COVID pandemic as an opportunity for improving mental health treatments of the homeless people

Martin, C.; Andrés, Pilar; Bullón, A; Villegas, José Luis Villca; Iglesia-Larrad, Javier I. de la; Bote, Berta; Prieto, N.; Roncero, Carlos

doi:10.1177/0020764020950770

Cited by 33 publications

(49 citation statements)

References 41 publications

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“…19 quantitative studies were conducted in the USA [23À41], three in Canada [42À44],three in France [16,45,46], two in Italy [47,48], and one in Belgium [49], Spain [50], Slovakia [51], and Denmark [52], respectively. The data collection period considering all studies ranged from January 2020 to October 2020.…”

Section: Resultsmentioning

confidence: 99%

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis

et al. 2021

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Background: People experiencing homelessness (PEH) may be at risk for COVID19. We synthesised evidence on SARS-Cov-2 infection, transmission, outcomes of disease, effects of non-pharmaceutical interventions (NPI), and the effectiveness of strategies for infection prevention and control (IPC). Methods: Systematic review of articles, indexed in electronic databases (EMBASE, WHOÀ ÀCovid19, Web of Science), institutional websites and the Norwegian Institute of Public Health's live map of COVID-19 evidence, and published from December 1st, 2019, to March 3rd, 2021. Empirical papers of any study design addressing Covid-19 and health(-related) outcomes in PEH or shelters' staff were included. (PROSPERO-2020-CRD42020187033) Findings: Of 536 publications, 37 studies were included (two modelling, 31 observational, four qualitative studies). Random-effect meta-analysis yields a baseline SARS-Cov-2 prevalence of 232% (95% Confidence-Interval, 95%CI=130À334) in PEH and 155% (95%CI=079À231) in staff. In outbreaks, the pooled prevalence increases to 3159% (95%CI=2048À4271) in PEH and 1480% (95%CI=1073À1887) in staff. Main IPC strategies were universal rapid testing, expansion of non-congregate housing, and in-shelter measures (bed spacing, limited staff rotation, reduction in number of residents). Interpretation: 32% of PEH and 15% staff are infected during outbreaks of SARS-Cov-2 in homeless shelters. Most studies were conducted in the USA. No studies were found quantifying health-related outcomes of NPI. Overview and evaluation of IPC strategies for PEH, a better understanding of disease transmission, and reliable data on PEH within Covid-19 notification systems are needed. Qualitative studies may serve to voice PEH and shelter staff experiences, and guide future evaluations and IPC strategies.

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Section: Resultsmentioning

confidence: 99%

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis

et al. 2021

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“…Some of the measures that the ADDU adopted in the health area of Salamanca (Spain) include the implementation of telemedicine. Simultaneously, two new health care programs were initiated: one aimed at mental health care for professionals and patients (PASMICOR) and another program for homeless people (HP) ( Martin et al, 2020 ). The staff in the ADDU have maintained face-to-face assessment with patients who required an immediate check-up, and they implemented different protective measures: the patient answered questions aimed at detecting symptoms of COVID-19 before the patient came for consultation, patients and staff wore face masks during the entire check-up, and they maintained social distance at all times.…”

Section: Methodsmentioning

confidence: 99%

A real-world ten-week follow-up of the COVID outbreak in an outpatient drug clinic in Salamanca (Spain)

Aguilar

Vicente-Hernández

Remón-Gallo

et al. 2021

Journal of Substance Abuse Treatment

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Objective To compare over ten weeks the number of relapses, hospital admissions, calls made, admissions to therapeutic communities, face-to-face visits, treatment adjustment, number of injectables administered, and number of emergencies attended due to emotional and behavioral alterations and/or substance use disorder, and to describe and quantify social emergencies in an outpatient drug clinic (ODC) in Salamanca (Spain) from March 16, 2020, to May 22, 2020. Methods This is an ecological study of the COVID pandemic over ten weeks. The study examines the set of alcohol or other drug-dependent or dual disorder patients in the population of Salamanca, Spain. The measurements were: professionals; calls made; percentage of successful calls; face-to-face visits; first visits made; reviews made; techniques; injectable treatments; other treatments; evolution; relapses. The ODC includes about 375 new patients each year and another 650 other patients annually. Results The study found the number of relapses to be greater in the last five weeks of the 10-week study period. Patients' psychopathological instability also increased, and face-to-face visits were necessary. The most frequent psychopathology that required face-to-face intervention was depressive disorder. The number of interventions with patients increased. In parallel, social workers' efforts were greater after the seventh week. There was a decrease in response to calls. Throughout this time, the ODC attended to patients who needed to be treated for the first time. Conclusions Confinement due to the coronavirus pandemic generated maladaptive emotional responses and other behaviors, such as excessive alcohol consumption. The number of face-to-face consultations, admissions, and referrals to therapeutic communities increased. Patients under stress and in social isolation resorted more often to substance use. The ODC had to adopt a flexible approach to evaluate patients with more serious problems, by using face-to-face assessments.

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“…This research has applications relevant not only to the COVID-19 pandemic, but to future periods of mental health disparity resulting of immediate social or health crises. Much of the temporary accommodation this study recruited from, created in response to the pandemic, was, or will soon be, subsequently disbanded [82,83]. The effects this may have on mental health warrant investigation.…”

Section: Future Applicationsmentioning

confidence: 99%

Depression during the COVID-19 pandemic amongst residents of homeless shelters in France

Scarlett

Davisse‐Paturet

Longchamps

et al. 2021

Preprint

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BackgroundAccumulating evidence suggests that the COVID-19 pandemic has negatively affected global mental health and well-being. However, the impact amongst homeless persons has not been fully evaluated. The ECHO study reports factors associated with depression amongst the homeless population living in shelters in France during the Spring of 2020.MethodsInterview data were collected from 527 participants living in temporary and/or emergency accommodation following France’s first lockdown (02/05/20 – 07/06/20), in the metropolitan regions of Paris (74%), Lyon (19%) and Strasbourg (7%). Interviews were conducted in French, English, or with interpreters (33% of participants, ∼20 languages). Presence of depression was ascertained using the Patient Health Questionnaire (PHQ-9).ResultsAmongst ECHO study participants, 30% had symptoms of moderate to severe depression (PHQ-9≥ 10). Multivariate analysis revealed depression to be associated with being female (aOR: 2.15; CI: 1.26-3.69), being single (aOR: 1.60; CI: 1.01-2.52), having a chronic illness (aOR: 2.32; CI: 1.43:-3.78), facing food insecurity (aOR: 2.12; CI: 1.40-3.22) and participants’ region of origin. Persons born in African and Eastern Mediterranean regions showed levels of depression comparable to those of French participants (30-33%) but higher than migrants from European countries (14%). Reduced rates of depression were observed amongst participants aged 30-49 (aOR: 0.60; CI: 0.38-0.95) and over 50 (aOR: 0.28; CI: 0.13-0.64), compared to 18-29-year-olds.ConclusionsOur results indicate high levels of depression among homeless persons during the COVID-19 pandemic. The value of these findings extends beyond the health crisis, as predicted future instability and economic repercussions could particularly impact the mental health of this vulnerable group.

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COVID pandemic as an opportunity for improving mental health treatments of the homeless people

Cited by 33 publications

References 41 publications

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis

A real-world ten-week follow-up of the COVID outbreak in an outpatient drug clinic in Salamanca (Spain)

Depression during the COVID-19 pandemic amongst residents of homeless shelters in France

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