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

Abstract

BackgroundHomelessness 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.ObjectivesThe 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.MethodsA 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.ResultsSeventy-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).ConclusionsFamily 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.

Health problems and healthcare service utilisation amongst homeless adults in Africa- a scoping review

“…Apart from one study from North Africa [40], all other studies were conducted in sub- Sahara Africa predominantly South Africa [30,[36][37][38]44] and Ethiopia [11,39,42,45,46]. The remaining studies were conducted in Nigeria [35], Ghana [41], and Mozambique [43].…”

“…Studies mostly drew sample from rough sleepers [11, 35-37, 39, 42, 43, 46]. Studies also drew samples from people in squats and slums [41], and people in accommodation services including homeless clinics, shelters and drop-in centres [30,43,44]. One study sampled from both streets and shelters [38], and one study failed to mention category of homeless people studied [40].…”

“…Skin diseases such as scabies, chicken pox, and rashes [38], headache [37,46], malaise [46], diabetes, arthritis, and dental problems [37] were also reported among both street dwellers and people in shelters. Five studies explored and reported a range of mental health problems across four sub-Saharan African countries [11,38,[41][42][43]. The studies identified three groups of mental health problems: psychotic disorders, mood disorders, self-harm and suicidal behaviour, and intellectual disability.…”

“…One of the five studies looked at general health and documented any illness reported including mental disorder [38]. The other four studies specifically examined mental disorders [11,[41][42][43], including one that specifically looked at mental, neurologic, and substance use disorder [11]. Four studies measured psychosis [11,38,42,43]; three of which were based only on street samples [11,42,43] and one sampled from both streets and shelters [38]; with sample sizes ranging from 71 to 1247.…”

“…The other four studies specifically examined mental disorders [11,[41][42][43], including one that specifically looked at mental, neurologic, and substance use disorder [11]. Four studies measured psychosis [11,38,42,43]; three of which were based only on street samples [11,42,43] and one sampled from both streets and shelters [38]; with sample sizes ranging from 71 to 1247. Regardless of differences in setting and sample sizes, three studies measured psychosis using standardised clinical assessments such as the WHO Self Reporting Questionnaire (SRQ20) [11], Psychosis Screening Questionnaire (PSQ) [42], and Mini International Neuropsychiatric Interview (MINI) [43], and prevalence estimates ranged from 68 to 88% (see supplementary Table 2).…”