Homeless people in Western countries have substantially higher rates of mental health problems than the general population, according to results from a systematic review and meta-analysis published in PLoS Medicine this week.
Searching for studies over the past four decades containing data on the prevalence of mental disorders in homeless people, Seena Fazel and colleagues of the University of Oxford identified 29 studies involving 5,684 homeless individuals based in the US, UK, mainland Europe, and Australia. Combining the data from the surveys, the researchers found that the prevalence of serious mental disorders was raised compared with expected rates in the general population.
The most common mental disorders appeared to be alcohol and drug abuse, with pooled prevalence estimates of 37.9% (95% CI 27.8%.0%) and 24.4% (95% CI 13.2%.6%), respectively. Furthermore, the rate of alcohol abuse has increased in recent decades. The prevalence estimates for psychosis were found to be as high as those for depression which contrasts with community estimates and other "at risk" populations such as prisoners and refugees, where depression is more common.
In an accompanying Perspective, Helen Herrman of the University of Melbourne, who was uninvolved with the research, discusses the implications of the findings for policy and planning. She notes that "The rate of mental disorders among homeless people is useful information for advocacy and for monitoring policy and practice change in a community."
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