascular disease, related to poverty, use of psychotropic medication, and higher rate of preventable risk factors such as smoking, addiction, poor diet and lack of exercise. Moreover, psychiatric and organic disorders can develop together in different conditions of toxic substance and prescription drug use or abuse, especially in the emergency setting population. Different combinations with mutual interaction of psychiatric disorders and substance use disorders are defined by the so called "dual diagnosis". The hypotheses that attempt to explain the psychiatric disorders and substance abuse relationship are examined: (1) common risk factors; (2) psychiatric disorders precipitated by substance use; (3) psychiatric disorders precipitating substance use (self-medication hypothesis); and (4) synergistic interaction. Diagnostic and therapeutic difficulty concerning the problem of dual diagnosis, and legal implications, are also discussed. Substance induced psychiatric and organic symptoms can occur both in the intoxication and withdrawal state. Since ancient history, humans selected indigene psychotropic plants for recreational, medicinal, doping or spiritual purpose. After the isolation of active principles or their chemical synthesis, higher blood concentrations reached predispose to substance use, abuse and dependence. Abuse substances have specific molecular targets and very different acute mechanisms of action, mainly involving dopaminergic and serotoninergic systems, but finally converging on the brain's reward pathways, increasing dopamine in nucleus accumbens. The most common

  12. Suicidal behavior among homeless people in Japan.

    Science.gov (United States)

    Okamura, Tsuyoshi; Ito, Kae; Morikawa, Suimei; Awata, Shuichi

    2014-04-01

    The purpose of this study is to investigate the frequency and correlates of suicidal behavior among homeless people in Japan. A face-to-face survey was conducted in two districts of Tokyo, Japan, with 423 subjects who resided on streets and riversides and in urban parks and stations (street homeless) or who were residents of shelters, cheap hotels, or welfare homes for homeless people (sheltered homeless). When questioned about suicidal ideation in the previous 2 weeks, 51 subjects (12.2% of valid responses) had a recurring wish to die, 29 (6.9%) had frequent thoughts of suicide, and 22 (5.3%) had made suicide plans. In addition, 11 (2.9%) subjects had attempted suicide in the previous 2 weeks and 74 (17.7%) reported that they had ever attempted suicide. In univariate logistic regression analyses, street homelessness, lack of perceived emotional social support, poor subjective health perception, visual impairment, pain, insomnia, poor mental well-being, and current depression were significantly associated with recurrent thoughts of suicide in the previous 2 weeks. Among these, current depression had the greatest significance. In multivariate logistic regression analyses after controlling for depression, street homelessness and lack of perceived emotional social support were significantly associated with recurrent thoughts of suicide in the previous 2 weeks. Comprehensive interventions including housing and social support as well as mental health services might be crucial as effective strategies for suicide prevention among homeless people.

  13. Problemas conjugais e outros fatores associados a transtornos psiquiátricos do pós-parto Marital problems and other factors associated with postpartum psychiatric disorder

    Directory of Open Access Journals (Sweden)

    Suzi Roseli Kerber

    2011-06-01

    Full Text Available OBJETIVO: Estudar a associação entre transtornos mentais pós-parto e fatores demográficos e psicossociais, pré e perinatais. MÉTODOS: Todas as familias com crianças de quatro meses da Vila Jardim - Porto Alegre (RS - nascidos entre novembro de 1998 e dezembro de 1999 foram avaliadas. Utilizou-se o Self Report Questionnaire (SRQ-20 e entrevistas clínicas semiestruturadas individuais e do casal para fundamentar uma hipótese diagnóstica segundo os critérios do da quarta edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-IV. Realizou-se a avaliação da relação conjugal e do relacionamento da mãe com as famílias de origem e a rede social utilizando-se a Escala de Avaliação Global do Funcionamento Relacional (GARF. RESULTADOS: Foram avaliadas 148 mães e os 116 pais que coabitavam. Segundo o SRQ, 34,4% das mães e 25,4% dos pais apresentaram suspeita de transtorno psiquiátrico. Clinicamente os percentuais foram maiores. Coabitar ou não com companheiro não esteve associado com transtorno mental materno. Na análise da totalidade do grupo de mulheres, estiveram associados: baixa renda familiar (OR=0,8; pPURPOSE: To study the association between postpartum psychiatric disorder and demographic and psychosocial, pre- and perinatal factors. METHODS: All families having 4-month-old infants in Vila Jardim, a district of Porto Alegre, Brazil, born at a public hospital from November 1998 through December 1999 were assessed. The Self-Report Questionnaire (SRQ-20 and semi-structured interviews were used for the psychiatric assessment that included a possible diagnosis using Diagnostic and Statistical Manual of Mental Disorders IV (DSM- IV criteria. Relational functioning between couples, the relationship with mother's family of origin and social network were assessed using the DSM-IV Global Assessment of Relational Functioning Scale (GARF. RESULTS: A total of 148 mothers and 116 cohabiting fathers were assessed

  14. Risk factors associated with recurrent homelessness after a first homeless episode.

    Science.gov (United States)

    McQuistion, Hunter L; Gorroochurn, Prakash; Hsu, Eustace; Caton, Carol L M

    2014-07-01

    Alcohol and drug use are commonly associated with the experience of homelessness. In order to better understand this, we explored the prevalence of drug and alcohol use as it related to successful re-housing within a sample of first-time single homeless adults at municipal shelters. From within this sample, we compared the features of recurrent homelessness with those of chronic homelessness and of being stably housed. We interviewed 344 subjects upon shelter entry and followed each one every six months for 18 months using standardized social and mental health measures. We analyzed baseline assessments relative to housing experiences during follow-up using Chi square and multinomial logistic regression. Eighty-one percent (N = 278) obtained housing over 18 months, of which 23.7 % (N = 66) experienced homelessness again. Recurrent homelessness was more common among those with a high school education and if initially re-housed with family. Bivariate analysis resulted in the observation of the highest rate of alcohol and other drug use among this recurrent group and multinomial logistic regression supported this only with the coupling of arrest history and diagnosed antisocial personality disorder. With relatively high rates of recurrent homelessness, there were differences between subjects who experienced recurrent homelessness compared to those who were stably housed and with chronic homelessness. That alcohol and other substance use disorders were associated with recurrent homelessness only if they were linked to other risk factors highlights the complexity of causes for homelessness and a resultant need to organize them into constellations of causal risk factors. Consistent with this, there should be initiatives that span bureaucratic boundaries so as to flexibly meet multiple complex service needs, thus improving outcomes concerning episodes of recurrent homelessness.

  15. Time Seizures and the Self: Institutional Temporalities and Self Preservation among Homeless Women

    Science.gov (United States)

    Cooper, Amy

    2014-01-01

    This article documents temporalities of homelessness as experienced by many homeless people today, those living in the midst of an urban “services ghetto”—where social service organizations abound, but such organizations fail to coordinate the provision or timing of services, producing an incoherent multiplicity of offerings and schedules. I analyzed distinct but related temporal modes by which institutional timetables controlled homeless women’s existence, what I call empty time and overscheduled time. The paradoxes of institutionalized waiting and strict yet inconsistent timetables exacted profound material and psychological tolls. For homeless women in Chicago, many of whom experienced symptoms of severe mental illness, simply securing their daily needs was such a time-consuming endeavor that they had to focus on short-term self-preservation rather than seeking stable employment or housing. Using anthropological theories of self and subjectivity, I argue that what was at stake for many women was more than the exhaustion of shelter life—negotiating institutional timetables also threatened their sense of dignity and humanity. Through the everyday patterning of women’s time, nonprofit agencies whose stated aim was to eliminate homelessness paradoxically frustrated women’s efforts to escape life on the streets. I conclude the analysis with policy suggestions to address these problems. PMID:25287573

  16. "Are we moving again this week?" Children's experiences of homelessness in Victoria, Australia.

    Science.gov (United States)

    Kirkman, Maggie; Keys, Deborah; Bodzak, Daria; Turner, Alina

    2010-04-01

    This research aimed to gain insight into the homelessness experience of children accommodated in transitional support services in an urban setting in Australia. It joins a limited international literature. Interviews incorporating interactive activities were conducted with 20 children aged 6-12 from diverse ethnicities and cultural backgrounds, most of whom were living in supported accommodation. Twelve parents/guardians were also interviewed. Children had experienced between 3 and 11 changes of residence, including hotels or motels, refuges, sleeping rough or in cars, rooming or boarding houses, and caravan parks. It was evident that homelessness adversely affected children's sense of security, mood, behaviour, physical health, education, and overall experience of childhood. As families moved from one temporary accommodation to the next, they often lost touch with the extended family and their friends, became disconnected from any sense of community, and did without familiar possessions, treasures, toys, and pets. Experiencing chaotic sequences of accommodation could leave children feeling confused, insecure, sad, and angry. It could make children feel responsible for their discouraged and unwell parents and their younger siblings. Homelessness made many children expect instability as a way of life. Children continued to be affected by problems that preceded or precipitated homelessness, such as family violence, broken relationships, and parents grappling with drug and alcohol dependence. The overwhelming conclusion to be drawn from this research is that children affected by homelessness need security, stability, and the chance to become and remain part of a community. (c) 2010 Elsevier Ltd. All rights reserved.

  17. Time seizures and the self: institutional temporalities and self-preservation among homeless women.

    Science.gov (United States)

    Cooper, Amy

    2015-03-01

    This article documents temporalities of homelessness as experienced by many homeless people today, those living in the midst of an urban "services ghetto"-where social service organizations abound, but such organizations fail to coordinate the provision or timing of services, producing an incoherent multiplicity of offerings and schedules. I analyzed distinct but related temporal modes by which institutional timetables controlled homeless women's existence, what I call empty time and overscheduled time. The paradoxes of institutionalized waiting and strict yet inconsistent timetables exacted profound material and psychological tolls. For homeless women in Chicago, many of whom experienced symptoms of severe mental illness, simply securing their daily needs was such a time-consuming endeavor that they had to focus on short-term self-preservation rather than seeking stable employment or housing. Using anthropological theories of self and subjectivity, I argue that what was at stake for many women was more than the exhaustion of shelter life-negotiating institutional timetables also threatened their sense of dignity and humanity. Through the everyday patterning of women's time, non-profit agencies whose stated aim was to eliminate homelessness paradoxically frustrated women's efforts to escape life on the streets. I conclude the analysis with policy suggestions to address these problems.

  18. Oral health and its impact on the life quality of homeless people in Hong Kong.

    Science.gov (United States)

    Luo, Y; McGrath, C

    2008-09-01

    To report on the oral health status and its impact on the life quality of homeless people in Hong Kong. A cross sectional epidemiological survey involving clinical oral examinations and face-to-face interviews with 147 homeless participants. Clinical examinations were carried out following WHO criteria. The impact of oral health on quality of life was assessed with the short form of Oral Health Impact Profile, OHIP-14. Over 90% had caries experience and most related to untreated decay. The mean DMFT score for dentate subjects was 8.1 (DT = 3.4, MT = 4.0, FT = 0.7). Periodontal disease was highly prevalent, 96% having periodontal pockets. The burden of oral health on their daily lives was common, 88% reporting an oral health impact within the past year. A multiple regression analysis indicated that the OHIP-14 score had significant associations with self-rated oral health, dental pain, employment status and length of time being homeless (p dental pain in the past year, were unemployed, and homeless for more than one year had poorer oral health related quality of life (significantly higher OHIP scores) than their counterparts. Among the homeless population studied, oral health status was poor and its impact on their life quality was substantial. The oral health impact was associated with socio-demographics and perceived dental problems.

  19. Suicide Mortality of Suicide Attempt Patients Discharged from Emergency Room, Nonsuicidal Psychiatric Patients Discharged from Emergency Room, Admitted Suicide Attempt Patients, and Admitted Nonsuicidal Psychiatric Patients

    Science.gov (United States)

    Choi, Jae W.; Park, Subin; Yi, Ki K.; Hong, Jin P.

    2012-01-01

    The suicide mortality rate and risk factors for suicide completion of patients who presented to an emergency room (ER) for suicide attempt and were discharged without psychiatric admission, patients who presented to an ER for psychiatric problems other than suicide attempt and were discharged without psychiatric admission, psychiatric inpatients…

  20. OCCUPATIONAL ROLE AFTER PSYCHIATRIC HOSPITALIZATION

    Directory of Open Access Journals (Sweden)

    GH.R GHASSEMI

    2003-03-01

    Full Text Available Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization. Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA. Results: Majority of the patients (53 % were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r =0/66. Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P < 001. Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.

  1. A cross-sectional examination of the mental health of homeless mothers: does the relationship between mothering and mental health vary by duration of homelessness?

    Science.gov (United States)

    Zabkiewicz, Denise M; Patterson, Michelle; Wright, Alexandra

    2014-12-08

    This study draws on baseline data from the At Home/Chez Soi demonstration project to examine the association between parenting status and mental health among homeless women and whether the association varies by duration of homelessness. Structured interviews were conducted with participants in five cities across Canada including Moncton, Montreal, Toronto, Vancouver and Winnipeg. Eligibility criteria included those with legal adult status, with a mental illness, and who lacked a regular, fixed shelter. All 713 women who participated in the larger project were selected for inclusion in this analysis. The mental health conditions of interest include depression, post-traumatic stress disorder (PTSD), alcohol dependence and substance dependence. The relationship between parenting status and depression, as well as PTSD, varied by duration of homelessness. Among women who had been homeless for less than 2 years, no relationship was found between parenting status and depression, or PTSD. However, among women who had been homeless for 2 or more years, the odds of depression was twice as high among parenting women compared with others (aOR=2.05, p≤0.05). A similar relationship was found between parenting status and PTSD (aOR=2.03, p≤0.05). The odds of substance dependence was found to be 2.62 times greater among parenting women compared with others and this relationship did not vary by duration of homelessness (aOR=2.62; 95% CI 1.86 to 3.69). No relationship was found between parenting and alcohol dependence. Overall, the findings from this study suggest that there is a relationship between long-term homelessness and mothers' risk of poor mental health. Given the multiple demands mothers face, a failure to recognise their unique needs is likely to contribute to intergenerational legacies of homelessness and mental health problems. World Health Organization's International Clinical Trials Registry Platform (ISRCTN66721740 and ISRCTN57595077). Published by the BMJ

  2. Prevalence of mental illness, intellectual disability, and developmental disability among homeless people in Nagoya, Japan: A case series study.

    Science.gov (United States)

    Nishio, Akihiro; Yamamoto, Mayumi; Ueki, Hirofumi; Watanabe, Takahiro; Matsuura, Kenshin; Tamura, Osamu; Uehara, Ryosuke; Shioiri, Toshiki

    2015-09-01

    While it has been reported that the prevalence of mental illness is higher in homeless people than in the national population, few studies have investigated the prevalence of intellectual and developmental disability among the homeless. In this study, we conducted a survey to comprehensively assess these mental problems among homeless people in Nagoya, Japan. The subjects were 18 homeless men. Mental illness was diagnosed with semi-structured interviews conducted by psychiatrists. We used the Wechsler Adult Intelligence Scale III to diagnose intellectual disability. Discrepancies between Wechsler Adult Intelligence Scale III subtest scores were used as criteria for developmental disability. Eleven of the 18 participants were diagnosed with mental illness: six with mood disorder, two with psychotic disorder, and six with alcohol problems. The mean IQ of all subjects was 83.4 ± 27.4. The 95% confidence interval (CI) was 96.2-69.1. Seven participants were found to have intellectual disability. Three men showed discrepancies of more than 10 between subtest scores, and all of them were diagnosed with a mental illness. We divided the participants into four groups: those with mental illness only; those with intellectual disability only; those with both problems; and those without diagnosis. The men with intellectual disability only were significantly younger and had been homeless since a younger age than the other groups. Participants diagnosed with a mental illness had been homeless for longer than those without mental health problems. Although the sample size was limited, this study revealed the high prevalence of mental illness and intellectual disability, 61% (95%CI, 35-83%) and 39% (95%CI, 17-64%), respectively, in homeless people in Nagoya, Japan. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  3. Rehousing homeless citizens with assertive community treatment

    DEFF Research Database (Denmark)

    Benjaminsen, Lars

    This report presents the results of a study of an ACT-programme (Assertive Community Treatment) in Copenhagen, Denmark, which has been part of the Danish national homelessness strategy. The ACT-programme is aimed at rehousing homeless individuals and providing floating support in the citizens own...... home from a multidisciplinary support team. The target groups of ACT are homeless individuals with complex support needs due to for instance mental illness and/or substance abuse and for whom it is difficult to use mainstream support systems. The team consists of both social support workers and other...... out of homelessness and into a stable housing situation. The study is based on quantitative outcome measurement on about 80 citizens who have been assigned to the programme and who have received both a housing solution and support from the ACT-team. The study is not a randomized controlled trial...

