The Role of Neurocognition and Social Context in Predicting Community Functioning Among Formerly Homeless Seriously Mentally Ill Persons

Abstract

Neurocognition predicts community functioning among homeless persons with severe mental illness, but in a way that varies with the social context in which community functioning occurs.

Memory impairment among people who are homeless: A systematic review

“…Four of the included studies (Caplan et al, 2006;Schutt et al, 2007;Seidman et al, 1997;Seidman et al, 2003) were part of the Boston McKinney Project, designed to test the effects of housing on the neuropsychological functioning of severely and persistently mentally ill homeless persons in Boston. In the other studies, unique samples of homeless persons were assessed (Andersen et al, 2014;Bousman et al, 2010;Cotman & Sandman, 1997;Medalia et al, 2003;Pluck, Kwang-Hyuk, David, Spence, & Parks, 2012;Solliday-McRoy et al, 2004;Stergiopoulos, Burra, Rourke, & Hwang, 2011).…”

“…For example, Solliday-McRoy et al (2004) considered participants staying in a shelter to be homeless, while others such as Bousman et al (2010) defined homelessness as a dichotomous variable ("ever homeless" and "never homeless") according to set criteria in the Stewart B. McKinney Act of 1987. In half of the studies, the average amount of time that participants had been homeless was not reported (Caplan et al, 2006;Cotman & Sandman, 1997;Medalia et al, 2003;Schutt et al, 2007;Seidman et al, 2003). How the duration of homelessness was reported also varied greatly between studies as can be seen in Table 2.…”

“…In fact, recent research reveals that up to 80% of homeless individuals demonstrate cognitive impairments such as learning and memory (Burra et al, 2009). Cognitive impairments may interfere with an individual's ability to function independently in the community and may, therefore, increase the risk of becoming and remaining homeless (Caplan, Schutt, Turner, Goldfinger, & Seidman, 2006;Schutt, Seidman, Caplan, Martsinkiv, & Goldfinger, 2007;Solliday-McRoy, Campbell, Melchert, Young, & Cisler, 2004;Spence, Stevens, & Parks, 2004). Understanding and treating cognitive impairment in this population may be one crucial pathway to ending the cycle of homelessness for many individuals.…”

“…Longitudinal (Cohen, Forbes, Mann, & Blanchard, 2006;Milev, Ho, Arndt, & Andreasen, 2005;Schutt et al, 2007) and cross-sectional (Green, Kern, Braff, & Mintz, 2000) studies have shown that deficits in memory may have wideranging implications for social functioning. For example, the inability to retain information may create barriers to maintaining employment and managing activities of daily living such as paying bills and managing finances, which can potentially lead to homelessness.…”

Structural brain markers are differentially associated with neurocognitive profiles in socially marginalized people with multimorbid illness.

“…Poor outcomes resulting from preventable illnesses, such as viral infection and psychosis (Jones et al, 2015) and geriatric syndromes (Brown, Kiely, Bharel, & Mitchell, 2007) are most appropriate given differential levels of physical and mental health care needs . Relatedly, those with substantial impairments in executive functioning and memory would benefit most from a supportive group home environment as oppose to living alone (Schutt et al, 2007). A practical recommendation moving forward would be to screen for cognitive impairment given the central role of neurocognition in performing complex everyday activities (Gorman et al, 2009;Morgan & Heaton, 2009).…”