Mental illness among homeless individuals in a suburban county

• Published in: Psychiatric services (Washington, D.C.) Vol. 48; no. 4; pp. 504 - 509
• Main Authors: HAUGLAND, G, SIEGEL, C, HOPPER, K, ALEXANDER, M. J
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01-04-1997; American Psychiatric Association
• Subjects: Adolescent; Adult; Aged; Alcoholism - diagnosis; Alcoholism - epidemiology; Alcoholism - psychology; Biological and medical sciences; Cross-Sectional Studies; Female; Homeless Persons - psychology; Homeless Persons - statistics & numerical data; Humans; Incidence; Institutionalization - statistics & numerical data; Male; Medical sciences; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental health; Middle Aged; New York - epidemiology; Organization of mental health. Health systems; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotropic Drugs; Public Housing - statistics & numerical data; Social psychiatry. Ethnopsychiatry; Street Drugs; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Suburban Population - statistics & numerical data; New York; United States; North America; America; Human; Drug addiction; Community home; Homeless; Suburban environment; Follow up study; Alcoholism; Mental disorder; Evolution; Public health
• ISSN: 1075-2730; 1557-9700
• DOI: 10.1176/ps.48.4.504

OBJECTIVE: This paper compares the prevalence of mental illnesses and
alcohol and drug abuse and the residential histories of homeless
individuals identified as having a mental illness and individuals who are
not so identified. The cohort consisted of single persons applying for
shelter over a 12-week period in Westchester County, a suburban county in
New York State. METHODS: The sample of 201 persons (89 percent male, with a
mean age of 37) represented 77 percent of consecutive single shelter
applicants in a single-point-of-entry system over the study period.
Information from an intake assessment was augmented by a semistructured
interview to reconstruct subjects' residential history for the last five
years, including periods of homelessness and time in institutions. RESULTS:
Twenty-one percent of the cohort was classified as having mental illness.
Seventy-two percent had a diagnosis of drug abuse or dependence, and 51
percent had alcohol abuse or dependence. For individuals with a mental
illness, the use of cocaine and heroin was significantly lower, but alcohol
use was somewhat greater, compared with other homeless persons. Persons
with mental illness also experienced homelessness of some kind over a
significantly longer period (a mean of seven years versus a mean of three
years for other subjects), and they spent almost twice as many weeks during
the previous five years literally homeless. Institutional time, most of
which consisted of time in jail or prison, was equivalent for both groups.
CONCLUSIONS: Not only is residential instability heightened among shelter
users with mental illness, but over time public institutions play a
critical role in their accommodations. For some homeless persons with
mental illness, the circuit of shelters, rehabilitation programs, jails,
and prisons may function as a makeshift alternative to inpatient care or
supportive housing and may reinforce the marginalization of this
population.