Prolonged and persistent homelessness: multivariable analyses in a cohort experiencing current homelessness and mental illness in Vancouver, British Columbia

Abstract

Recent research and policy making concerning homelessness has focused on the particular challenges associated with ending chronic homelessness. It is generally assumed that individuals who have been homeless for longer durations have a greater impact on the public system of care and are in need of the most assistance. The aim of this study was to examine key sample characteristics by duration of homelessness (total lifetime duration and longest single episode) using bivariate and multivariable regression analysis. Participants (n ¼ 425) were adults recruited in Vancouver, BC on the basis of absolute homelessness or precarious housing and a current mental disorder. Interviewer-administered questionnaires elicited details concerning demographics, mental illness, substance use, service use, and duration of homelessness. In multivariable models, ''persistent'' homelessness (lifetime duration of three or more years) was independently predicted by male gender, older age, younger age when first homeless, incomplete high school, past month alcohol use, and daily illicit drug use. ''Prolonged'' homelessness, a single episode of one year or more, was independently predicted by older age, younger age when first homeless, current substance dependence, daily illicit drug use, and not seeing a psychiatrist in the past month. Substance use is strongly associated with prolonged and persistent homelessness among people with mental disorders, as is the early experience of first becoming homeless. Our findings replicate and extend those of previous studies, and are discussed in terms of their implications for service delivery and the broader construct of social inclusion.

Daily Substance Use and Mental Health Symptoms among a Cohort of Homeless Adults in Vancouver, British Columbia

“…1,2 Homeless individuals who use substances are more likely to drop out of treatment programs, 3 have higher rates of post-treatment relapse, 4 premature mortality, 5 chronic physical illness, and longer durations of homelessness. 6 Recently, Housing First has been shown to be effective among homeless individuals with active substance use disorders. 2,7 However, while substance use per se was prevalent among participants in these studies, the implications of different severities and forms of substance use have not been well characterized in this context.…”

Are Substance Use and Mental Illness Associated to an Earlier Onset of Homelessness?

“…or more, was significantly associated with younger age when first homeless, incomplete high school education, having children under the age of eighteen years, having more than one current mental disorder or a current substance dependence, infectious disease positivity, history of head injury, needing health care but not receiving it, not having seen a psychiatrist, contact with the police that did not result in arrest. Prolonged homelessness was independently predicted by older age at enrollment in the study, younger age when first becoming homeless, a current substance dependence, daily illicit drug use, not having seen a psychiatrist in the past month [43].…”

Patología dual en poblaciones especiales: una revisión narrativa

“…Diversos estudios han encontrado prevalencias de PD en esta población que pueden variar entre 10 y 60%, siendo las concurrencias de TCS con trastornos psicóti-cos, afectivos y de ansiedad, las más prevalentes (Fazel, Khosla, Doll, & Geddes, 2008;Fichter & Quadflieg, 2005;Nielsen, Hjorthøj, Erlangsen, & Nordentoft, 2011;Patterson et al, 2012;Torchalla, Strehlau, Li, & Krausz, 2011). Con respecto a las diferencias de género, se ha encontrado que el riesgo de mortalidad atribuible a la PD es significativamente mayor en mujeres que en hombres (Nielsen et al, 2011).…”