  4. Homelessness in a Scandinavian welfare state

    DEFF Research Database (Denmark)

    Benjaminsen, Lars

    2016-01-01

    This article analyses the risk of homelessness in the Danish adult population. The study is based on individual, administrative micro-data for about 4.15 million Danes who were 18 years or older on 1 January 2002. Homelessness is measured by shelter use from 2002 to 2011. Data also cover civil...... status, immigration background, education, employment, income, mental illness, drug and alcohol abuse, and previous imprisonment over five years prior to the measurement period.Prevalence of shelter use shows a considerable risk of homelessness amongst individuals experiencing multidimensional social...... exclusion. Nonetheless, even in high-risk groups such as drug abusers and people with a dual diagnosis, the majority have not used shelters. A multivariate analysis shows significantly higher use of homeless shelters amongst immigrants and individuals with low income, unemployment, low education, mental...

  5. Joint replacement surgery in homeless veterans

    Directory of Open Access Journals (Sweden)

    Chase G. Bennett, MD

    2017-12-01

    Full Text Available Total joint arthroplasty (TJA in a homeless patient is generally considered contraindicated. Here, we report our known medical and social (housing and employment results of homeless veterans who had TJA. Thirty-seven TJAs were performed on 33 homeless patients (31 men at our hospital between November 2000 and March 2014. This was 1.2% of all TJAs. Average age was 54 years. Average hospital stay was 4.1 days. There were no major inpatient complications. Thirty-four cases had at least 1-year follow-up in any clinic within the Veterans Affairs health care system. There were no known surgery-related reoperations or readmissions. At final follow-up, 24 patients had stable housing and 9 were employed. The extensive and coordinated medical and social services that were provided to veterans from the Department of Veterans Affairs contributed to our positive results. Keywords: Homeless, Veteran, Joint replacement, Total hip, Total knee, Employment

  6. Street Kids--Homeless and Runaway Youth. Hearing before the Subcommittee on Children, Family, Drugs and Alcoholism of the Committee on Labor and Human Resources, United States Senate. One Hundred First Congress, Second Session.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    This hearing was the second in a series examining the impact of homelessness and dislocation on young people in America. This session focused on the problems of homeless and runaway adolescents. Witnesses described the need for multiple services for this population, for effective provision of services, and for greater coordination and planning.…

  7. Illness narratives of people who are homeless

    Directory of Open Access Journals (Sweden)

    Cecilia Håkanson

    2016-11-01

    Full Text Available Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and “freedom” in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony. The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.

  8. The Occupational Wellbeing of People Experiencing Homelessness

    OpenAIRE

    Thomas, Yvonne; Gray, M.; McGinty, S.

    2017-01-01

    This paper reports findings of a study that utilised an occupational perspective to explore how wellbeing was achieved and sustained by the occupations of people experiencing homelessness in Australia. Thirty three in-depth qualitative interviews were conducted with homeless individuals in a regional city in Australia. Data from the interviews were thematically analysed to understand the relationship between wellbeing, as defined by the individual, and the occupations engaged in by people exp...

  9. Health care for homeless veterans. Final rule.

    Science.gov (United States)

    2011-08-23

    This final rule establishes regulations for contracting with community-based treatment facilities in the Health Care for Homeless Veterans (HCHV) program of the Department of Veterans Affairs (VA). The HCHV program assists certain homeless veterans in obtaining treatment from non-VA community-based providers. The final rule formalizes VA's policies and procedures in connection with this program and clarifies that veterans with substance use disorders may qualify for the program.

  10. Military Sexual Trauma Among Homeless Veterans

    OpenAIRE

    Pavao, Joanne; Turchik, Jessica A.; Hyun, Jenny K.; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

    2013-01-01

    ABSTRACT BACKGROUND Military sexual trauma (MST) is the Veteran Health Administration?s (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. OBJECTIVE To estimate the prevale...

  11. Illness narratives of people who are homeless.

    Science.gov (United States)

    Håkanson, Cecilia; Öhlén, Joakim

    2016-01-01

    Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and "freedom" in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony). The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.

  12. Political Participation of the Homeless in Brazil

    OpenAIRE

    Baumgarten, Britta

    2013-01-01

    Most researchers regard the mobilization of the most deprived as a rare case that needs further explanation. In this contribution the Brazilian National Movement of the Homeless (Movimento Nacional População Rua – MNPR) will be analysed to show mechanisms of mobilization of the most deprived. Unlike other rare cases of homeless mobilization, the movement is active beyond the local level; it has existed for almost a decade, gaining access to and impacting on politics at all leve...

  13. Seeking place: young people, homelessness and violence

    OpenAIRE

    Jordan, Lucinda May

    2017-01-01

    This thesis draws upon in-depth qualitative interviews with 33 young people in Melbourne, Australia, to examine the impact of homelessness, violence and policing on their sense of self, place and belonging. Specifically, this research highlights the pervasive presence of violence and policing in homeless young people’s lives, and argues that these experiences exclude young people from public and private spaces that are important to them, undermine their sense of belonging as citizens, and vio...

  14. Costs of services for homeless people with mental illness in 5 Canadian cities: a large prospective follow-up study.

    Science.gov (United States)

    Latimer, Eric A; Rabouin, Daniel; Cao, Zhirong; Ly, Angela; Powell, Guido; Aubry, Tim; Distasio, Jino; Hwang, Stephen W; Somers, Julian M; Stergiopoulos, Vicky; Veldhuizen, Scott; Moodie, Erica E M; Lesage, Alain; Goering, Paula N

    2017-07-18

    Limited evidence on the costs of homelessness in Canada is available. We estimated the average annual costs, in total and by cost category, that homeless people with mental illness engender from the perspective of society. We also identified individual characteristics associated with higher costs. As part of the At Home/Chez Soi trial of Housing First for homeless people with mental illness, 990 participants were assigned to the usual-treatment (control) group in 5 Canadian cities (Vancouver, Winnipeg, Toronto, Montréal and Moncton) between October 2009 and June 2011. They were followed for up to 2 years. Questionnaires ascertained service use and income, and city-specific unit costs were estimated. We adjusted costs for site differences in sample characteristics. We used generalized linear models to identify individual-level characteristics associated with higher costs. Usable data were available for 937 participants (94.6%). Average annual costs (excluding medications) per person in Vancouver, Winnipeg, Toronto, Montréal and Moncton were $53 144 (95% confidence interval [CI] $46 297-$60 095), $45 565 (95% CI $41 039-$50 412), $58 972 (95% CI $52 237-$66 085), $56 406 (95% CI $50 654-$62 456) and $29 610 (95% CI $24 995-$34 480), respectively. Net costs ranged from $15 530 to $341 535. Distributions of costs across categories varied significantly across cities. Lower functioning and a history of psychiatric hospital stays were the most important predictors of higher costs. Homeless people with mental illness generate very high costs for society. Programs are needed to reorient this spending toward more effectively preventing homelessness and toward meeting the health, housing and social service needs of homeless people. Copyright 2017, Joule Inc. or its licensors.

  15. Homelessness Comes to School: How Homeless Children and Youths Can Succeed

    Science.gov (United States)

    Murphy, Joseph F.; Tobin, Kerri J.

    2011-01-01

    Homelessness is a complex and layered phenomenon, but schools can be effective in reducing its educational consequences. Schools currently are not doing enough. The next step is to consider the services that are needed for students as they arrive on the school campus. Taking care of homeless children in school systems involves seven provisos:…

  16. Early Care and Education for Young Children Experiencing Homelessness. Best Practices in Homeless Education Brief Series

    Science.gov (United States)

    National Center for Homeless Education at SERVE, 2013

    2013-01-01

    Given the number of young children experiencing homelessness and its devastating impacts on development, preschool programs play a critical role in meeting these children's need for quality early care and education; yet, most young homeless children do not receive early childhood services. Many barriers limit access to early childhood programs for…

  17. Local Homeless Education Liaisons: Important Information for New Liaisons. Best Practices in Homeless Education Brief Series

    Science.gov (United States)

    National Center for Homeless Education at SERVE, 2015

    2015-01-01

    Homeless children and youth experience many challenges in enrolling and attending school and achieving educational success. The McKinney-Vento Homeless Assistance Act (reauthorized under Title X, Part C of the No Child Left Behind Act of 2001, and subsequently referred to as the McKinney-Vento Act in this brief) ensures rights and services for…

  18. Educational Rights of Homeless Youth: Exploring Racial Dimensions of Homeless Educational Policy

    Science.gov (United States)

    Aviles de Bradley, Ann Marie

    2009-01-01

    Research that addresses educational rights of unaccompanied homeless youth in grades 9-12 is limited. The McKinney-Vento Act was created to address the many needs of homeless individuals, including children and youth's right to an education. McKinney-Vento was created over twenty-years ago, and this research sought to examine the implementation of…

  19. Young and Homeless: Exploring the Education, Life Experiences and Aspirations of Homeless Youth

    Science.gov (United States)

    Byrom, Tina; Peart, Sheine

    2017-01-01

    Why do young people become homeless, and what might be done about it? This new study is important reading for academics and students of education, sociology or social work who wish to explore and understand the experiences of homeless young people. Their stories about their aspirations, experiences of schooling and the family breakdowns that…

  20. Problem Solving in Practice

    Science.gov (United States)

    Greene, Kim; Heyck-Williams, Jeff; Timpson Gray, Elicia

    2017-01-01

    Problem solving spans all grade levels and content areas, as evidenced by this compilation of projects from schools across the United States. In one project, high school girls built a solar-powered tent to serve their city's homeless population. In another project, 4th graders explored historic Jamestown to learn about the voices lost to history.…

  1. Actors, observers, and causal attributions of homelessness: Differences in attribution for the causes of homelessness among domiciled and homeless people in Madrid (Spain).

    Science.gov (United States)

    Vázquez, José Juan; Panadero, Sonia; Zúñiga, Claudia

    2017-01-01

    The study analyzes the differences in causal attributions of homelessness and attributions of responsibility among the members of 3 groups: homeless group, consisting of a representative sample of homeless people in Madrid, Spain (n = 188); domiciled service-users group, consisting of people at risk of homelessness (n = 164); and domiciled nonservice-users group, consisting of people at no imminent risk of homelessness (n = 180). The domiciled service-users group and domiciled nonservice-users group were matched to the homeless group or sex, age, and nationality. The article also analyzes homeless people's causal attributions as regards their own situation. The results show that compared with the domiciled nonservice-users group, a higher percentage of members of the homeless group and domiciled service-users group attributed homelessness to individualistic causes and they blamed homeless people for their situation to a greater extent. The results also show that there was no "actor-observer bias" in causal attributions for homelessness in Madrid. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Patient and program predictors of 12-month outcomes for homeless veterans following discharge from time-limited residential treatment.

    Science.gov (United States)

    McGuire, James; Rosenheck, Robert A; Kasprow, Wesley J

    2011-05-01

    The U.S. Department of Veterans Affairs provides transitional residential treatment to homeless veterans through three types of programs: VA-staffed Domiciliary care, and two types of community-based treatment (one funded through locally managed contracts and the other through national grants). This study compared treatment process and outcomes in these three programs and also sought to identify differences in outcome between dually diagnosed veterans, veterans with substance abuse problems or psychiatric problems alone, and those with no psychiatric diagnoses. Altogether, 1,338 veterans admitted to the 3 types of program were recruited to participate in a prospective naturalistic study which evaluated housing, clinical and community adjustment outcomes during the year following discharge. Data on 1,003 veterans for whom psychiatric diagnostic, social climate and length of stay data were available were used to compare participants in the three program types at baseline. Regression models were used to compare outcomes across program and diagnostic types net of baseline differences between study participants, and of differences in social climate and length of stay. The overall follow-up rate across all time points was 72%. Significant differences across programs were observed on only 2 baseline measures as well as on several baseline values of the outcome measures, length of stay and a measure of social climate. Adjusting for veteran baseline differences alone there were no differences in outcomes by program after correction for multiple comparisons. Dually diagnosed veterans had poorer mental health and overall quality of life outcomes. Longer length of stay and more positive social climate were associated with superior outcomes on several measures. The adjusted mean estimate of the proportion of veterans housed at 12 months follow-up was 78%, similar to published outcomes for supported housing. Length of stay, rather than program funding configuration or

  3. Homeless Point-In-Time (2007-2016)

    Data.gov (United States)

    City and County of Durham, North Carolina — These raw data sets contain Point-in-Time (PIT) estimates and national PIT estimates of homelessness as well as national estimates of homelessness by state and...

  4. Homelessness and Its Relation to the Mental Health and Behavior of Low-Income School-Age Children.

    Science.gov (United States)

    Buckner, John C.; Bassuk, Ellen L.; Weinreb, Linda F.; Brooks, Margaret G.

    1999-01-01

    Examined the relationship between housing status and depression, anxiety, and problem behaviors among elementary school-aged children from low-income, single-parent, female-headed families. Found that mother-reported problem behaviors were above normal levels for both homeless and poor, housed youths, but self-reported depression and anxiety were…

  5. Multiply disadvantaged: Health and service utilisation factors faced by homeless injecting drug consumers in Australia.

    Science.gov (United States)

    Whittaker, Elizabeth; Swift, Wendy; Roxburgh, Amanda; Dietze, Paul; Cogger, Shelley; Bruno, Raimondo; Sindicich, Natasha; Burns, Lucy

    2015-07-01

    Homelessness status is strongly correlated with higher rates of substance use. Few studies, however, examine the complex relationship between housing status and substance use in people who inject drugs (PWID). This study extends previous research by comparing the physical and mental health status and service utilisation rates between stably housed and homeless PWID. A cross-sectional sample of 923 PWID were recruited for the 2012 Illicit Drug Reporting System. Multivariate models were generated addressing associations between homelessness and the domains of demographics; substance use; and health status, service utilisation and criminal justice system contact, with significant correlates entered into a final multivariate model. Two-thirds of the PWID sample were male. The median age was 39 years and 16% identified as Indigenous. Almost one-quarter (23%) reported that they were homeless. Homeless PWID were significantly more likely to be unemployed [adjusted odds ratio (AOR) 2.83, 95% confidence interval (CI) 1.26, 6.34], inject in public (AOR 2.01, 95% CI 1.38, 3.18), have poorer mental health (AOR 0.98, 95% CI 0.97, 1.00), report schizophrenia (AOR 2.31, 95% CI 1.16, 4.60) and have a prison history (AOR 1.53, 95% CI 1.05, 2.21) than stably housed PWID. Findings highlight the challenge of mental health problems for homeless PWID. Our results demonstrate that further research that evaluates outcomes of housing programs accommodating PWID, particularly those with comorbid mental health disorders, is warranted. Results also emphasise the need to better utilise integrated models of outreach care that co-manage housing and mental health needs. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  6. Sleep in Children With Psychiatric Disorders.

