Psychiatric disorders and mortality among people in homeless shelters in Denmark: a nationwide register-based cohort study

Nielsen, Sandra Feodor; Hjorthøj, Carsten; Erlangsen, Annette; Nordentoft, Merete

doi:10.1016/s0140-6736(11)60747-2

Cited by 182 publications

(204 citation statements)

References 28 publications

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“…National mappings of homelessness, based on 1-week-counts, show that about 80 per cent of the homeless in Denmark have either mental illness, substance abuse problems or both (Benjaminsen, 2009;Benjaminsen & Christensen, 2007;Benjaminsen & Lauritzen, 2013;Lauritzen et al, 2011). Moreover, a previous analysis of Danish shelter data has shown a high occurrence of both mental illness and substance abuse amongst shelter users (Nielsen et al, 2011), although that study did not include any further analysis of underlying types of shelter users.…”

Section: Homelessness In Denmark and The Usamentioning

confidence: 96%

Testing a Typology of Homelessness Across Welfare Regimes: Shelter Use in Denmark and the USA

Benjaminsen

Andrade

2015

Housing Studies

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This article compares patterns of homeless shelter use in Denmark and the USA. Combining data from homeless shelters in Denmark with population registers, we find that the prevalence of shelter use is substantially lower in Denmark than in the USA. A cluster analysis of shelter stays identifies three types of users similar to findings from US research: the transitionally, episodically and chronically homeless. However, the transitionally homeless in Denmark have a higher tendency of suffering from mental illness and substance abuse than the transitionally homeless in the USA. The results support Stephens and Fitzpatrick' hypothesis that countries with more extensive welfare systems and lower levels of poverty have lower levels of homelessness, mainly amongst those with complex support needs, whereas in countries with less extensive welfare systems homelessness affects broader groups and is more widely associated with poverty and housing affordability problems.

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Section: Homelessness In Denmark and The Usamentioning

confidence: 96%

Testing a Typology of Homelessness Across Welfare Regimes: Shelter Use in Denmark and the USA

Benjaminsen

Andrade

2015

Housing Studies

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“…There is also an increase in the number of people with mental illnesses living on the streets or in shelters or hostels [13,14] and a nationwide, prospective, register-based cohort study of homeless people in Denmark showed that registered substance abuse disorder was associated with the highest mortality risk compared with no psychiatric contact registered [15]. Several review articles have confirmed that psychiatric disorders are more prevalent among people who are homeless in 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 Western countries than in the age-matched general population and they are more likely to have alcohol and drug dependence [16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of childhood abuse among people who are homeless in Western countries: a systematic review and meta-analysis

Sundin

Baguley

2014

Soc Psychiatry Psychiatr Epidemiol

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Purpose: This article systematically reviews studies of prevalence of childhood experience of physical and sexual abuse in adult people who are homeless in Western countries.Methods: Medline, PsychInfo, and the Cochrane Library were searched using the keywords: homeless*, child* abuse, child* trauma, and child* adversity and the bibliographies of identified articles were reviewed. Sources of heterogeneity in the prevalence rates were explored by meta-regression analysis Results: Twenty-four reports published between January 1990 and August 2013 in three countries provided estimates obtained from up to 9,730 adult individuals who were homeless.Prevalence of reported childhood physical abuse ranged from 6 to 94% with average prevalence of 37%, 95% CI [25, 51]. Reported sexual abuse ranged from 4 to 62%, with average prevalence estimated as 32%, 95% CI [23, 44] for females and 10% for males, 95% CI [6,17]. Substantial heterogeneity was observed among the studies (I 2 ≥ 98%). Including moderators greatly reduced but did not eliminate this heterogeneity. Moderator analyses suggested that reported physical abuse tended to be higher for predominately white samples and tended to be lower for younger samples. Sexual abuse was far more prevalent in predominately female samples and slightly higher in non-US samples and convenience samples.Conclusions: The findings of this study suggest that childhood physical and sexual abuse is more prevalent among the homeless in Western countries than in the global population. Physical abuse appears to be particularly prevalent in younger samples and sexual abuse rates are higher in predominately female samples. Further investigation is needed to advance our understanding of how trauma informed treatment and care for the homeless effectively can take into account the service user's experiences of childhood abuse.

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“…It is important to be mindful that the acute services offered to the homeless will carry long-term consequences for both patient health and public expenditure, which are likely to amount to a far greater sum than the cost of a typical brief hospital spell. It is worth emphasising that although the homeless incur a loss of expected life of 10-20 years, 4 this implies that an immediate death during or shortly after becoming homeless is not typical, with most homeless patients continuing to live with chronic illnesses for many years. The long-term cost-benefit implications of many acute services for the homeless contrast with a policy environment in which it has been commonplace for policy initiatives for acute services to demonstrate how reform would reduce short-term hospital costs.…”

Section: Resultsmentioning

confidence: 99%

“…Research has improved awareness of the extremely poor health of the homeless [1][2][3][4][5] and given a better understanding of the effectiveness of community-based healthcare interventions. 3,[6][7][8] A more recent focus of reform, driven by the distinct morbidities and pre-and post-treatment circumstances of homeless patients, is the redesign of hospital services to offer cost-effective patient pathways that better address the needs of the homeless.…”

Section: Introductionmentioning

confidence: 99%

Hospital care and costs for homeless people

McCormick

White²

2016

Clinical Medicine

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The national picture of the comparative costs and diagnoses of hospitalised homeless patients are examined using the 'no fixed abode' flag in English hospital statistics. Comparable studies sample patients in single cities, eg New York and Toronto. The most common diagnosis is substance misuse; the share of homeless NHS patients with this diagnosis is rising, and now equals that found in North American cities. About half of the cost of homeless patients relates to diagnoses of mental illness, although these comprise a much smaller share of homeless patients than in North America. Hospital costs for homeless patients -both total and per admissionhave fallen significantly in recent years, primarily because of fewer admissions and shorter lengths of stay for mentally ill patients. Aims to reduce NHS costs at the level of individual institutions have often shaped policy. Broader policy to prevent and reduce homelessness offers substantial long-term reductions in the cost of chronic care.

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Psychiatric disorders and mortality among people in homeless shelters in Denmark: a nationwide register-based cohort study

Cited by 182 publications

References 28 publications

Testing a Typology of Homelessness Across Welfare Regimes: Shelter Use in Denmark and the USA

Testing a Typology of Homelessness Across Welfare Regimes: Shelter Use in Denmark and the USA

Prevalence of childhood abuse among people who are homeless in Western countries: a systematic review and meta-analysis

Hospital care and costs for homeless people

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