Evidence-based mental health · 2014
Mental health problems in young people with experiences of homelessness and the relationship with health service use: a follow-up study.
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Hodgson Kate J, Shelton Katherine H, van den Bree Marianne B M
Аннотация
BACKGROUND: Homeless young people represent one of the most vulnerable and underserved populations.
OBJECTIVE: To assess the prevalence of psychiatric disorder and comorbidity among a UK sample, and examine the longitudinal relationship between psychiatric conditions and different types of health service use.
METHODS: 90 young people with experiences of homelessness were interviewed using a full psychiatric assessment. Participants were followed up 8-12 months later and completed an interview that included information about recent health service use (mental health, emergency room, general practitioner, hospital for physical problems, drug or alcohol services).
FINDINGS: The prevalence of psychiatric disorder (88% current; 93% lifetime) and psychiatric comorbidity (73%) was high and that of mental health service use low in comparison (31%). Mood disorders, psychosis and suicide risk were significantly associated with mental health service use (OR 5.21, 95% CI 1.64 to 16.58; OR 10.0, CI 1.58 to 94.58; OR 6.25, CI 1.82 to 21.43, respectively). Emergency department use was predicted by mood disorders (OR 5.19, CI 1.68 to 16.0), psychosis (OR 7.33, CI 1.24 to 43.29), anxiety disorder (OR 2.88, CI 1.04 to 7.97), high-suicide risk (OR 3.42, CI 1.86 to 13.67) and comorbidity (OR 1.41, CI 1.05 to 1.90).
DISCUSSION AND CLINICAL IMPLICATIONS: The prevalence of psychiatric disorders in homeless young people was high and considerably higher than that reported for this age group in the general population. There is a need for improved uptake of services delivering longer term treatment of psychiatric problems among vulnerable groups of socially excluded young people.
OBJECTIVE: To assess the prevalence of psychiatric disorder and comorbidity among a UK sample, and examine the longitudinal relationship between psychiatric conditions and different types of health service use.
METHODS: 90 young people with experiences of homelessness were interviewed using a full psychiatric assessment. Participants were followed up 8-12 months later and completed an interview that included information about recent health service use (mental health, emergency room, general practitioner, hospital for physical problems, drug or alcohol services).
FINDINGS: The prevalence of psychiatric disorder (88% current; 93% lifetime) and psychiatric comorbidity (73%) was high and that of mental health service use low in comparison (31%). Mood disorders, psychosis and suicide risk were significantly associated with mental health service use (OR 5.21, 95% CI 1.64 to 16.58; OR 10.0, CI 1.58 to 94.58; OR 6.25, CI 1.82 to 21.43, respectively). Emergency department use was predicted by mood disorders (OR 5.19, CI 1.68 to 16.0), psychosis (OR 7.33, CI 1.24 to 43.29), anxiety disorder (OR 2.88, CI 1.04 to 7.97), high-suicide risk (OR 3.42, CI 1.86 to 13.67) and comorbidity (OR 1.41, CI 1.05 to 1.90).
DISCUSSION AND CLINICAL IMPLICATIONS: The prevalence of psychiatric disorders in homeless young people was high and considerably higher than that reported for this age group in the general population. There is a need for improved uptake of services delivering longer term treatment of psychiatric problems among vulnerable groups of socially excluded young people.