Mental illness and substance use among sheltered homeless persons in lower-density population areas

Abstract

Although mental illness, especially psychosis, and substance abuse may be somewhat less prevalent among homeless persons in lower-density population areas than in large urban areas, they are nevertheless significant problems.

Homelessness and Depressive Symptoms

“…Fitzpatrick et al (2007) found that 31% of the homeless sampled reported suicidal ideation, a 10-fold higher rate than that of the nonhomeless population. Some other studies reported variable incidence of suicidal ideation in this special population: 17% (Coohey et al, 2014), with one third of the overall sample reporting suicidal attempts; suicidal attempts were similarly revealed in 30.3% of homeless subjects in the report by Kales et al (1995), representing one third of the sample, as well as in 26.9% in the study by Sarajlija et al (2014). Lower rates of suicidal ideation/risk were detected by Roze et al (2020) (16.9% of the sample), Hamid et al (1995) (2%), and Kaplan et al (2019) (7.8%).…”

“…Supplementary Table S1 (Supplemental Digital Content 1, http://links.lww.com/JNMD/A132) presents the measures of the studies included in the present review. There were 15 cross-sectional studies from the United States, which presented a median prevalence of depressive symptoms of 46.3%, ranging from 17.7% to 77.5% (Dawson-Rose et al, 2020; Desai et al, 2003; Diblasio and Belcher, 1993; Fitzpatrick, 2016; Fitzpatrick et al, 2007; Goldstein et al, 2012; Hernandez et al, 2020; Irwin et al, 2008; Kales et al, 1995; Lee et al, 2017; Notaro et al, 2012; Prigerson et al, 2003; Rhoades et al, 2014; Savage et al, 2006).…”

“…The remaining 10 studies used neither standard instruments nor psychiatric interviews. They used depression questions with dichotomous items, which make it difficult to compare their results (Chinman et al, 2000; D’Amore et al, 2001; Desai et al, 2003; Goldstein et al, 2012; Kales et al, 1995; Kermode et al, 1998; O’Carroll and O’Reilly, 2008; Stuart and Arboleda-Flórez, 2000; Swabri et al, 2019).…”

“…Despite considerable variability, the prevalence of depressive symptoms in adult homeless individuals is very high (Chinman et al, 2000; Coohey et al, 2014; Desai et al, 2003; Diblasio and Belcher, 1993; Goldstein et al, 2012; Greenwood et al, 2005; Hamid et al, 1995; Heckert et al, 1999; Kales et al, 1995; Keogh et al, 2015; Kermode et al, 1998; Lam and Rosenheck, 2000; McInnes et al, 2014; Notaro et al, 2012; Prinsloo et al, 2012; Rhoades et al, 2014; Sarajlija et al, 2014; Savage et al, 2006; Schanzer et al, 2007; Swabri et al, 2019). Comparative studies found higher levels of depressive symptoms among homeless individuals compared with the general population (D’Amore et al, 2001; Pluck et al, 2008; Ritchey et al, 1990).…”

“…Desai et al (2003) showed that the prevalence of suicidal ideation was 10-fold higher in homeless than in the general population, presenting a prevalence of 66.2% of suicidal ideation during the lifetime (Desai et al, 2003). In general, the incidence of suicide attempts is also high, with one third of the sample reporting lifetime attempts (Coohey et al, 2014; Kales et al, 1995). In addition, homeless people with depressive symptoms were more likely to think about suicide and even to attempt suicide than nondepressed homeless people (Lee et al, 2017).…”