Explaining excess morbidity amongst homeless shelter users: A multivariate analysis for the Danish adult population

Benjaminsen, Lars; Birkelund, Jesper Fels

doi:10.1177/1403494818759839

Cited by 9 publications

(11 citation statements)

References 29 publications

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“…The epidemiological homelessness literature reports an accumulation of risk factors and exclusion mechanisms (2,(35)(36)(37). The relevance of (severe) mental illness to the risk of marginalization is generally accepted (5,(38)(39)(40)(41)(42). In the early nineties, homeless people with SMI and addiction were part of the "special populations" targeted in case management care such as Assertive Community Treatment (ACT) or Intermediate Case Management (ICM) (43,44).…”

Section: Discussionmentioning

confidence: 99%

Health Patterns Reveal Interdependent Needs of Dutch Homeless Service Users

Everdingen

Peerenboom²,

Velden

et al. 2021

Front. Psychiatry

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Background: Homelessness is an increasing problem in Western European countries. Dutch local authorities initiated cross-sectional reviews to obtain accurate health and needs information on Homeless Service (HS) users.Methods: The Homeless People Treatment and Recovery (HOP-TR) study uses a comprehensive assessment strategy to obtain health data. Using a naturalistic meta-snowball sampling in 2015–2017, 436 Dutch HS users were assessed. The lived experience of HS users was the primary data source and was enriched with professional assessments. The InterRAI Community Mental Health questionnaire and “Homelessness Supplement” provided information in different areas of life. The approach for mental health assessments was transdiagnostic. Raw interview data were recoded to assess health and needs. The positive health framework structured symptomatic, social, and personal health domains relevant to recovery.Results: Most subjects were males, low educated, with a migration background. The majority were long-term or intermittently homeless. Concurrent health problems were present in two domains or more in most (95.0%) subjects. Almost all participants showed mental health problems (98.6%); for a significant share severe (72.5%). Frequent comorbid conditions were addiction (78%), chronic physical conditions (59.2%), and intellectual impairments (39.9%).Conclusion: The HOP-TR study reveals significant concurrent health problems among Dutch HS users. The interdependent character of different needs requires an integrated 3-D public health approach to comprehensively serve symptomatic, social, and personal dimensions, required to facilitate recovery.

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Section: Discussionmentioning

confidence: 99%

Health Patterns Reveal Interdependent Needs of Dutch Homeless Service Users

Everdingen

Peerenboom²,

Velden

et al. 2021

Front. Psychiatry

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“…Stable housing is an important prerequisite for recovery. Persons who lack stable housing, particularly the homeless, commonly experience higher rates of physical and mental illness, poor quality of life and high mortality (70)(71)(72)(73)(74). At the core of homelessness are the processes of marginalization and exclusion, with multiple risk factors driving these experiences (75)(76)(77)(78).…”

Section: Homelessness and Housingmentioning

confidence: 99%

The interRAI Suite of Mental Health Assessment Instruments: An Integrated System for the Continuum of Care

et al. 2020

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The lives of persons living with mental illness are affected by psychological, biological, social, economic, and environmental factors over the life course. It is therefore unlikely that simple preventive strategies, clinical treatments, therapeutic interventions, or policy options will succeed as singular solutions for the challenges of mental illness. Persons living with mental illness receive services and supports in multiple settings across the health care continuum that are often fragmented, uncoordinated, and inadequately responsive. Appropriate assessment is an important tool that health systems must deploy to respond to the strengths, preferences, and needs of persons with mental illness. However, standard approaches are often focused on measurement of psychiatric symptoms without taking a broader perspective to address issues like growth, development, and aging; physical health and disability; social relationships; economic resources; housing; substance use; involvement with criminal justice; stigma; and recovery. Using conglomerations of instruments to cover more domains is impractical, inconsistent, and incomplete while posing considerable assessment burden. interRAI mental health instruments were developed by a network of over 100 researchers, clinicians, and policy experts from over 35 nations. This includes assessment systems for adults in inpatient psychiatry, community mental health, emergency departments, mobile crisis teams, and long-term care settings, as well as a screening system for police officers. A similar set of instruments is available for child/youth mental health. The instruments form an integrated mental health information system because they share a common assessment language, conceptual basis, clinical emphasis, data collection

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“…10,11,15,25,57,64,80 Several studies described statistically significant higher prevalence of dermatologic conditions among PEH compared to the general population. 11,19,25,41 The prevalence of common skin conditions described among PEH such as acne, 32,37,64 psoriasis, 37,64 seborrheic dermatitis, 32,37 atopic dermatitis, 37,64 lichen simplex chronicus, 64 pruritus, 25 and skin trauma/injuries 15,32,55,64 is reported in Table 1. The average scores for dermatology life quality index (DLQI) for acne, psoriasis, eczema and skin cancer were generally higher among PEH when compared to the values described among non-homeless populations.…”

Section: Dermatologic Conditions In Adult Populationmentioning

confidence: 99%

Understanding Dermatologic Concerns Among Persons Experiencing Homelessness: A Scoping Review and Discussion for Improved Delivery of Care

et al. 2021

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There is a paucity of information surrounding dermatologic care for persons experiencing homelessness (PEH). This scoping review aims to map existing literature and provide a summary of the most common cutaneous manifestations among PEH, risk factors for dermatologic disease, describe any reported interventions, as well as identify research gaps for future studies. Search strategies developed for MEDLINE and hand searching yielded 486 articles. Out of the 486 articles screened, 93 articles met the inclusion criteria. The majority were cohort studies, cross-sectional studies, and case-control studies concentrated in North America and Europe. Excluding the pediatric population, the prevalence of dermatologic conditions ranged from 16.6% to 53.5%. Common skin conditions described in PEH were: acne, psoriasis, seborrheic dermatitis, atopic dermatitis, and lichen simplex chronicus. There were no studies comparing the extent or severity of these cutaneous diseases in PEH and the general population. PEH have a higher prevalence of skin infections and non-melanoma skin cancers. This scoping review has direct implications on public health interventions for PEH and highlights the need for evidence-based interventions to provide optimum and safe dermatologic healthcare for PEH. We propose several recommendations for improved care delivery, including addressing upstream factors and comorbidities impacting skin health, providing trauma informed care, reducing barriers to care, preventing and managing skin conditions, as well as including PEH in the planning and implementation of any proposed intervention.

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Explaining excess morbidity amongst homeless shelter users: A multivariate analysis for the Danish adult population

Abstract: Ill health amongst homeless shelter users is widely explained by substance abuse problems and other risk factors. Nonetheless, for many diseases homelessness poses an additional risk to the health.

Cited by 9 publications

References 29 publications

Health Patterns Reveal Interdependent Needs of Dutch Homeless Service Users

Health Patterns Reveal Interdependent Needs of Dutch Homeless Service Users

The interRAI Suite of Mental Health Assessment Instruments: An Integrated System for the Continuum of Care

Understanding Dermatologic Concerns Among Persons Experiencing Homelessness: A Scoping Review and Discussion for Improved Delivery of Care

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