Higher rates of mental illness among the homeless in Western countries

Key points
- 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.
- 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%ܳȞ.6%), respectively.
- 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.
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%ܳȞ.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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Citation: Fazel S, Khosla V, Doll H, Geddes J (2008) The prevalence of mental disorders among the homeless in Western countries: Systematic review and meta-regression analysis. PLoS Med 5(12): e225. doi:10.1371/journal.pmed.0050225
CONTACT:
Seena Fazel
University of Oxford
Psychiatry
Warneford Hospital
Oxford, Oxfordshire OX3 7JX
United Kingdom
+44 1865 226447
[email protected]
Related PLoS Medicine Perspective
Citation: Herrman H (2008) Mental disorders among homeless people in Western countries. PLoS Med 5(12): e237. doi:10.1371/journal.pmed.0050237
CONTACT:
Helen Herrman
University of Melbourne
Melbourne
Australia
[email protected]
Contact: Andrew Hyde
[email protected]
44-122-346-3330
Public Library of Science
Written and revised by
Andrey Nailor, M.D.
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