    Science.gov (United States)

    Ramtekkar, Ujjwal; Ivanenko, Anna

    2015-06-01

    Sleep disturbances are common in pediatric psychiatric disorders and constitute key elements in diagnostic symptomatology of various primary psychiatric disorders including bipolar disorder, depression, and anxiety disorder. Although sleep is not included in key defining criteria of some impairing illnesses such as obsessive-compulsive disorder and schizophrenia, these disorders present with a very high prevalence of sleep disturbances. The interaction between sleep and psychopathology is very complex with significant interrelationship in development, severity, and prognosis of psychiatric disorders and comorbid sleep disturbances. The research ranging from small intervention case series to large epidemiologic studies have demonstrated the role of specific sleep complaints in specific psychiatric diagnoses. However, the research using objective instruments such as polysomnography and actigraphy remains limited in youth with psychiatric disorders. The intervention studies using pharmaceutical treatment specifically focusing on sleep disturbances in psychiatric disorders are also sparse in the pediatric literature. Early identification of sleep disturbances and behavioral management using cognitive behavior therapy-based tools appear to be the most effective approach for treatment. The use of psychotropic medications such as selective serotonin reuptake inhibitors for the treatment of primary psychiatric disorder often alleviate the psychological barriers for sleep but may lead to emergence of other sleep issues such as restless leg syndrome. The safety and efficacy data of hypnotics for primary sleep disorders are limited in pediatrics and should be avoided or used with extreme caution in children with comorbid sleep and psychiatric problems. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Cross-National Variations in Behavioral Profiles Among Homeless Youth

    OpenAIRE

    Milburn, Norweeta G.; Rotheram-Borus, Mary Jane; Rice, Eric; Mallet, Shelley; Rosenthal, Doreen

    2006-01-01

    Cross-national comparisons of homeless youth in Melbourne, Australia, and Los Angeles, CA, United States were conducted. Newly (n = 427) and experienced (n = 864) homeless youth were recruited from each site. Compared to Australia, homeless youth in the United States were younger, more likely to be in school or jail, demonstrated fewer sexual and substance use risk acts, fewer suicidal acts, and reported less need for social services. Across sites, experienced homeless youth were more likely ...

  8. Barriers to Psychosocial Services among Homeless Women Veterans

    OpenAIRE

    HAMILTON, ALISON B.; POZA, INES; HINES, VIVIAN; WASHINGTON, DONNA L.

    2012-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to se...

  9. Self-Reported Emotional and Behavioral Problems, Family Functioning and Parental Bonding among Psychiatric Outpatient Adolescent Offspring of Croatian Male Veterans with Partial PTSD

    Science.gov (United States)

    Sarajlic Vukovic, Iris; Boricevic Maršanic, Vlatka; Aukst Margetic, Branka; Paradžik, Ljubica; Vidovic, Domagoj; Buljan Flander, Gordana

    2015-01-01

    Background: Posttraumatic stress disorder (PTSD) in male veterans has been linked with impaired family relationships and psychopathology in their children. Less is known about symptoms in children of veterans with partial PTSD. Objective: To compare mental health problems, family functioning and parent-child bonding among adolescent offspring of…

  10. The checkered history of American psychiatric epidemiology.

    Science.gov (United States)

    Horwitz, Allan V; Grob, Gerald N

    2011-12-01

    American psychiatry has been fascinated with statistics ever since the specialty was created in the early nineteenth century. Initially, psychiatrists hoped that statistics would reveal the benefits of institutional care. Nevertheless, their fascination with statistics was far removed from the growing importance of epidemiology generally. The impetus to create an epidemiology of mental disorders came from the emerging social sciences, whose members were concerned with developing a scientific understanding of individual and social behavior and applying it to a series of pressing social problems. Beginning in the 1920s, the interest of psychiatric epidemiologists shifted to the ways that social environments contributed to the development of mental disorders. This emphasis dramatically changed after 1980 when the policy focus of psychiatric epidemiology became the early identification and prevention of mental illness in individuals. This article reviews the major developments in psychiatric epidemiology over the past century and a half. The lack of an adequate classification system for mental illness has precluded the field of psychiatric epidemiology from providing causal understandings that could contribute to more adequate policies to remediate psychiatric disorders. Because of this gap, the policy influence of psychiatric epidemiology has stemmed more from institutional and ideological concerns than from knowledge about the causes of mental disorders. Most of the problems that have bedeviled psychiatric epidemiology since its inception remain unresolved. In particular, until epidemiologists develop adequate methods to measure mental illnesses in community populations, the policy contributions of this field will not be fully realized. © 2011 Milbank Memorial Fund.

  11. The Relationship Between Gambling and Homelessness: A Commentary on Sharman et al. (2014).

    Science.gov (United States)

    Griffiths, Mark D

    2015-12-01

    The relationship between problem gambling and homelessness is a little studied area in the gambling studies field. A recent study by Sharman et al. (J Gambl Stud, doi: 10.1007/s10899-014-9444-7, 2014) is the first quantitative study in Great Britain on this interesting and important topic. In this context, the study is to be commended and provides an empirical benchmark on which other studies can build. The study reported a problem gambling prevalence rate of 11.6% and is significantly higher than the problem gambling rate of the general population in Great Britain (which is studies may be used by anti-gambling lobby groups to serve their own political agendas. While it is good that such an area has been empirically investigated in Great Britain, this paper briefly (1) places the issue of problem gambling among the homeless into the wider context of problems among the homeless more generally (particularly in relation to mental health problems and other addictive behaviors), (2) highlights some of the methodological problems and weaknesses of the study, and (3) notes a number of factual errors made in the paper.

  12. Art messaging to engage homeless young adults.

    Science.gov (United States)

    Nyamathi, Adeline; Slagle, Alexandra; Thomas, Alexandra; Hudson, Angela; Kahilifard, Farinaz; Avila, Glenna; Orser, Julie; Cuchilla, Manuel

    2011-01-01

    Art has been shown to be an empowering and engaging entity with numerous benefits to vulnerable populations, including the homeless persons and young adults. However, little is known how homeless young adults perceive the use of art as messages that can communicate the danger of initiating or continuing drug and alcohol use. The purpose of this study was to solicit perspectives of homeless, drug-using young adults as to how art can be used to design messages for their peers about the danger of initiating or continuing drug and alcohol use. Qualitative methodology via focus group discussions was utilized to engage 24 homeless young adults enrolled from a drop-in site in Santa Monica, California. The findings revealed support for a myriad of delivery styles, including in-person communication, flyers, music, documentary film, and creative writing. The young adults also provided insight into the importance of the thematic framework of messages. Such themes ranged from empowering and hopeful messages to those designed to scare young homeless adults into not experimenting with drugs. The findings indicate that in addition to messages communicating the need to prevent or reduce drug and alcohol use, homeless young adults respond to messages that remind them of goals and dreams they once had for their future, and to content that is personal, real, and truthful. Our research indicates that messages that reinforce protective factors such as hope for the future and self-esteem may be as important to homeless young adults as information about the risks and consequences of drug use.

  13. Chromosomal abnormalities in a psychiatric population

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, K.E.; Lubetsky, M.J.; Wenger, S.L.; Steele, M.W. [Univ. of Pittsburgh Medical Center, PA (United States)

    1995-02-27

    Over a 3.5 year period of time, 345 patients hospitalized for psychiatric problems were evaluated cytogenetically. The patient population included 76% males and 94% children with a mean age of 12 years. The criteria for testing was an undiagnosed etiology for mental retardation and/or autism. Cytogenetic studies identified 11, or 3%, with abnormal karyotypes, including 4 fragile X positive individuals (2 males, 2 females), and 8 with chromosomal aneuploidy, rearrangements, or deletions. While individuals with chromosomal abnormalities do not demonstrate specific behavioral, psychiatric, or developmental problems relative to other psychiatric patients, our results demonstrate the need for an increased awareness to order chromosomal analysis and fragile X testing in those individuals who have combinations of behavioral/psychiatric, learning, communication, or cognitive disturbance. 5 refs., 1 fig., 2 tabs.

  14. Cyberbullying: implications for the psychiatric nurse practitioner.

    Science.gov (United States)

    Carpenter, Lindsey M; Hubbard, Grace B

    2014-08-01

    The purpose of this article is to inform and educate psychiatric nurse practitioners about the pervasiveness of the rapidly increasing problem of cyberbullying. As more children and adolescents obtain access to the Internet, mobile devices, and social networking sites, the exposure to bullying in the virtual format increases. Cyberbullying is a growing public health concern and can affect mental health and school performance. Cyberbullying often results in a range of psychiatric symptoms and has been linked to suicide attempts and completions. The psychiatric nurse practitioner is uniquely prepared to provide a range of interventions for patients, families, and communities who have experienced cyberbullying. © 2014 Wiley Periodicals, Inc.

  15. PSYCHIATRIC MORBIDITY IN A CHILDREN'S HOME1

    Science.gov (United States)

    Chaturvedi, P. K.; Agarwal, A. K; Gupta, S. C.

    1980-01-01

    SUMMARY Sixty-two inmates of a children's home were examined by using a symptom check list and Hindi adaptation of Stanford Binet Intelligence Scale—Form LM (1960). A high proportion (69.4%) of the inmates had one or other psychiatric problem. Mild mental retardation (I. Q. 50—70) was most common (40.3%), 11.3% were diagnosed as having unsocialized disturbance of conduct. Four most common psychiatric symptoms were stealing, quarrelsome behaviour, destructive behaviour and bed wetting. No significant correlation was found between psychiatric illnesses and present age, duration of stay and age at entry into the home. PMID:22058478

  16. Homelessness in the Elementary School Classroom: Social and Emotional Consequences

    Science.gov (United States)

    Chow, Kirby A.; Mistry, Rashmita S.; Melchor, Vanessa L.

    2015-01-01

    This study examined elementary school teachers' experiences working with homeless students. Specifically, we focused on the psychosocial impacts of homelessness on students and their teachers. Qualitative, semi-structured interviews were conducted with 28 teachers who worked at designated public schools for family homeless shelters. A prominent…

  17. The Heterogeneity of Homelessness and the Consequences for Service Provision

    DEFF Research Database (Denmark)

    Koch-Nielsen, Inger; Børner Stax, Tobias

    Based on a literature study this chapter reflects upon the concept of homelessness and related terms in a Danish context. We then presents different types of accommodations for the homeless that is currently used. The chapter is taken from an anthology which deals with understandings and measures...... directed towards the homeless people in different European countries....

  18. Homeless High School Students in America: Who Counts?

    Science.gov (United States)

    Cumming, John M.; Gloeckner, Gene W.

    2012-01-01

    After interviewing homeless high school students, the research team in a Colorado school district discovered that many students had not revealed their true living conditions (homelessness) to anyone in the school district. This research team developed an anonymous survey written around the homeless categories identified in the McKinney-Vento…

  19. Hosting a Tent City: Student Engagement and Homelessness

    Science.gov (United States)

    McKinney, Jennifer; Snedker, Karen A.

    2017-01-01

    In response to increasing homelessness in our city, Seattle Pacific University invited a homeless encampment (Tent City) to reside on our university campus for three months. This provided an opportunity to engage students on issues of poverty and inequality. Building from a service-learning model, we devised course work around homelessness and…

  20. Simple mathematical models for housing allocation to a homeless ...

    African Journals Online (AJOL)

    We present simple mathematical models for modelling a homeless population and housing allocation. We look at a situation whereby the local authority makes temporary accommodation available for some of the homeless for a while and we examine how this affects the number of families homeless at any given time.

  1. From substance use to homelessness or vice versa?

    Science.gov (United States)

    McVicar, Duncan; Moschion, Julie; van Ours, Jan C

    2015-07-01

    Homelessness is associated with substance use, but whether substance use precedes or follows homelessness is unclear. We investigate the nature of the relationship between homelessness and substance use using data from the unique Australian panel dataset Journeys Home collected in 4 surveys over the period from October 2011 to May 2013. Our data refer to 1325 individuals who were homeless or at risk of becoming homeless. We investigate dynamics in homelessness and substance use over the survey period. We find that the two are closely related: homeless individuals are more likely to be substance users and substance users are more likely to be homeless. These relationships, however, are predominantly driven by observed and unobserved individual characteristics which cause individuals to be both more likely to be homeless and to be substance users. Once we take these personal characteristics into account it seems that homelessness does not affect substance use, although we cannot rule out that alcohol use increases the probability that an individual becomes homeless. These overall relationships also hide some interesting heterogeneity by 'type' of homelessness. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. From substance use to homelessness or vice versa?

    NARCIS (Netherlands)

    McVicar, Duncan; Moschion, Julie; van Ours, Jan

    Homelessness is associated with substance use, but whether substance use precedes or follows homelessness is unclear. We investigate the nature of the relationship between homelessness and substance use using data from the unique Australian panel dataset Journeys Home collected in 4 surveys over the

  3. Transforming Teacher Constructs of Children and Families Who Are Homeless

    Science.gov (United States)

    Powers-Costello, Beth; Swick, Kevin J.

    2011-01-01

    The focus of this article is on articulating the importance of teacher development of constructs about homeless children and families and examining factors that influence teachers' perceptions of children and families who are homeless or at high-risk of becoming homeless. The article also explores some strategies to support teachers in…

  4. The Multi-Dimensional Lives of Children Who Are Homeless

    Science.gov (United States)

    Grineski, Steve

    2014-01-01

    It is widely reported that children who are homeless are victimized by overwhelming challenges like poverty and ill-advised policy decisions, such as underfunding the McKinney-Vento Homeless Assistance Act. This act is the only federal legislation devoted to this marginalized group. Children who are homeless, however, should not be characterized…

  5. Homeless Adolescents' Perceptions of Positive Development: A Comparative Study

    Science.gov (United States)

    Nott, Brooke Dolenc; Vuchinich, Samuel

    2016-01-01

    Background: While some recent research has addressed homeless youth from a strengths-based approach, comparative studies of homeless and non-homeless youth from a strengths perspective are few; research that includes youth's views on positive youth development are also limited. Objective: Addressing these gaps and using an inductive approach,…

  6. Exploring the Lived Experiences of Homeless Families with Young Children

    Science.gov (United States)

    Hinton, Stephanie; Cassel, Darlinda

    2013-01-01

    This study researched the experiences of homeless families with young children between the ages of four and eight. Many families experience homelessness every year; therefore, it is important for early childhood educators to have an understanding of how homelessness affects families with young children so that educators can effectively serve the…

  7. Hidden in Plain Sight: Homeless Students in America's Public Schools

    Science.gov (United States)

    Ingram, Erin S.; Bridgeland, John M.; Reed, Bruce; Atwell, Matthew

    2017-01-01

    Student homelessness is on the rise, with more than 1.3 million homeless students identified during the 2013-14 school year. This is a 7 percent increase from the previous year and more than double the number of homeless students in 2006-07. As high as these numbers seem, they are almost certainly undercounts. Despite increasing numbers, these…

  8. Addressing the clinical needs of problem drug user patients

    Science.gov (United States)

    Krupski, Antoinette; West, Imara I.; Graves, Meredith C.; Atkins, David C.; Maynard, Charles; Bumgardner, Kristin; Donovan, Dennis; Ries, Richard; Roy-Byrne, Peter

    2016-01-01

    Introduction Illicit drug use is a serious public health problem associated with significant co-occurring medical disorders, mental disorders, and social problems. Yet most individuals with drug use disorders have never been treated, though they often seek medical treatment in primary care. The purpose of the present study was to examine baseline characteristics of persons presenting in primary care across a range of problem drug use severity to identify their clinical needs. Methods We examined socio-demographic characteristics, medical and psychiatric comorbidities, drug use severity, social and legal problems, and service utilization for 868 patients with drug problems recruited from primary care clinics in a safety-net medical setting. Based on Drug Abuse Screening Test (DAST-10) results, individuals were categorized as having low, intermediate, or substantial/severe drug use severity. Results Patients with substantial/severe drug use severity had serious drug use (opiates, stimulants, sedatives, intravenous drug use), high levels of homelessness (50%), psychiatric comorbidity (69%), arrests for serious crimes (24%), and frequent use of expensive emergency department and inpatient hospitals. Patients with low drug use severity were primarily users of marijuana with little reported use of other drugs, less psychiatric co-morbidity, and more stable lifestyles. Patients with intermediate drug use severity fell in-between the substantial/severe and low drug use severity subgroups on most variables. Conclusions Patients with highest drug use severity are likely to require specialized psychiatric and substance abuse care in addition to ongoing medical care that is equipped to address the consequences of severe/substantial drug use including intravenous drug use. Because of their milder symptoms, patients with low drug use severity may benefit from a collaborative care model that integrates psychiatric and substance abuse care in the primary care setting. Patients

  9. Human trafficking: what psychiatric nurses should know to help children and adolescents.

    Science.gov (United States)

    Newby, Amy; McGuinness, Teena M

    2012-04-01

    Psychiatric nurses are in key positions to identify and stop human trafficking, as well as aid its survivors. The combination of emotional trauma, sexual violence, and physical injuries experienced by these victims leads to high rates of posttraumatic stress disorder, depression, and anxiety. To detect human trafficking, it is important to identify the salient risk factors of homelessness and runaway history. This article offers key questions to help identify victims, as well as web-based resources. Copyright 2012, SLACK Incorporated.

