Systematic review and meta‐analyses of randomized control trials of the effectiveness of psychosocial interventions for homeless adults

Abstract

Aims To evaluate the effect of psychosocial interventions for homeless adults on their psychosocial outcomes. Design A systematic review and meta‐analyses were performed for critical appraisal and synthesis of the included studies. Data sources A systematic search of studies published before 10 September 2018 was performed using PubMed, Cochrane Library, EMBASE, PsycINFO, and CINAHL. Review methods The review included randomized controlled trials conducting psychosocial interventions and assessing psychosocial outcomes for homeless adults. After systematically describing study and intervention characteristics, we conducted meta‐analyses by the type of outcome and subgroup meta‐analyses by the type of intervention and outcome. Fourteen studies were included in this review and 11 were included in the meta‐analyses. Results A significant effect of psychosocial interventions in reducing anxiety and enhancing mental health status among homeless adults was noted. Conclusion The meta‐analyses showed that psychosocial interventions may reduce anxiety and enhance the mental health status of homeless people. Specifically, we suggest that relaxation response training may be effective in improving anxiety and mental health status and cognitive behavioural therapy may reduce anxiety. Impact Although psychosocial interventions for homeless persons have been implemented for a decade, their impact for psychosocial outcomes among homeless adults has not been evaluated. This review suggest that psychosocial interventions may improve anxiety and mental health status among homeless adults. The findings of the present study may provide directions for developing psychosocial interventions to help vulnerable homeless adults in managing psychological outcomes.

Homelessness and health-related outcomes: an umbrella review of observational studies and randomized controlled trials

“…Although substantially overlapping, we nonetheless recorded “people not experiencing homelessness” and “general population” controls, as documented by the original study at review. The included MA of RCTs controlled for various treatment exposures [ 220 ].…”

“…One eligible MA of intervention studies documented two therapeutic interventions, evaluated by 10 unique RCTs from 10 original reports, estimating interventions associated with mental health status among PEH [ 220 ]. One association concerned the psychological interventions among PEH diagnosed with depression, while the remaining one dealt with psychological interventions for anxiety.…”

Scoping Review: Suicide Specific Intervention Programmes for People Experiencing Homelessness

“…Most efforts to reduce suicidal ideation and behavior among people who are homeless rely on indirect approaches to prevent suicide. These include strategies to enhance mental health through the reduction of anxiety and depression, enhancing perceived self-efficacy and empowerment [ 42 ], or through interventions such as Housing First (HF). Of course, an ongoing effort to address underlying housing insecurity and to tackle primary social determinants leading to poverty should be prioritized.…”

“…However, the evidence is mixed on whether HF improves the complex mental health needs of those who are homeless compared with treatment as usual. Most studies have found that although HF is an essential intervention to provide housing stability and has been shown to increase quality of life and decrease hospital stays, it does not show greater improvements in mental health scores or reduce suicidal ideation or attempts any more than treatment as usual [ 42 , 43 ].…”

Nursing Process Addressing the Focus “Anxiety”: A Scoping Review

“…Nurses seem to play an important role in reducing anxiety as a symptom, that is, the “feeling of threat, danger or distress,” represented, for instance, on the focus and the diagnosis axes of the International Classification for Nursing Practice ® (ICNP ® ) (International Council of Nurses [ICN], 2019). Also, the efficacy and effectiveness of nursing interventions addressing anxiety have already been evaluated in several studies (e.g., Hyun et al, 2020; Sampaio et al, 2018), mostly with positive results. However, while some research has been conducted to evaluate the efficacy and effectiveness of nursing interventions addressing the nursing focus “anxiety,” no literature was identified which summarised those interventions.…”