  10. The state of ocular health among London's homeless population.

    Science.gov (United States)

    Sawers, N

    2017-04-01

    PurposeTo investigate the demographics, visual impairment, and diagnoses of patients presenting to Vision Care for Homeless People (VCHP), Crisis clinics for London's under-researched homeless population.Patients and methodsTwo hundred eighty-three patients records, including data on sociodemographic, diabetic status, visual acuity, and ocular examination, via a comprehensive eye test were reviewed from the VCHP clinics held at 10 London 'Crisis at Christmas' centres in 2014.ResultsTwo hundred eighty-three individual patients were seen at the VCHP clinics. Eighty-nine percent of patients were male and 11% were female. Thirty-two percent (90) patients had an ocular pathology. Lens problems, including cataracts (7%), vitreoretinal (6%), ocular motility (5%), and external eye disease (5%), were the four most common pathologies. In total, 6.4% of the patients reported that they were diabetic and a medical referral letter was given to 10% of the patients seen. Two hundred thirty-three were dispensed glasses (82%). Readers were most common (39%), then distance (28%), bifocals (15%). Presenting visual impairment was 12% in the patients tested. After refractive correction, this dropped to 2.5%.ConclusionThis study shows that there is a high prevalence of uncorrected refractive error among patients attending the Crisis for Christmas eye clinic. These data also show high prevalence of ocular pathology. There is a clear need for the provision of eye tests and spectacles to tackle the issues and prevent visual impairment. More research and eye care services are needed to investigate how this is linked to their living status and enable this vulnerable population to transition out of homelessness.

  11. Financing Cocaine Use in a Homeless Population

    Directory of Open Access Journals (Sweden)

    Carol S. North

    2017-10-01

    Full Text Available Background: Cocaine use is highly prevalent among homeless populations, yet little is known about how it is financed. This study examined associations of income sources with cocaine use and financing of drugs in a longitudinal evaluation of a homeless sample. Methods: A homeless sample was recruited systematically in St. Louis in 1999–2001 and longitudinally assessed annually over two years using the Diagnostic Interview Schedule and the Homeless Supplement, with urine drug testing. Results: More than half (55% of participants with complete follow-up data (N = 255/400 had current year cocaine use. Current users spent nearly $400 (half their income in the last month on drugs at baseline. Benefits, welfare, and disability were negatively associated and employment and income from family/friends, panhandling, and other illegal activities were positively associated with cocaine use and monetary expenditures for cocaine. Conclusions: Findings suggest that illegal and informal income-generating activities are primary sources for immediate gratification with cocaine use and public entitlements do not appear to be primary funding sources used by homeless populations. Policy linking drug testing to benefits is likely to have little utility, and public expenditures on measures to unlink drug use and income might be more effectively used to fund employment and treatment programs.

  12. Perpetuating stigma? Differences between advertisements for psychiatric and non-psychiatric medication in two professional journals.

    Science.gov (United States)

    Foster, Juliet L H

    2010-02-01

    Continuing debates regarding advertising and the pharmaceutical industry, and others detailing the continued stigmatization of mental health problems. To establish whether there are any differences in advertisements for psychiatric and non-psychiatric medication aimed at health professionals. Quantitative (t-tests, Chi-squared) and qualitative analysis of all unique advertisements for medication that appeared in two professional journals (the British Medical Journal and the British Journal of Psychiatry) between October 2005 and September 2006 was undertaken. Close attention was paid to both images and text used in the advertisements. Significant differences were found between advertisements for psychiatric and non-psychiatric medication in both quantitative and qualitative analysis: advertisements for psychiatric medication contain less text and are less likely to include specific information about the actual drug than non-psychiatric medication advertisements; images used in advertisements for psychiatric medication are more negative than those used for non-psychiatric medication, and are less likely to portray people in everyday situations. A distinction between mental health problems and other forms of ill health is clearly being maintained in medication advertisements; this has potentially stigmatizing consequences, both for professional and public perceptions. There are also troubling implications in light of the debates surrounding Direct to Consumer Advertising.

  13. Homeless People’s Transition from the Hidden World of Socialism to the Quasi-Welfare Social Safety of Contemporary Hungary: Evidence from Szeged

    Directory of Open Access Journals (Sweden)

    NAGY, Terézia

    2015-03-01

    Full Text Available In Hungary, homelessness has reappeared in the 1990s as a kind of social problem and also as a phenomenon. The intention of this study is to show how homelessness has become visible to society and why the problem was perceived so late, despite the fact that homeless people were part of the socialist society, even if in a latent way. Fieldwork was carried out in Szeged, a city in southern Hungary after 2002. During the research, I have participated in the everyday lives of homeless groups as an observer; I have conducted interviews and examined the social networks, problems and possibilities of the homeless. In this study, I show that the Hungarian circumstances, politics and structural changes were different from their Western counterparts, since Hungary took a different path. This trajectory infl uences the fate of those who become homeless. Even so, twenty years aft er the end of socialism, a number of parallels with the West, and with the United States in particular, can be discerned.

  14. Psychiatric disorders after radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Kokai, Masahiro [Hyogo Coll. of Medicine, Nishinomiya (Japan); Soejima, Toshinori; Wang, Shangdong; Shinfuku, Naotaka

    2001-04-01

    This review focuses on the mental and psychological effects of medical radiation exposure, the nuclear accident at Three Mile Island, the Chernobyl disaster, atomic bomb explosions at Nagasaki and Hiroshima, and accidents at nuclear power plants and nuclear waste plants. Studies have shown that anxiety about the adverse effects of radiation in medicine (such as infertility, carcinogenicity, and genotoxicity) and fear for exposure has caused psychiatric disorders. Several studies on the mental health effects of the nuclear accident at Three Mile Island were conducted, and the results indicated that psychiatric distress persisted for a certain period of time, particularly in pregnant women and women who have children, even when no evidence of substantial of radiation exposure is seen clinically. The psychological consequences of the Chernobyl disaster have been investigated continuously, and various problems, e.g., acute stress reaction, neurosis, and psychosis, have been identified, although no physical damage due to the radiation or PTSD have been reported. By contrast, PTSD has been seen in survivors of the Nagasaki and Hiroshima nuclear explosions. A study in Ohio, (United States), which has a nuclear waste plant, investigated PTSD in people living near the plant and found that the symptom level was mild. In general, the most common symptoms among people with mental and psychological disorders due to radiation exposure are depression and anxiety, with many people having associated somatoform disorders, and some people complain of PTSD. Vague anxiety and fear of sequelae, regardless of the exposure dose, appears to cause such psychiatric disorders. Although it is rare for psychiatrists to see such cases of psychiatric disorders due to radiation exposure, their number may increase as psychiatric services become more widely available. (K.H.)

  15. Assessing sexual trauma histories in homeless women.

    Science.gov (United States)

    Weinrich, Sally; Hardin, Sally; Glaser, Dale; Barger, Mary; Bormann, Jill; Lizarraga, Cabiria; Terry, Micheal; Criscenzo, Jeeni; Allard, Carolyn B

    2016-01-01

    Almost 1 out of every 3 homeless women (32%) in the United States, United Kingdom, and Australia has experienced childhood sexual trauma. We assessed lifetime sexual trauma histories among 29 homeless women from three Southern California community sites: one residential safe house and two safe parking areas. More than half of the women (54%) reported a history of sexual trauma. That rate was higher (86%) among women living at the safe home than among women staying at the safe parking sites (only 42%). All four of the women who had served in the military reported having experienced military sexual trauma. The high percentages of sexual trauma found in homeless women highlight the need for effective interventions for sexual trauma.

  16. Ubuntu is homeless: An urban theological reflection

    Directory of Open Access Journals (Sweden)

    Stephanus F. de Beer

    2015-06-01

    Full Text Available This article is reading ubuntu in the light of homelessness in the cities and towns of South Africa. It suggests that ubuntu itself is homeless and displaced as a way of being human together. Instead of the mediation of dignity and justice through an ubuntu-solidarity, street homeless people and others living vulnerably and in precarious circumstances are violated and excluded through a displacement of ubuntu-values. It also suggests a growing disconnect between the philosophy of ubuntu and its actual embodiment in the local urban political economy, local faith communities and local universities. Acknowledging the aspirational edge of ubuntu, the article then concludes to envision going beyond mere abstractions in the said spheres � the political economy, faith communities and local universities � in order to seek for concrete expressions of ubuntu-solidarity, asserting and mediating respect, dignity and justice.

  17. The hunger-obesity paradox: obesity in the homeless.

    Science.gov (United States)

    Koh, Katherine A; Hoy, Jessica S; O'Connell, James J; Montgomery, Paul

    2012-12-01

    Despite stereotypes of the homeless population as underweight, the literature lacks a rigorous analysis of weight status in homeless adults. The purpose of this study is to present the body mass index (BMI) distribution in a large adult homeless population and to compare this distribution to the non-homeless population in the United States. Demographic, BMI, and socioeconomic variables from patients seen in 2007-2008 were collected from the Boston Health Care for the Homeless Program (BHCHP). This population was compared to non-homeless adults from the National Health and Nutrition Examination Survey (NHANES). Among 5,632 homeless adults, the mean BMI was 28.4 kg/m(2) and the prevalence of obesity was 32.3 %. Only 1.6 % of homeless adults were underweight. Compared to mean BMI in NHANES (28.6 kg/m(2)), the difference was not significant in unadjusted analysis (p = 0.14). Adjusted analyses predicting BMI or likelihood of obesity also showed that the homeless had a weight distribution not statistically different from the general population. Although underweight has been traditionally associated with homelessness, this study suggests that obesity may be the new malnutrition of the homeless in the United States.

  18. College Access and Success for Students Experiencing Homelessness: A Toolkit for Educators and Service Providers

    Science.gov (United States)

    Dukes, Christina

    2013-01-01

    This toolkit serves as a comprehensive resource on the issue of higher education access and success for homeless students, including information on understanding homeless students, assisting homeless students in choosing a school, helping homeless students pay for application-related expenses, assisting homeless students in finding financial aid…

  19. Suicide risk among homeless population

    Directory of Open Access Journals (Sweden)

    Fran Calvo-García

    2016-06-01

    Full Text Available There exists little scientific production on autolytic behaviour in homeless people, despite the fact that it is one of the groups that is more at risk. The aim of this study is to determine the prevalence of previous attempted suicide and suicide risk and its connection with the main risk factors. In order to do so, central tendency and dispersion measures, correlations, contingence tables, and average comparison tables according to type of variable and normality were used. The Plutchik suicide-risk test was used in order to determine the risk of suicide, and specific tests for the main risk factors analysed. The main results show a 24.7% suicide rate and 45.2% (n = 66 displayed suicide risk. The main predictive factor of the risk of suicide was the daily consumption of alcohol (OR = 1.011, p less than .001, followed by being a woman (OR = 1.381, p = .021. It is necessary to design and apply suicide prevention strategies for this population.

  20. Surviving Violence in Everyday Life: A Communicative Approach to Homelessness.

    Science.gov (United States)

    Hsieh, Elaine

    2017-02-17

    In this narrative review, the author synthesizes the literature on homelessness across various disciplines (e.g., public health, social work, sociology, and communication) to demonstrate how the experiences of homelessness can be created, maintained, and reinforced through communication, including interpersonal interactions and public discourse. By conceptualizing homelessness as a culturally constructed and socially situated phenomenon, the author examines (a) the complex conceptualization of homelessness, (b) everyday violence faced by people who are homeless, and (c) coping strategies of people who are homeless. In summary, homelessness is a complex social phenomenon, involving tensions between individuals, families, and social systems, all of which are situated in the larger sociocultural and sociopolitical contexts of a specific time and place.

  1. Difficult behaviors in the emergency department: a cohort study of housed, homeless and alcohol dependent individuals.

    Directory of Open Access Journals (Sweden)

    Tomislav Svoboda

    Full Text Available This study contrasted annual rates of difficult behaviours in emergency departments among cohorts of individuals who were homeless and low-income housed and examined predictors of these events.Interviews in 1999 with men who were chronically homeless with drinking problems (CHDP (n = 50, men from the general homeless population (GH (n = 61, and men residing in low-income housing (LIH (n = 58 were linked to catchment area emergency department records (n = 2817 from 1994 to 1999. Interview and hospital data were linked to measures of difficult behaviours.Among the CHDP group, annual rates of visits with difficult behaviours were 5.46; this was 13.4 (95% CI 10.3-16.5 and 14.3 (95% CI 11.2-17.3 times higher than the GH and LIH groups. Difficult behaviour incidents included physical violence, verbal abuse, uncooperativeness, drug seeking, difficult histories and security involvement. Difficult behaviours made up 57.54% (95% CI 55.43-59.65%, 24% (95% CI 19-29%, and 20% (95% CI 16-24% of CHDP, GH and LIH visits. Among GH and LIH groups, 87% to 95% were never involved in verbal abuse or violence. Intoxication increased all difficult behaviours while decreasing drug seeking and leaving without being seen. Verbal abuse and violence were less likely among those housed, with odds ratios of 0.24 (0.08, 0.72 and 0.32 (0.15, 0.69, respectively.Violence and difficult behaviours are much higher among chronically homeless men with drinking problems than general homeless and low-income housed populations. They are concentrated among subgroups of individuals. Intoxication is the strongest predictor of difficult behaviour incidents.

  2. Reaching out to Ray: delivering palliative care services to a homeless person in Melbourne, Australia.

    Science.gov (United States)

    MacWilliams, Judy; Bramwell, Michael; Brown, Sally; O'Connor, Margaret

    2014-02-01

    Most terminally ill people express a preference for dying at home. Within established models of palliative care, achieving death at home is a particular challenge for homeless people. This paper describes a quality-improvement project undertaken by a community-based palliative care service in Melbourne, Australia, to understand homeless people's palliative care needs and the challenges that workers face. Six semi-structured interviews with workers in hospital and community-based settings were undertaken and a case study documented. The results were used to initiate discussion about how policy and protocols for the community-based palliative care service might serve this population more effectively. The findings confirmed that homeless people have complex psychosocial and medical needs. They may be periodically uncontactable or living in unsafe settings, experience isolation from social support networks, and have issues of compliance with treatment protocols exacerbated by mental health problems and/or substance abuse. Service providers had particular challenges in meeting the palliative care needs of homeless people. A flexible, compassionate, and coordinated response is required, and more work is needed to explore how the needs of this particular group can be met.

  3. Screening for tuberculosis among homeless shelter staff.

    Science.gov (United States)

    Di Renzi, Simona; Tomao, Paola; Martini, Agnese; Capanna, Silvia; Rubino, Luca; D'Amico, Wanda; Tomei, Fabio; Visca, Paolo; Vonesch, Nicoletta

    2012-06-01

    The prevalence of tuberculosis (TB) among homeless shelter staff was assessed using the tuberculin skin test (TST) and the Quantiferon TB-Gold in tube interferon-γ release assay (QFT-TB). Investigation of 51 participants for whom both QFT-TB and TST results were available showed 47.1% and 43.1% positivity, respectively, with excellent (92%) concordance between the 2 tests. The high risk for acquiring occupational TB necessitates the development of TB surveillance protocols for homeless shelter staff in Italy. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  4. Predictors of Retention in a Homeless Veteran Intervention Program

    Science.gov (United States)

    2012-12-01

    psychiatric disorders, including anxiety and depression, are associated with high attrition. Very little research has been conducted to determine the...condition or disease); severe asthma; diabetes; arthritis-related conditions (including arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia ...treatment prior to exiting the program. A mental health problem may include serious depression, serious anxiety , hallucinations, violent behavior or

  5. Forgotten Youth: Homeless LGBT Youth of Color and the Runaway and Homeless Youth Act

    National Research Council Canada - National Science Library

    Michelle Page

    2017-01-01

    [...]there is presently a disproportionate percentage of youth of color, and especially LGBT youth of color, who experience homelessness in a given year compared to their overall percentage in the general population...

  6. Psychiatric care in the German prison system.

    Science.gov (United States)

    Lehmann, Marc

    2012-01-01

    The purpose of this paper is to describe the nature of medical care within the German penal system. German prison services provide health care for all inmates, including psychiatric care. The reached level of equivalence of care and ethical problems and resource limitations are discussed and the way of legislation in this field since 2006 reform on federal law is described. The article summarizes basic data on German prison health care for mentally ill inmates. The legislation process and factors of influence are pointed out. A description of how psychiatric care is organized in German prisons follows. It focuses on the actual legal situation including European standards of prison health care and prevention of torture, psychiatric care in German prisons themselves, self harm and addiction. Associated problems such as blood born diseases and tuberculosis are included. The interactions between prison staff and health care personal and ethic aspects are discussed. The legislation process is still going on and there is still a chance to improve psychiatric care. Mental health problems are the major challenge for prison health care. Factors such as special problems of migrants, shortage of professionals and pure statistic data are considered. The paper provides a general overview on psychiatric services in prison and names weak points and strengths of the system.

  7. Service dogs, psychiatric hospitalization, and the ADA.

    Science.gov (United States)

    Muramatsu, Russ S; Thomas, Kelly Jones; Leong, Stephanie L; Ragukonis, Frank

    2015-01-01

    A service dog is defined as "any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability." Some psychiatric patients may depend on a service dog for day-to-day functioning. The Americans with Disabilities Act (ADA) established certain rights and responsibilities for individuals with disabilities and health care providers. Psychiatric hospitalization of a patient with a service dog may pose a problem and involves balancing the requirement to provide safe and appropriate psychiatric care with the rights of individuals with disabilities. This Open Forum examines issues that arise in such circumstances, reviews the literature, and provides a foundation for the development of policies and procedures.

  8. Barriers in the treatment of psychiatric disorders

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2016-07-01

    Full Text Available Psychiatric illnesses are very common in prevalence. But not everyone who has a mental illness gets a psychiatric consultation. The causes are many. First, many time people don’t recognise and accept mental illnesses in them as a result of lack of insight and awareness. Secondly, even if they know they have a mental illness, they don’t feel comfortable in disclosing it. Third, after knowing that they have some problems which require help from a doctor, they don’t know whom to consult, where to consult, and how to consult. Fourth, in spite of all possible awareness, there may not be psychiatric facilities nearby. Thus, it becomes utmost necessary to discuss those factors which stop people with psychiatric illnesses to get adequate help so that remedial steps could be taken.

  9. Psychiatric services in Algeria.

    Science.gov (United States)

    Benmebarek, Zoubir

    2017-02-01

    The paper describes the current provision of psychiatric services in Algeria - in particular, in-patient and out-patient facilities, child psychiatry and human resources. Education, training, associations and research in the field of mental health are also briefly presented. The challenges that must dealt with to improve psychiatric care and to comply with international standards are listed, by way of conclusion.

  10. The Prevalence of Mental Disorders among the Homeless in Western Countries: Systematic Review and Meta-Regression Analysis

    Science.gov (United States)

    Fazel, Seena; Khosla, Vivek; Doll, Helen; Geddes, John

    2008-01-01

    Background There are well over a million homeless people in Western Europe and North America, but reliable estimates of the prevalence of major mental disorders among this population are lacking. We undertook a systematic review of surveys of such disorders in homeless people. Methods and Findings We searched for surveys of the prevalence of psychotic illness, major depression, alcohol and drug dependence, and personality disorder that were based on interviews of samples of unselected homeless people. We searched bibliographic indexes, scanned reference lists, and corresponded with authors. We explored potential sources of any observed heterogeneity in the estimates by meta-regression analysis, including geographical region, sample size, and diagnostic method. Twenty-nine eligible surveys provided estimates obtained from 5,684 homeless individuals from seven countries. Substantial heterogeneity was observed in prevalence estimates for mental disorders among the studies (all Cochran's χ2 significant at p 85%). The most common mental disorders were alcohol dependence, which ranged from 8.1% to 58.5%, and drug dependence, which ranged from 4.5% to 54.2%. For psychotic illness, the prevalence ranged from 2.8% to 42.3%, with similar findings for major depression. The prevalence of alcohol dependence was found to have increased over recent decades. Conclusions Homeless people in Western countries are substantially more likely to have alcohol and drug dependence than the age-matched general population in those countries, and the prevalences of psychotic illnesses and personality disorders are higher. Models of psychiatric and social care that can best meet these mental health needs requires further investigation. PMID:19053169

  11. The prevalence of mental disorders among the homeless in western countries: systematic review and meta-regression analysis.

    Directory of Open Access Journals (Sweden)

    Seena Fazel

    2008-12-01

    Full Text Available BACKGROUND: There are well over a million homeless people in Western Europe and North America, but reliable estimates of the prevalence of major mental disorders among this population are lacking. We undertook a systematic review of surveys of such disorders in homeless people. METHODS AND FINDINGS: We searched for surveys of the prevalence of psychotic illness, major depression, alcohol and drug dependence, and personality disorder that were based on interviews of samples of unselected homeless people. We searched bibliographic indexes, scanned reference lists, and corresponded with authors. We explored potential sources of any observed heterogeneity in the estimates by meta-regression analysis, including geographical region, sample size, and diagnostic method. Twenty-nine eligible surveys provided estimates obtained from 5,684 homeless individuals from seven countries. Substantial heterogeneity was observed in prevalence estimates for mental disorders among the studies (all Cochran's chi(2 significant at p 85%. The most common mental disorders were alcohol dependence, which ranged from 8.1% to 58.5%, and drug dependence, which ranged from 4.5% to 54.2%. For psychotic illness, the prevalence ranged from 2.8% to 42.3%, with similar findings for major depression. The prevalence of alcohol dependence was found to have increased over recent decades. CONCLUSIONS: Homeless people in Western countries are substantially more likely to have alcohol and drug dependence than the age-matched general population in those countries, and the prevalences of psychotic illnesses and personality disorders are higher. Models of psychiatric and social care that can best meet these mental health needs requires further investigation.

  12. Psychiatric disorders and pregnancy

    Directory of Open Access Journals (Sweden)

    "SH. Akhondzadeh

    2006-07-01

    Full Text Available Psychiatric disorders are common in women during their childbearing years. Special considerations are needed when psychotic disorders present during pregnancy. Early identification and treatment of psychiatric disorders in pregnancy can prevent morbidity in pregnancy and in postpartum with the concomitant risks to mother and baby. Nevertheless, diagnosis of psychiatric illnesses during pregnancy is made more difficult by the overlap between symptoms of the disorders and symptoms of pregnancy. In majority of cases both psychotherapy and pharmacotherapy should be considered. However, psychiatric disorders in pregnancy are often under treated because of concerns about potential harmful effects of medication. This paper reviews findings about the presentation and course of major psychiatric disorders during pregnancy.

  13. Perinatal psychiatric episodes

    DEFF Research Database (Denmark)

    Munk-Olsen, Trine; Maegbaek, M L; Johannsen, B M

    2016-01-01

    and childbirth, which suggests differences in the underlying etiology. We further speculate varying treatment incidence and prevalence in pregnancy vs postpartum may indicate that the current Diagnostic and Statistical Manual of Mental Disorders-5 peripartum specifier not adequately describes at-risk periods......Perinatal psychiatric episodes comprise various disorders and symptom severity, which are diagnosed and treated in multiple treatment settings. To date, no studies have quantified the incidence and prevalence of perinatal psychiatric episodes treated in primary and secondary care, which we aimed...... psychiatric facilities, 2.5 births were followed by an episode treated at outpatient psychiatric facility and 12 births by GP-provided pharmacological treatment. We interpret our results the following way: treated severe and moderate psychiatric disorders have different risk patterns in relation to pregnancy...

  14. 76 FR 81959 - Notice of Proposed Information Collection: Comment Request; Homelessness Prevention Study Site...

    Science.gov (United States)

    2011-12-29

    ... URBAN DEVELOPMENT Notice of Proposed Information Collection: Comment Request; Homelessness Prevention... following information: Title of Proposal: Homelessness Prevention Study Site Visits. OMB Control Number, if... requirements associated with HUD's Homelessness Prevention Study Site Visits. This information collection...

  15. [Characteristics of Hospitalizations of Homeless Persons in Seville, Spain].

    Science.gov (United States)

    Tornero Patricio, Sebastián; Fernández Ajuria, Alberto; Charris Castro, Liliana

    2016-02-10

    The aim was to determine the characteristics of hospital admissions of homeless persons in Seville, Spain. Observational study of 103,802 hospital admissions of 71,756 patients admitted in the Hospitals "Virgen del Rocío" and "Virgen Macarena" (Seville), in 2013 and 2014. Bivariate analysis were performed using χ2 and t-Student tests and multivariate analysis using binomial logistic regression model. 0.16% (n=163) of admissions were homeless persons and 99.84% (n=103,639) were not. The mean age at admission in homeless patients was 48 years and 76.5% of them were men. Hospital deaths of homeless patients occurred being 23 years younger. 92% of hospital admissions came from emergency departments and 10.0% of their discharges were against medical advice. The average length of stay was 4.8 days longer in homeless persons and the most frequent diagnoses on admission were mental (27.0%), infectious (19.6%) and respiratory diseases (18.4%). Mental disorders were present on 83.7% of homeless patients as secondary diagnose and 77.6% referred drugs consumption. Hospital admissions characteristics of homeless persons were particularly different. Homeless patients were hospitalized and died at a younger age than non-homeless patients. The morbidity and mortality of homeless persons reflect their vulnerable health condition.

  16. The Vocational Interests of Homeless, Unemployed Men.

    Science.gov (United States)

    Laufer, William S.

    1981-01-01

    Examined the vocational interests and personality characteristics of 69 homeless unemployed men using the Vocational Preference Inventory. Results indicated significant occupational interest, comparable to data reported on employed adults and numerous vocational "types." Personality scales, however, were indicative of possible behavioral…

  17. SHELCOM: Going High Tech with the Homeless.

    Science.gov (United States)

    Scheffer, Ludo C. P.

    1995-01-01

    SHELCOM, an adult education project in homeless shelters in Philadelphia, Pennsylvania, investigated the effects of using computer technology on participants' writing and communication skills. The project consisted of 2-hour workshops, twice weekly, complemented by online support and instruction. Learners paired across the city worked on creating…

  18. 34 CFR 300.19 - Homeless children.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Homeless children. 300.19 Section 300.19 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES General Definitions Used in This...

  19. 77 FR 20849 - Homeless Veterans' Reintegration Program

    Science.gov (United States)

    2012-04-06

    ... Veterans' Reintegration Program AGENCY: Veterans' Employment and Training Service (VETS), Department of...: Section 2021 of Title 38 of the United States Code (U.S.C.) reauthorizes the Homeless Veterans Reintegration Program (HVRP) through fiscal year (FY) 2012 and indicates: ``the Secretary of Labor shall conduct...

  20. The New Vagabonds? Homelessness Outside the Megalopolis.

    Science.gov (United States)

    Huff, Dan; Johnson, David

    This paper reports results of a survey of 47 homeless adults, interviewed in Ada County, Idaho. Most respondents were male, white, currently single, with no religious preference. The mean number of years of formal education was 11.6. Seventeen percent of the sample were American Indians. Ninety-three percent were unemployed. Twenty-five percent of…

  1. The Mediating Roles of Stress and Maladaptive Behaviors on Self-Harm and Suicide Attempts among Runaway and Homeless Youth

    Science.gov (United States)

    Moskowitz, Amanda; Stein, Judith A.; Lightfoot, Marguerita

    2013-01-01

    Runaway and homeless youth often have a constellation of background behavioral, emotional, and familial problems that contribute to stress and maladaptive behaviors, which, in turn, can lead to self-harming and suicidal behaviors. The current study examined the roles of stress and maladaptive behaviors as mediators between demographic and…

  2. Online communities of practice as a communication resource for community health nurses working with homeless persons.

    Science.gov (United States)

    Valaitis, Ruta K; Akhtar-Danesh, Noori; Brooks, Fiona; Binks, Sally; Semogas, Dyanne

    2011-06-01

    This study explored community health nurses' viewpoints about a Canadian online community of practice to support their practice with homeless or under-housed populations. Community health nurses who specifically work with homeless and marginally housed populations often report feelings of isolation and stress in managing complex problems in resource constraints. To strengthen intra-professional ties and enhance information access, an online community of practice was designed, implemented and evaluated by and for them. Q-methodology was used. Sixty-six statements about the community of practice were collected from an online survey and focus groups, refined and reduced to 44 statements. In 2009, sixteen participants completed the Q-sort activity, rating each statement relative to the others. Scores for each participant were subjected to by-person factor analysis. Respondents fell into two groups -tacit knowledge warriors and tacit knowledge communicators. Warriors strongly believed that the community of practice could combat stigma associated with homelessness and promote awareness of homelessness issues, and valued its potential to validate and improve practice. Communicators would have used the community of practice more with increased discussion, facilitation and prompt responses. Generally, nurses viewed the community of practice as a place to share stories, validate practice and adapt best practices to their work context. Online communities of practice can be valuable to nurses in specialized fields with limited peer support and access to information resources. Tacit knowledge development is important to nurses working with homeless populations: this needs to be valued in conjunction with scientifically based knowledge. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  3. Visual impairment and unmet eye care needs among homeless adults in a Canadian city.

    Science.gov (United States)

    Noel, Christopher W; Fung, Henry; Srivastava, Raman; Lebovic, Gerald; Hwang, Stephen W; Berger, Alan; Lichter, Myrna

    2015-04-01

    The ocular status of homeless populations remains largely unknown. Given that visual acuity has been shown to be heavily correlated with reduced well-being and decreased earning potential, findings of poor vision could have important health implications for people experiencing homelessness. To assess the prevalence of visual impairment and to identify unmet eye care needs in an adult homeless population. For this cross-sectional study, we recruited 100 homeless persons using a stratified random sampling technique from January to March 2014. Recruitment took place at 10 randomly selected adult shelters in Toronto, Ontario, Canada. All English-speaking persons older than 18 years of age were eligible to participate. Information was obtained on sociodemographic characteristics, ocular history, and subjective visual acuity. A comprehensive vision screening and an undilated retinal examination were performed for each participant. Rates of functional visual impairment and prevalence of nonrefractive eye pathology. The median age of participants was 48 years (interquartile range, 36-56 years), and 62% were men. The median lifetime duration of homelessness was 12 months (interquartile range, 5-36 months). Based on the participants' presenting visual acuity, the age-standardized rate of visual impairment was 25.2% (95% CI, 16.7%-33.7%). After pinhole occlusion, this number decreased to 15.2% (95% CI, 7.7%-22.7%). In total, 13.0% (95% CI, 7.8%-20.0%) of participants experienced visual impairment secondary to a correctable refractive error. Although the major problem for this demographic was limited access to refractive correction, a large degree of nonrefractive pathology was also observed. Of all the participants, 34.0% (95% CI, 24.7%-43.3%) had 1 or more abnormal findings during the vision screening, and 8% (95% CI, 2.7%-13.3%) required urgent referral to an ophthalmologist. A large majority of participants (89.0%) indicated interest in accessing free eye examinations

  4. Tackling Health Disparities for People Who Are Homeless? Start with Social Determinants

    OpenAIRE

    Amanda Stafford; Lisa Wood

    2017-01-01

    Background: Homelessness is associated with enormous health inequalities, including shorter life expectancy, higher morbidity and greater usage of acute hospital services. Viewed through the lens of social determinants, homelessness is a key driver of poor health, but homelessness itself results from accumulated adverse social and economic conditions. Indeed, in people who are homeless, the social determinants of homelessness and health inequities are often intertwined, and long term homeless...

  5. Increasing Access to Higher Education for Unaccompanied Homeless Youth: Information for Colleges and Universities. Best Practices in Homeless Education Brief Series

    Science.gov (United States)

    National Center for Homeless Education at SERVE, 2012

    2012-01-01

    Each year, more than a million young people in the United States experience homelessness; some of these young people, known as unaccompanied homeless youth, will face the challenges of homelessness while living on their own without the support of a caring adult. Unaccompanied homeless youth face the same struggles as other young people: trying to…

  6. Social exclusion, health and hidden homelessness.

    Science.gov (United States)

    Watson, J; Crawley, J; Kane, D

    2016-10-01

    Homelessness and poverty are extreme forms of social exclusion which extend beyond the lack of physical or material needs. The purpose of this study was to explore and expand the concept of social exclusion within the social determinants of health perspective - to understand how the social environment, health behaviours and health status are associated with material and social deprivation. Fundamental qualitative description with tones of focused ethnography. Participants who identified as hidden homeless described their everyday living conditions and how these everyday conditions were impacted and influenced by their social environments, coping/health behaviours and current health status. Research Ethics Board approval was granted and informed consents were obtained from 21 participants prior to the completion of individual interviews. Qualitative content analysis examined the descriptions of men and women experiencing hidden homelessness. Participants described the 'lack of quality social interactions and supports' and their 'daily struggles of street life'. They also shared the 'pain of addiction' and how coping strategies influenced health. Participants were hopeful that their insights would 'better the health of homeless people' by helping shape public policy and funding of community resources that would reduce barriers and improve overall health. Health professionals who understand health behaviours as coping mechanisms for poor quality social environments can provide more comprehensive and holistic care. The findings of this study can be used to support the importance of housing as a key factor in the health and well-being of people experiencing poverty, homelessness and social exclusion; and consequently, reinforces the need for a national housing strategy. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  7. A practice research study concerning homeless service user involvement with a programme of social support work delivered in a specialized psychological trauma service.

    Science.gov (United States)

    Archard, P J; Murphy, D

    2015-08-01

    -directive, person-centred approach and staffed by student social workers. The study aim was to explore the support work programme as it was received by service users domiciled in supported housing for homeless persons, encompassing experiencing the programme, worker-service user engagement and contextual influences bearing upon positive outcomes. Narrative interviews gathered the impressions of service users and support workers and the data arising from these interviews was analysed thematically. Service user participants valued support work that combined practical and relational elements, but would have preferred a longer-term involvement. They also spoke of feelings of disconnection and estrangement from their peers in the supported accommodation and their families. The worker participants valued the flexibility of person-centred work tailored to service users' individual needs and echoed service user concerns around the short-term nature of their involvement. Psychiatric nurses carrying out, or supervising, mental health support work with homeless service users should be mindful of the potential impact of temporary staffing arrangements on continuity of care. They should also consider how working from a person-centred perspective and addressing client's practical needs may aid in developing rapport and trust with homeless service users. © 2015 John Wiley & Sons Ltd.

  8. Challenges to access and provision of palliative care for people who are homeless: a systematic review of qualitative research.

    Science.gov (United States)

    Hudson, Briony F; Flemming, Kate; Shulman, Caroline; Candy, Bridget

    2016-12-03

    People who are homeless or vulnerably housed are a marginalized group who often experience high rates of morbidity and die young as a result of complex problems. Access to health care and support can be challenging, with access to palliative care even more so. This review presents a synthesis of published qualitative research exploring from the perspective of homeless people and those working to support them, current challenges to palliative care access and provision, in addition to suggestions for what may improve palliative care for this population. Systematic review of qualitative research analysed using thematic synthesis. PsycINFO, Medline, Sociological Abstracts, Social Services Abstracts, Science citations index and CINAHL were searched up to September 2016. Thematic synthesis involved a three-step inductive process to develop a deeper understanding of the challenges to and suggestions for the access and provision of palliative care for homeless people. Thirteen qualitative articles, reporting nine studies were identified. The challenges to access and provision to palliative care were drawn from the data covering three broad areas, namely "the chaotic lifestyles sometimes associated with being homeless", "the delivery of palliative care within a hostel for homeless people" and provision within "mainstream health care systems". Obstacles were related to homeless persons competing day-to-day priorities, their experience of stigma in mainstream settings, the high burden on hostel staff in supporting residents at the end of life and inflexibility in mainstream health care systems. Suggestions for improving access to palliative care include building trust between homeless persons and health professionals, increasing collaboration between and flexibility within services, and providing more training and support for all professionals. The provision of palliative care can be complicated for all populations, however delivering palliative care for people who are

  9. Oxytocin and Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Gokce Nur Say

    2016-06-01

    Full Text Available Oxytocin is a neuropeptide that plays critical role in mother-infant bonding, pair bonding and prosocial behaviors. Several neuropsychiatric disorders such as autism, schizophrenia, affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, alcohol/substance addiction, aggression, suicide, eating disorders and personality disorders show abnormalities of oxytocin system. These findings have given rise to the studies searching therapeutic use of oxytocin for psychi-atric disorders. The studies of oxytocin interventions in psychiatric disorders yielded potentially promising findings. This paper reviews the role of oxytocin in emotions, behavior and its effects in psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 102-113

  10. Vancouver At Home: pragmatic randomized trials investigating Housing First for homeless and mentally ill adults

    Science.gov (United States)

    2013-01-01

    Background Individuals with mental illnesses are overrepresented among the homeless. Housing First (HF) has been shown to promote positive outcomes in this population. However, key questions remain unresolved, including: how to match support services to client needs, the benefits of housing in scattered sites versus single congregate building, and the effectiveness of HF with individuals actively using substances. The present study aimed to recruit two samples of homeless mentally ill participants who differed in the complexity of their needs. Study details, including recruitment, randomization, and follow-up, are presented. Methods Eligibility was based on homeless status and current mental disorder. Participants were classified as either moderate needs (MN) or high needs (HN). Those with MN were randomized to HF with Intensive Case Management (HF-ICM) or usual care. Those with HN were randomized to HF with Assertive Community Treatment (HF-ACT), congregate housing with support, or usual care. Participants were interviewed every 3 months for 2 years. Separate consent was sought to access administrative data. Results Participants met eligibility for either MN (n = 200) or HN (n = 297) and were randomized accordingly. Both samples were primarily male and white. Compared to participants designated MN, HN participants had higher rates of hospitalization for psychiatric reasons prior to randomization, were younger at the time of recruitment, younger when first homeless, more likely to meet criteria for substance dependence, and less likely to have completed high school. Across all study arms, between 92% and 100% of participants were followed over 24 months post-randomization. Minimal significant differences were found between study arms following randomization. 438 participants (88%) provided consent to access administrative data. Conclusion The study successfully recruited participants meeting criteria for homelessness and current mental disorder. Both MN

  11. Ayahuasca in adolescence: a preliminary psychiatric assessment.

    Science.gov (United States)

    Da Silveira, Dartiu Xavier; Grob, Charles S; de Rios, Marlene Dobkin; Lopez, Enrique; Alonso, Luisa K; Tacla, Cristiane; Doering-Silveira, Evelyn

    2005-06-01

    Ayahuasca is believed to be harmless for those (including adolescents) drinking it within a religious setting. Nevertheless controlled studies on the mental/ psychiatric status of ritual hallucinogenic ayahuasca concoction consumers are still lacking. In this study, 40 adolescents from a Brazilian ayahuasca sect were compared with 40 controls matched on sex, age, and educational background for psychiatric symptomatology. Screening scales for depression, anxiety, alcohol consumption patterns (abuse), attentional problems, and body dysmorphic disorders were used. It was found that, compared to controls, considerable lower frequencies of positive scoring for anxiety, body dismorphism, and attentional problems were detected among ayahuasca-using adolescents despite overall similar psychopathological profiles displayed by both study groups. Low frequencies of psychiatric symptoms detected among adolescents consuming ayahuasca within a religious context may reflect a protective effect due to their religious affiliation. However further studies on the possible interference of other variables in the outcome are necessary.

  12. Psychiatric conditions in an evolutionary context.

    Science.gov (United States)

    Fabrega Jr, Horacio

    2004-01-01

    Psychiatric conditions and the institutions and practices that modern society has evolved to handle them originated during the nineteenth century in Anglo European societies. They are products of a historically contingent and culture specific formulation of a class of social problems of behavior that came to the fore in relation to intellectual and political economic changes of those societies. However, such problems have a long ancestry. They are intrinsic to human species and the social and cultural systems that its members have evolved since their emergence. This article reviews intellectual quandaries raised by evolutionary study of psychiatric conditions, those of crossing the human/animal divide and crossing historically contingent cultures; and of framing history of psychiatry in terms of social and cultural evolution. The biological architecture underlying psychiatric conditions and the breakthroughs that indigenous psychiatry of different types of societies underwent in formulating signs and symptoms are discussed. Copyright (c) 2004 S. Karger AG, Basel.

  13. Barriers to Psychosocial Services among Homeless Women Veterans

    Science.gov (United States)

    HAMILTON, ALISON B.; POZA, INES; HINES, VIVIAN; WASHINGTON, DONNA L.

    2015-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to services, and lack of coordination across services. Compared to non-veteran homeless women, women veterans potentially face additional challenges of trauma exposure during military service, post-military readjustment issues, and few services specific to women veterans. Understanding their service needs and experiences is critical to the development of relevant and appropriate services that move homeless women veterans away from vulnerability, into safety. PMID:26617471

  14. The meaning of family routines in a homeless shelter.

    Science.gov (United States)

    Schultz-Krohn, Winifred

    2004-01-01

    This exploratory investigation sought to understand what meaning parents, living in a homeless shelter, attribute to family routines and the nature of those routines. In-depth interviews were conducted with 12 parents living in a homeless shelter. Thematic analysis was employed to develop descriptive codes and themes from transcribed data and field notes. Parents described family routines focused on three features: promoting intimacy, maintaining or developing a legacy, and connections with the community. These routines seemed to preserve family integrity while homeless and to provide hope for the family to continue into the future. Homeless parents, in this investigation, seemed to expend a substantial amount of energy to create or maintain family routines while living in a homeless shelter. Findings suggest that occupational therapy services may help support homeless parents as they exercise their role as the organizer of family routines.

  15. Barriers to Psychosocial Services among Homeless Women Veterans.

    Science.gov (United States)

    Hamilton, Alison B; Poza, Ines; Hines, Vivian; Washington, Donna L

    2012-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to services, and lack of coordination across services. Compared to non-veteran homeless women, women veterans potentially face additional challenges of trauma exposure during military service, post-military readjustment issues, and few services specific to women veterans. Understanding their service needs and experiences is critical to the development of relevant and appropriate services that move homeless women veterans away from vulnerability, into safety.

  16. Psychiatric evaluation of intellectually disabled offenders referred to ...

    African Journals Online (AJOL)

    Psychiatric evaluation of intellectually disabled offenders referred to the Free State Psychiatric Complex, 1993 - 2003. ... Increased crime is a problem in South Africa and complications arise when the accused is intellectually disabled. The accountability and fitness to stand trial of such individuals is an important facet that ...

  17. Challenges of Recognition of the Psychiatric Aspects of Intimate ...

    African Journals Online (AJOL)

    Background: Even though intimate partner violence represents a major public health problem in Nigeria, much of its associated burden of psychiatric morbidity presenting in the clinical setting goes unrecognized and untreated. Objectives: The purpose of this paper is to clarify the psychiatric perspectives on intimate partner ...

  18. The Role of Sleep in Childhood Psychiatric Disorders

    Science.gov (United States)

    Alfano, Candice A.; Gamble, Amanda L.

    2009-01-01

    Although sleep problems often comprise core features of psychiatric disorders, inadequate attention has been paid to the complex, reciprocal relationships involved in the early regulation of sleep, emotion, and behavior. In this paper, we review the pediatric literature examining sleep in children with primary psychiatric disorders as well as…

  19. A Closer Evaluation of Current Methods in Psychiatric Assessments

    Science.gov (United States)

    2009-01-01

    The biopsychosocial model, the current method in psychiatric assessments, is reviewed and critiqued. The history and original intents leading to the conception of the biopsychosocial model are briefly discussed. Five inherent problems with the use of the biopsychosocial model in psychiatric assessments and training programs are presented. Two alternative approaches are discussed and promoted for clinical, educational, and research practices in medicine. PMID:19724745

  20. Homeless Aging Veterans in Transition: A Life-Span Perspective

    OpenAIRE

    Thompson, Carla J.; Bridier, Nancy L.

    2013-01-01

    The need for counseling and career/educational services for homeless veterans has captured political and economic venues for more than 25 years. Veterans are three times more likely to become homeless than the general population if veterans live in poverty or are minority veterans. This mixed methods study emphasized a life-span perspective approach for exploring factors influencing normative aging and life-quality of 39 homeless veterans in Alabama and Florida. Seven descriptive quantitative...

  1. Sexual Health Information Seeking Online Among Runaway and Homeless Youth

    OpenAIRE

    Barman-Adhikari, Anamika; Rice, Eric

    2011-01-01

    Research shows runaway and homeless youth are reluctant to seek help from traditional health providers. The Internet can be useful in engaging this population and meeting their needs for sexual health information, including information about HIV and other sexually transmitted infections (STIs). Using a sample of homeless youth living in Los Angeles, California in June 2009, this study assesses the frequency with which runaway and homeless youth seek sexual health information via the Internet,...

  2. Personality disorders and treatment drop out in the homeless

    OpenAIRE

    Salavera C; Tricás JM; Lucha O

    2013-01-01

    Carlos Salavera,1 José M Tricás,2 Orosia Lucha21Faculty of Education, University of Zaragoza, Zaragoza, Spain; 2Physiotherapy Research Unit, University of Zaragoza, Zaragoza, SpainAbstract: The homeless drop out of treatment relatively frequently. Also, prevalence rates of personality disorders are much higher in the homeless group than in the general population. We hypothesize that when both variables coexist – homelessness and personality disorders &ndash...

  3. Comprehensive Psychiatric Evaluation

    Science.gov (United States)

    ... Guide - Table of Contents Facts For Families Guide - View by Topic Chinese Facts for Families Guide ... Psychiatric Evaluation No. 52; Updated October 2017 Evaluation by a child and adolescent psychiatrist is appropriate for any child or adolescent ...

  4. Homeless people's access to primary care physiotherapy services: an exploratory, mixed-method investigation using a follow-up qualitative extension to core quantitative research.

    Science.gov (United States)

    Dawes, Jo; Deaton, Stuart; Greenwood, Nan

    2017-06-30

    The purpose of this study was to appraise referrals of homeless patients to physiotherapy services and explore perceptions of barriers to access. This exploratory mixed-method study used a follow-up qualitative extension to core quantitative research design. Over 9 months, quantitative data were gathered from the healthcare records of homeless patients referred to physiotherapy by a general practitioner (GP) practice, including the number of referrals and demographic data of all homeless patients referred. Corresponding physiotherapy records of those people referred to physiotherapy were searched for the outcome of their care. Qualitative semi-structured telephone interviews, based on the quantitative findings, were carried out with staff involved with patient care from the referring GP practice and were used to expand insight into the quantitative findings. Two primary care sites provided data for this study: a GP practice dedicated exclusively to homeless people and the physiotherapy department receiving their referrals. Quantitative data from the healthcare records of 34 homeless patient referrals to physiotherapy were collected and analysed. In addition, five staff involved in patient care were interviewed. 34 referrals of homeless people were made to physiotherapy in a 9-month period. It was possible to match 25 of these to records from the physiotherapy department. Nine (36%) patients did not attend their first appointment; seven (28%) attended an initial appointment, but did not attend a subsequent appointment and were discharged from the service; five (20%) completed treatment and four patients (16%) had ongoing treatment. Semi-structured interviews revealed potential barriers preventing homeless people from accessing physiotherapy services, the complex factors being faced by those making referrals and possible ways to improve physiotherapy access. Homeless people with musculoskeletal problems may fail to access physiotherapy treatment, but opportunities

  5. Culture and Psychiatric Diagnosis

    OpenAIRE

    Lewis-Fernández, Roberto; Aggarwal, Neil Krishan

    2013-01-01

    Since the publication of DSM-IV in 1994, a number of components related to psychiatric diagnosis have come under criticism for their inaccuracies and inadequacies. Neurobiologists and anthropologists have particularly criticized the rigidity of DSM-IV diagnostic criteria that appear to exclude whole classes of alternate illness presentations as well as the lack of attention in contemporary psychiatric nosology to the role of contextual factors in the emergence and characteristics of psychopat...

  6. Hyperthyroidism and psychiatric morbidity

    DEFF Research Database (Denmark)

    Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind

    2014-01-01

    Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity.......Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....

  7. Educating Homeless Youth in Texas: The McKinney-Vento Homeless Education Assistance Improvements Act of 2001.

    Science.gov (United States)

    Windsor, Liliane Cambraia; Thompson, Sanna J

    2008-07-01

    This paper discusses homeless youth in the US focusing on educational issues addressed by the implementation of the McKinney-Vento Homeless Education Assistance Improvements Act of 2001. This law requires that states ensure each homeless child has equal access to public education. Moreover, the law requires states to identify and remove barriers to homeless children's education, such as requirements for previous school records and proof of residency. Following description of homelessness, educational issues, and barriers for homeless youth, the McKinney-Vento Act is described as it is applied in Texas. Finally, the paper concludes that further development, education, and commitment from service providers in schools and other community agencies will be needed to improve outcomes for these highly vulnerable youth.

  8. Australian homeless persons' experiences of social connectedness, isolation and loneliness.

    Science.gov (United States)

    Bower, Marlee; Conroy, Elizabeth; Perz, Janette

    2018-03-01

    Both loneliness and a lack of social integration are associated with serious physical and psychological health issues. One population highly susceptible to social isolation and loneliness are individuals who are homeless, who also experience high rates of mental disorder and relationship breakdown. Despite this, little research has explored how social networks, isolation and loneliness are experienced for those with a history of homelessness. In-depth, semi-structured interviews were used to get a nuanced understanding of how social networks and isolation are experienced and understood by individuals experiencing homelessness. Sixteen participants who were either homeless (n = 11) or previously homeless (n = 5) in Sydney, Australia, completed one-off interviews that were audio-recorded and transcribed. Data were analysed using thematic analysis. Participants constructed their social networks as being both constrained and enabled by marginalisation. They experienced rejection from the non-homeless: the loss of critical network members, including rejection from family and a lack of companionship, and low quality and precarious relationships within the homeless community. These accounts were best conceptualised through loneliness theory. Participant's accounts signal that the homeless will likely continue feeling isolated if mainstream attitudes towards homelessness remain stigmatising and discriminatory. © 2017 John Wiley & Sons Ltd.

  9. The Factor Structure of the Brief Psychiatric Rating Scale (Expanded Version) in a Sample of Forensic Psychiatric Patients

    NARCIS (Netherlands)

    Beek, J. van; Vuijk, P.J.; Harte, J.M.; Smit, B.L.; Nijman, H.L.I.; Scherder, E.J.A.

    2015-01-01

    Severe behavioral problems, aggression, unlawful behavior, and uncooperativeness make the forensic psychiatric population both hard to treat and study. To fine-tune treatment and evaluate results, valid measurement is vital. The Brief Psychiatric Rating Scale-Extended (BPRS-E) is a widely used scale

  10. The factor structure of the Brief Psychiatric Rating Scale (Expanded version) in a sample of forensic psychiatric patients

    NARCIS (Netherlands)

    van Beek, J.; Vuijk, P.J.; Harte, J.M.; Smit, B.L.; Nijman, H.; Scherder, E.J.A.

    2015-01-01

    Severe behavioral problems, aggression, unlawful behavior, and uncooperativeness make the forensic psychiatric population both hard to treat and study. To fine-tune treatment and evaluate results, valid measurement is vital. The Brief Psychiatric Rating Scale-Extended (BPRS-E) is a widely used scale

  11. Self-management of health care: multimethod study of using integrated health care and supportive housing to address systematic barriers for people experiencing homelessness.

    Science.gov (United States)

    Parsell, Cameron; Ten Have, Charlotte; Denton, Michelle; Walter, Zoe

    2017-04-07

    Objectives The aims of the present study were to examine tenants' experiences of a model of integrated health care and supportive housing and to identify whether integrated health care and supportive housing improved self-reported health and healthcare access. Methods The present study used a mixed-method survey design (n=75) and qualitative interviews (n=20) performed between September 2015 and August 2016. Participants were tenants of permanent supportive housing in Brisbane (Qld, Australia). Qualitative data were analysed thematically. Results Integrated health care and supportive housing were resources for tenants to overcome systematic barriers to accessing mainstream health care experienced when homeless. When homeless, people did not have access to resources required to maintain their health. Homelessness meant not having a voice to influence the health care people received; healthcare practitioners treated symptoms of poverty rather than considering how homelessness makes people sick. Integrated healthcare and supportive housing enabled tenants to receive treatment for health problems that were compounded by the barriers to accessing mainstream healthcare that homelessness represented. Conclusions Extending the evidence about housing as a social determinant of health, the present study shows that integrated health care and supportive housing enabled tenants to take control to self-manage their health care. In addition to homelessness directly contributing to ill health, the present study provides evidence of how the experience of homelessness contributes to exclusions from mainstream healthcare. What is known about the topic? People who are homeless experience poor physical and mental health, have unmet health care needs and use disproportionate rates of emergency health services. What does the paper add? The experience of homelessness creates barriers to accessing adequate health care. The provision of onsite multidisciplinary integrated health care in

  12. Recurrent abdominal pain in children: psychiatric diagnoses and parental psychopathology.

    Science.gov (United States)

    Garber, J; Zeman, J; Walker, L S

    1990-07-01

    Approximately 12% of children report recurrent episodes of abdominal pain. In only about 10% of these cases, however, can an organic etiology be identified, and therefore it often is assumed that these children have emotional problems. To test this hypothesis, children with recurrent abdominal pain (RAP) with no identifiable organic cause were compared to children with an organic diagnosis for their abdominal pain, children with psychiatric disorders, and healthy controls. Both groups of children with abdominal pain had significantly more psychiatric disorders (predominantly anxiety and depression) than did the healthy group. Both RAP and psychiatric children had significantly higher Child Behavior Checklist internalizing scores; psychiatric children were rated as significantly more maladjusted on the Children's Global Assessment Scale. Mothers of RAP children were significantly more anxious than mothers of organic pain and healthy children. Psychiatric children were significantly more likely than the other three groups to underreport their psychiatric symptoms relative to their mothers.

  13. Psychiatric disorders and sleep issues.

    Science.gov (United States)

    Sutton, Eliza L

    2014-09-01

    Sleep issues are common in people with psychiatric disorders, and the interaction is complex. Sleep disorders, particularly insomnia, can precede and predispose to psychiatric disorders, can be comorbid with and exacerbate psychiatric disorders, and can occur as part of psychiatric disorders. Sleep disorders can mimic psychiatric disorders or result from medication given for psychiatric disorders. Impairment of sleep and of mental health may be different manifestations of the same underlying neurobiological processes. For the primary care physician, key tools include recognition of potential sleep effects of psychiatric medications and familiarity with treatment approaches for insomnia in depression and anxiety. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. How Do We Measure Success in Homelessness Services? : Critically Assessing the Rise of the Homelessness Outcomes Star

    OpenAIRE

    Johnson, Guy; Pleace, Nicholas

    2016-01-01

    The Homelessness Outcomes Star (HOS) is probably the most widespread form of outcome measurement employed by homelessness service providers. Developed in the UK, the HOS is now being used by homelessness services in other European countries and Australia, while being promoted internationally as a validated set of key performance indicators. This paper examines the ideological framework that underpins the HOS, as well as the theoretical and methodological approaches that inform its operation. ...

  15. Characteristics, clinical course, and outcomes of homeless and non-homeless patients admitted to ICU: A retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Orla M Smith

    Full Text Available Little is known about homeless patients in intensive care units (ICUs.To compare clinical characteristics, treatments, and outcomes of homeless to non-homeless patients admitted to four ICUs in a large inner-city academic hospital.63 randomly-selected homeless compared to 63 age-, sex-, and admitting-ICU-matched non-homeless patients.Compared to matched non-homeless, homeless patients (average age 48±12 years, 90% male, 87% admitted by ambulance, 56% mechanically ventilated, average APACHE II 17 had similar comorbidities and illness severity except for increased alcohol (70% vs 17%,p<0.001 and illicit drug(46% vs 8%,p<0.001 use and less documented hypertension (16% vs 40%,p = 0.005 or prescription medications (48% vs 67%,p<0.05. Intensity of ICU interventions was similar except for higher thiamine (71% vs 21%,p<0.0001 and nicotine (38% vs 14%,p = 0.004 prescriptions. Homeless patients exhibited significantly lower Glasgow Coma Scores and significantly more bacterial respiratory cultures. Longer durations of antibiotics, vasopressors/inotropes, ventilation, ICU and hospital lengths of stay were not statistically different, but homeless patients had higher hospital mortality (29% vs 8%,p = 0.005. Review of all deaths disclosed that withdrawal of life-sustaining therapy occurred in similar clinical circumstances and proportions in both groups, regardless of family involvement. Using multivariable logistic regression, homelessness did not appear to be an independent predictor of hospital mortality.Homeless patients, admitted to ICU matched to non-homeless patients by age and sex (characteristics most commonly used by clinicians, have higher hospital mortality despite similar comorbidities and illness severity. Trends to longer durations of life supports may have contributed to the higher mortality. Additional research is required to validate this higher mortality and develop strategies to improve outcomes in this vulnerable population.

  16. Food security among individuals experiencing homelessness and mental illness in the At Home/Chez Soi Trial.

    Science.gov (United States)

    O'Campo, Patricia; Hwang, Stephen W; Gozdzik, Agnes; Schuler, Andrée; Kaufman-Shriqui, Vered; Poremski, Daniel; Lazgare, Luis Ivan Palma; Distasio, Jino; Belbraouet, Slimane; Addorisio, Sindi

    2017-08-01

    Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population. At Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months). Community settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver). Homeless adults with mental illness (n 2148). Approximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites. Our large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.

  17. Effects of a nurse-managed program on hepatitis A and B vaccine completion among homeless adults.

    Science.gov (United States)

    Nyamathi, Adeline; Liu, Yihang; Marfisee, Mary; Shoptaw, Steven; Gregerson, Paul; Saab, Sammy; Leake, Barbara; Tyler, Darlene; Gelberg, Lillian

    2009-01-01

    Hepatitis B virus (HBV) infection constitutes a major health problem for homeless persons. Ability to complete an HBV vaccination series is complicated by the need to prioritize competing needs, such as addiction issues, safe places to sleep, and food, over health concerns. The objectives of this study were to evaluate the effectiveness of a nurse-case-managed intervention compared with that of two standard programs on completion of the combined hepatitis A virus (HAV) and HBV vaccine series among homeless adults and to assess sociodemographic factors and risk behaviors related to the vaccine completion. A randomized, three-group, prospective, quasi-experimental design was conducted with 865 homeless adults residing in homeless shelters, drug rehabilitation sites, and outdoor areas in the Skid Row area of Los Angeles. The programs included (a) nurse-case-managed sessions plus targeted hepatitis education, incentives, and tracking (NCMIT); (b) standard targeted hepatitis education plus incentives and tracking (SIT); and (c) standard targeted hepatitis education and incentives only (SI). Sixty-eight percent of the NCMIT participants completed the three-series vaccine at 6 months, compared with 61% of SIT participants and 54% of SI participants. NCMIT participants had almost 2 times greater odds of completing vaccination than those of participants in the SI program. Completers were more likely to be older, to be female, to report fair or poor health, and not to have participated in a self-help drug treatment program. Newly homeless White adults were significantly less likely than were African Americans to complete the vaccine series. The use of vaccination programs incorporating nurse case management and tracking is critical in supporting adherence to completion of a 6-month HAV/HBV vaccine. The finding that White homeless persons were the least likely to complete the vaccine series suggests that programs tailored to address their unique cultural issues are needed.

  18. Childhood antecedents of incarceration and criminal justice involvement among homeless veterans.

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2013-10-01

    Although criminal justice involvement and incarceration are common problems for homeless veterans, few studies have examined childhood risk factors for criminal justice involvement among veterans. This study examined the association between three types of childhood problems, family instability, conduct disorder behaviors, and childhood abuse, and criminal justice involvement and incarceration in adulthood. Data from 1,161 homeless veterans across 19 sites participating in the Housing and Urban Development-Veterans Affairs Supportive Housing program were examined. After controlling for sociodemographics and mental health diagnoses, veterans who reported more conduct disorder behaviors during childhood tended to report more criminal charges of all types, more convictions, and longer periods of incarceration during adulthood. However, the variance explained in criminal behavior by childhood was not large, suggesting that there are other factors that affect the trajectory by which homeless veterans become involved in the criminal justice system. Further research is needed to intervene in the pathway to the criminal justice system and guide efforts to prevent incarceration among veterans. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  19. Student-led oral health education for the homeless community of East London.

    Science.gov (United States)

    Pritchett, R M; Hine, C E; Franks, M A; Fisher-Brown, L

    2014-07-01

    Within the BDS curriculum, dental public health and the importance of social responsibility is clearly emphasised though often in a didactic manner, without practical application. Preventative concepts are taught and relayed to individual patients being treated within a dental school. The impact of oral disease on general health within disadvantaged communities is a problem commonly addressed by healthcare professionals. Part of this responsibility should be shared with and experienced by the next generation of dental practitioners through health education outreach programmes within the undergraduate curriculum. Not only will this benefit recipients within disadvantaged populations such as the homeless, but it will also develop and encourage a philosophy of social responsibility throughout the future careers of undergraduate dental and hygiene/therapy students. To explore the feasibility of achieving this objective, we devised an oral health awareness programme to address the needs of 'hard to reach' homeless people within the communities served by the Community Dental Service of Tower Hamlets, City and Hackney, London.

  20. Barriers and facilitators to Veterans Administration collaboration with community providers: the Lodge Project for homeless veterans.

    Science.gov (United States)

    Cretzmeyer, Margaret; Moeckli, Jane; Liu, William Ming

    2014-01-01

    Since 2009, the U.S. Veterans Administration has made concentrated efforts to end homelessness among veterans. As part of these efforts, the Iowa City, Iowa, VA Health Care System in collaboration with local community providers deployed a supportive housing program aimed at homeless veterans. Called the Lodge program, it is intended to serve a Mid-Western mid-size city and its surrounding rural communities. This article presents qualitative findings from a mixed-method, two-year formative evaluation of the Lodge's implementation. Primary barriers to the effectiveness of the Lodge program were regulations hindering cooperation between service programs, followed by problems regarding information sharing and client substance abuse. Facilitators included personal communication and cooperation between individuals within and among service groups. The feasibility of implementing a Lodge program in a more rural community than Iowa City was also discussed.

  1. The distinguishing factor of migration in homelessness

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Navarro Lashayas

    2016-06-01

    Full Text Available In recent years has increased the number of homeless immigrants. The article shows the relationship between legal status and acculturative stress with sociodemographic variables, social support, substance abuse, stressful life events and emotional distress in a sample of 107 homeless migrants. To this end has been made In-depth interviews and self-reports analyzing relationships between variables using various techniques of data analysis and content analysis. The results show the importance of the qualitative variable for «legal status» that has little correlation with the other variables. It also highlights the importance of social resources in acculturative stress over other variables such as culture shock or nostalgia for the country.

  2. Violence, self-harm, victimisation and homelessness in patients admitted to an acute inpatient unit in South Australia.

    Science.gov (United States)

    Ash, David; Galletly, Cherrie; Haynes, John; Braben, Peter

    2003-06-01

    To measure the incidence of traumatic and potentially socially disruptive events prior to admission to a psychiatric hospital. One hundred and nineteen patients were interviewed and further information was obtained from case notes. Data were collected concerning rates of violence, self-harm, threats of violence or self-harm, physical assault and homelessness. The patients' mean age was 35 years, 70% were male and 77% were currently single. More than half were legally detained. The most common diagnoses were substance abuse disorders, schizophrenia and related psychoses and mood disorders. Eighteen per cent of patients were physically violent at the time of admission. They were more likely to have a diagnosis of substance abuse. Significantly more men (30%) than women (8%) made threats of violence. Eighteen per cent of patients had physically harmed themselves. Significantly more women (70%) than men (40%) had threatened to harm themselves. Eight per cent of patients had been physically assaulted prior to admission. Twenty-seven per cent of patients were homeless. These patients were severely disabled with high rates of comorbidity. Socially disruptive behaviours were common, and almost a quarter of the patients were homeless. This study highlights the need for development of targeted services in the community.

  3. Poverty, Homelessness, and Family Break-Up.

    Science.gov (United States)

    Shinn, Marybeth; Gibbons-Benton, Jessica; Brown, Scott R

    2015-01-01

    This study examines the extent and correlates of family separations in families experiencing homelessness. Of 2,307 parents recruited in family shelters across 12 sites, a tenth were separated from partners and a quarter from one or more children. Additional separations before and after shelter entry and reasons, from parents' perspectives, were documented in qualitative interviews with a subsample of 80 parents. Separations were associated with economic hardship, shelter conditions, and family characteristics.

  4. Psychiatric services: a platform for MTM.

    Science.gov (United States)

    Lynum, Karimah S Bell; Hill, Angela M

    2015-02-01

    Deinstitutionalization in the 1960s shifted the care of the mentally ill from state-funded institutions to community settings. Unfortunately, funding to support the treatment needs of this population has continued to be minimized, and countless individuals have not received much needed care. This has resulted in a large increase in mentally ill patients surfacing in jails, homeless shelters, and emergency departments. Subsequently, the federal government has begun to prioritize funding to address the mental health needs of our communities. Pharmacists are in a unique position to influence treatment outcomes for patients with mental illnesses, and the current state of health reform provides avenues for the pharmacist to become an essential part of the health care delivery team in numerous ambulatory care clinical settings. The challenges with adherence, medical and psychiatric comorbidities, polypharmacy with psychotropics, potential for life-threatening adverse effects, and the ever-present need for patient education are but a few reasons why pharmacists can be utilized to provide Medication Therapy Management services for these patients. © The Author(s) 2015.

  5. Patient Aggression and the Wellbeing of Nurses: A Cross-Sectional Survey Study in Psychiatric and Non-Psychiatric Settings

    Directory of Open Access Journals (Sweden)

    Virve Pekurinen

    2017-10-01

    worse subjective health and work ability than both of the non-psychiatric nursing groups, while their psychiatric wellbeing is better and they have less sleep problems compared to medical and surgical nurses. Psychiatric nurses maintain better psychiatric wellbeing and experience fewer sleep problems than non-psychiatric nurses after events of exposure to patient aggression. This suggest that more attention should be given to non-psychiatric settings for maintaining the wellbeing of nurses after exposure to patient aggression.

  6. Content Analysis of Advantages and Disadvantages of Drinking Among Individuals With the Lived Experience of Homelessness and Alcohol Use Disorders.

    Science.gov (United States)

    Collins, Susan E; Taylor, Emily; Jones, Connor; Haelsig, Laura; Grazioli, Véronique S; Mackelprang, Jessica L; Holttum, Jessica; Koker, Molly; Hatsukami, Alyssa; Baker, Madeline; Clifasefi, Seema L

    2018-01-02

    Alcohol use disorders (AUDs) are more prevalent among people who are homeless than in the general population. Thus, homeless individuals experience disproportionately high levels of alcohol-related problems and associated publicly funded criminal justice and healthcare system utilization. Available treatment services, however, are not effective at engaging and treating this population. To better tailor treatment services to their needs, it is imperative we understand this population's perceptions of their alcohol use. The aim of this study was to provide description and relative rankings of the advantages and disadvantages of alcohol use from this population's perspectives. Participants were 44 individuals with lived experiences of AUDs and homelessness who received services at community-based agencies in Seattle, Washington. Open-ended prompts were used in interviews conducted in 2013-2014 to assess the perceived role of alcohol in participants' lives, including participants' perceptions of the advantages and disadvantages of their current drinking, and a conventional content analysis was conducted. The most frequently mentioned advantages of drinking included positively and negatively reinforcing psychological reasons, perceived control over drinking, and social benefits. Physical effects, concerns about dependence on alcohol, and health problems were the most commonly mentioned disadvantages. Conclusions/importance: By documenting the perceived advantages and disadvantages of drinking among people with the lived experience of homelessness and AUDs, this study supplies information providers may use to better tailor treatment services to this multimorbid, high service-utilizing population's needs and interests.

  7. Shelter-based convalescence for homeless adults in Amsterdam: a descriptive study

    Directory of Open Access Journals (Sweden)

    Klazinga Niek

    2009-11-01

    Full Text Available Abstract Background Adequate support for homeless populations includes shelter and care to recuperate from illness and/or injury. This is a descriptive analysis of diagnoses and use of shelter-based convalescence in a cohort of homeless adults in Amsterdam. Methods Demographics of ill homeless adults, diagnoses, referral pattern, length of stay, discharge locations, and mortality, were collected by treating physicians during outreach care provision in a shelter-based convalescence care facility in Amsterdam, from January 2001 through October 2007. Results 629 individuals accounted for 889 admissions to the convalescence care facility. 83% were male and 53% were born in the Netherlands. The mean age was 45 years (SD 10 years. The primary physical problems were skin disorders (37%, respiratory disorders (33%, digestive disorders (24% and musculoskeletal disorders (21%. Common chronic conditions included addictions 78%, mental health disorders 20%, HIV/AIDS 11% and liver cirrhosis 5%. Referral sources were self-referred (18%, general hospitals (21% and drug clinics (27%. The median length of stay was 20 days. After (selfdischarge, 63% went back to the previous circumstances, 10% obtained housing, and 23% went to a medical or nursing setting. By March 2008, one in seven users (n = 83; 13% were known to have died, the Standard Mortality Ratio was 7.5 (95% CI: 4.1-13.5. Over the years, fewer men were admitted, with significantly more self neglect, personality disorders and cocaine use. Lengths of stay increased significantly during the study period. Conclusion Over the last years, the shelter-based convalescence care facility users were mainly homeless single males, around 45 years of age, with chronic problems due to substance use, mental health disorders and a frail physical condition, many of whom died a premature death. The facility has been flexible and responsive to the needs of the users and services available.

  8. Electronic case management with homeless youth.

    Science.gov (United States)

    Bender, Kimberly; Schau, Nicholas; Begun, Stephanie; Haffejee, Badiah; Barman-Adhikari, Anamika; Hathaway, Jessica

    2015-06-01

    Case management, a widely practiced form of service brokerage, is associated with a variety of positive outcomes for homeless youth, but it may be difficult to implement, as youth face logistical barriers to attending in-person meetings. As part of a larger clinical trial, the current study investigates the feasibility of providing electronic case management (ECM) to homeless youth, using cell-phones, texts, email, and Facebook. Youth were given prepaid cell-phones and a case manager who provided four ECM sessions every 2-3 weeks over a 3-month period. Contact logs were used to record how many youth engaged in ECM, how many attempts were necessary to elicit engagement, and youths' preferred technology methods for engaging. Although engagement in the number of ECM sessions varied, the majority of youth (87.5%) engaged in at least one ECM session. Youth (41%) most commonly needed one contact before they engaged in an ECM session, and the majority responded by the third attempt. While youth most commonly answered calls directly, their chosen method of returning calls was texting. The majority of youth (80%) described ECM positively, reporting themes of convenience, connection, and accountability. The use of ECM, particularly of texting, offers promising implications for providing services to homeless youth. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Factors Associated with Community Participation among Individuals Who Have Experienced Homelessness

    Directory of Open Access Journals (Sweden)

    Feng-Hang Chang

    2015-09-01

    Full Text Available Community participation is an important goal for people who have experienced homelessness. The aim of this study was to use the International Classification of Functioning, Disability and Health (ICF as a framework to examine factors associated with community participation among people who are homeless or recently housed through housing programs. Participants (n = 120 recruited from six housing placement and search programs completed measures of community participation (including productivity, social and leisure, and community-services-use domains, psychiatric and physical symptoms, functional limitations, and a demographic form. Multiple regression analyses were used to identify predictors of overall community participation and subdomain scores. Results suggested that cognitive and mobility limitations, relationship status, and housing status significantly predicted both overall participation and participation in productivity and social and leisure subdomains. Participants who were housed through housing programs, who had cognitive and mobility limitations, and who were single showed less community participation. The findings suggest that activity limitations and environmental and personal factors may need to be addressed in efforts to enhance community participation in this population.

  10. A Post-Hurricane Katrina Examination of Substance Abuse Treatment Discharges With Co-Occurring Psychiatric and Substance Use Disorders.

    Science.gov (United States)

    Shuler, Monique; Suzuki, Sumihiro; Podesta, Arwen; Qualls-Hampton, Raquel; Wallington, Sherrie Flynt

    2017-01-01

    There is increasing literature supporting the adverse effects of disasters on substance use and psychiatric disorders. The co-occurrence of psychiatric disorders with substance use intensifies the challenge of treatment delivery. Thus the aim of this study was to examine the prevalence of substance use, treatment characteristics, and demographics of discharges from substance abuse treatment in New Orleans, post-Hurricane Katrina. Trends associated with discharges that have a co-occurring psychiatric and substance use disorder (COD) were also assessed. The secondary aim of this study was to examine the association of successful substance abuse treatment completion among those with a COD post-Hurricane Katrina. Substance abuse treatment discharge data (N = 16,507) from New Orleans, Louisiana, for years 2006 through 2011 were obtained from the Treatment Episode Data Set-Discharge. Multiple logistic regression analysis was employed to examine the association of discharges with a COD and completion of substance abuse treatment. Demographic, psychiatric, and treatment characteristics of discharges in 2006 were compared to characteristics in 2011. Trends of characteristics were also assessed through the study period. Roughly a third (35.2%) of all discharges in New Orleans from 2006 to 2011 had a COD. After controlling for race, employment, treatment service setting at discharge, primary substance problem, and the discharge's principal source of referral, discharges with a COD were 29% less likely to complete treatment as compared to those with no COD (AOR = 0.71, 95% CI [0.56, 0.90], p = .004). Treatment completion among discharges with a COD has significantly declined from 36.8% in 2006 to 18.7% in 2011 (p Substance abuse treatment undergoes various changes in the event of a natural disaster. These changes may increase challenges for successful treatment completion for vulnerable populations such as those with a COD. Results of this study demonstrate that discharges

  11. Multilevel Considerations of Family Homelessness and Schooling in the Recession Era

    Science.gov (United States)

    Miller, Peter; Schreiber, James

    2012-01-01

    This mixed methods investigation of homeless education in a major urban region identified a number of significant developments and dilemmas amid the larger homeless crisis in the United States. We found that the wider community demographics of homelessness have shifted in recent years, resulting in a higher number of homeless families--many of…

  12. 77 FR 45421 - Homeless Emergency Assistance and Rapid Transition to Housing: Continuum of Care Program

    Science.gov (United States)

    2012-07-31

    ... commitment to the goal of ending homelessness; provide funding for efforts by nonprofit providers, and State... and dislocation caused to homeless individuals, families, and communities by homelessness; promote... optimize self-sufficiency among individuals and families experiencing homelessness. The HEARTH Act...

  13. Learning from Families Experiencing Homelessness--How School Leaders Can Make a Difference through Transformative Leadership

    Science.gov (United States)

    Warke, Amy L.

    2012-01-01

    Homelessness is a growing phenomenon, especially among women and children (Hulchanski, 2009). This study was conducted because of the increase in families experiencing homelessness registering in my school. In none of the current studies about homelessness have the researchers spoken to the families and children experiencing homelessness. This…

  14. 78 FR 26559 - Homeless Emergency Assistance and Rapid Transition to Housing: Rural Housing Stability Assistance...

    Science.gov (United States)

    2013-05-07

    ... creates the Rural Housing Stability Assistance program to replace the Rural Homelessness Grant program... definition on what constitutes an occasion of homelessness or homeless occasion. In the CoC interim rule, and... Rural Homelessness Grant program, and consequently regulations were never promulgated. Accordingly, this...

  15. Homelessness among Lesbian, Gay, and Bisexual Youth: Implications for Subsequent Internalizing and Externalizing Symptoms

    Science.gov (United States)

    Rosario, Margaret; Schrimshaw, Eric W.; Hunter, Joyce

    2012-01-01

    Although lesbian, gay, and bisexual (LGB) youth with a history of homelessness (running away or being evicted from their homes by parents) report more psychological symptoms than homeless heterosexual peers, it is unclear whether symptoms are due to homelessness, given the absence of a non-homeless comparison group. This study longitudinally…

  16. 75 FR 29366 - ``Homeless Veterans' Reintegration Program (HVRP) National Technical Assistance Center...

    Science.gov (United States)

    2010-05-25

    ... of the Assistant Secretary for Veterans' Employment and Training ``Homeless Veterans' Reintegration... the Homeless Veterans' Reintegration Program (HVRP) to include the Homeless Female Veterans and... to expedite the reintegration of homeless Veterans into the labor force. In order to assist the USDOL...

  17. Difficult Behaviors in the Emergency Department: A Cohort Study of Housed, Homeless and Alcohol Dependent Individuals

    National Research Council Canada - National Science Library

    Svoboda, Tomislav

    2015-01-01

    ... about homelessness and difficult behaviours shows that homelessness and alcohol use are risk factors.[9,10] Individuals who are chronically homeless and heavy alcohol users form a recognizable subset of the homeless population and are anecdotally known to experience more difficulties with behaviours.[11–15] Terms such as “public inebriates,”...

  18. Homeless Education and Social Capital: An Examination of School and Community Leaders

    Science.gov (United States)

    Miller, Peter M.

    2011-01-01

    Background/Context: This study contributes to the literature on the schooling of homeless and highly mobile students. Although previous work has detailed the demographics of homelessness, the effects of homelessness on academic progress, and particular legal issues in homeless education, this research focused on how individual and institutional…

  19. The Role of Sleep in Childhood Psychiatric Disorders

    OpenAIRE

    Alfano, Candice A.; Gamble, Amanda L.

    2009-01-01

    Although sleep problems often comprise core features of psychiatric disorders, inadequate attention has been paid to the complex, reciprocal relationships involved in the early regulation of sleep, emotion, and behavior. In this paper, we review the pediatric literature examining sleep in children with primary psychiatric disorders as well as evidence for the role of early sleep problems as a risk factor for the development of psychopathology. Based on these cumulative data, possible mechanis...

  20. Psychiatric patient and anaesthesia

    Directory of Open Access Journals (Sweden)

    Joginder Pal Attri

    2012-01-01

    Full Text Available Many patients with psychiatric illnesses are prescribed long-term drug treatment, and the anaesthesiologist must be aware of potential interactions with anaesthetic agents. Psychotropic drugs often given in combination with each other or with other non-psychiatric drugs generally exert profound effects on the central and peripheral neurotransmitter and ionic mechanisms. Hence, prior intake of these drugs is an important consideration in the management of the patient about to undergo anaesthesia and surgery. This article highlights the effects of anaesthetics on patients taking antipsychotics, tricyclic antidepressants, monoamine oxidase inhibitors and lithium carbonate. The risk that should be considered in the perioperative period are the extent of surgery, the patient′s physical state, anaesthesia, the direct and indirect effects of psychotropics, risk of withdrawal symptoms and risk of psychiatric recurrence and relapse.