St. Louis’ homeless: Mental health needs, services, and policy implications.

Morse, Gary A.; Shields, Nancy; Hanneke, Christine R.; McCall, George J.; Calsyn, Robert J.; Nelson, Bruce

doi:10.1037/h0099150

Cited by 14 publications

(8 citation statements)

References 10 publications

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“…Second, from a practice and policy perspective, the service willingness data contradict the view of many professionals and the public that psychiatric and alcoholic homeless people have no insight into their problems and are not willing to receive treatment. However, as we have reported elsewhere (Morse et al, 1986), these individuals are more interested in case management and day treatment programs than traditional psychiatric services such as inpatient, outpatient, and psychiatric medication.…”

Section: Discussionmentioning

confidence: 99%

Development and cross-validation of a system for classifying homeless persons

Morse¹,

Calsyn

Burger

1992

J. Community Psychol.

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The present study used cluster analysis to empirically derive and cross‐validate a system for classifying homeless persons on the basis of their service needs. Variables used in the subgroup identification phase of the study included psychopathology, alcoholism, social support, socioeconomic status, and health status. Four subgroups were identified: (1) an economically disadvantaged group, (2) an alcoholic group, (3) a mentally ill group, and (4) a relatively advantaged group. Subsequent analysis revealed few differences between the four groups in background characteristics. Moreover, subgroups were similar in service willingness and utilization, with the exception of utilization and willingness to receive treatment for alcohol and mental health problems. The results suggest the need for policies and services that address the core socioeconomic needs that cut across all subgroups, as well as for additional, specialized services for those with psychiatric or alcohol problems.

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Section: Discussionmentioning

confidence: 99%

Development and cross-validation of a system for classifying homeless persons

Morse¹,

Calsyn

Burger

1992

J. Community Psychol.

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“…In addition to help with housing, income, and other social services, these individuals need mental health services, but often reject outpatient and other traditional treatments. They may, however, accept help in the form of day treatments, case management, and housing assistance (Morse et al, 1986). For this reason, Morse and colleagues compared the number of days a sample of mentally ill homeless individuals were stably housed after being randomly assigned to receive intensive case management or to a control group.…”

Section: Empirical Examplementioning

confidence: 99%

The Combined Effects of Measurement Error and Omitting Confounders in the Single-Mediator Model

Fritz

Kenny

MacKinnon

2016

Multivariate Behavioral Research

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Mediation analysis requires a number of strong assumptions be met in order to make valid causal inferences. Failing to account for violations of these assumptions, such as not modeling measurement error or omitting a common cause of the effects in the model, can bias the parameter estimates of the mediated effect. When the independent variable is perfectly reliable, for example when participants are randomly assigned to levels of treatment, measurement error in the mediator tends to underestimate the mediated effect, while the omission of a confounding variable of the mediator to outcome relation tends to overestimate the mediated effect. Violations of these two assumptions often co-occur, however, in which case the mediated effect could be overestimated, underestimated, or even, in very rare circumstances, unbiased. In order to explore the combined effect of measurement error and omitted confounders in the same model, the impact of each violation on the single-mediator model is first examined individually. Then the combined effect of having measurement error and omitted confounders in the same model is discussed. Throughout, an empirical example is provided to illustrate the effect of violating these assumptions on the mediated effect.

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“…Apart from contributing to increased rates of mortality, including from suicide [ 5 , 18 ] and drug abuse [ 4 ], the presence of serious mental disorders in the homeless is likely to contribute to increased rates of violent victimization [ 19 ], criminality [ 20 – 22 ], and longer periods of homelessness [ 23 ]. The provision of good mental health care would therefore reduce psychiatric morbidity and have other public health benefits.…”

Section: Introductionmentioning

confidence: 99%

The Prevalence of Mental Disorders among the Homeless in Western Countries: Systematic Review and Meta-Regression Analysis

et al. 2008

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BackgroundThere are well over a million homeless people in Western Europe and North America, but reliable estimates of the prevalence of major mental disorders among this population are lacking. We undertook a systematic review of surveys of such disorders in homeless people.Methods and FindingsWe searched for surveys of the prevalence of psychotic illness, major depression, alcohol and drug dependence, and personality disorder that were based on interviews of samples of unselected homeless people. We searched bibliographic indexes, scanned reference lists, and corresponded with authors. We explored potential sources of any observed heterogeneity in the estimates by meta-regression analysis, including geographical region, sample size, and diagnostic method. Twenty-nine eligible surveys provided estimates obtained from 5,684 homeless individuals from seven countries. Substantial heterogeneity was observed in prevalence estimates for mental disorders among the studies (all Cochran's χ2 significant at p < 0.001 and all I 2 > 85%). The most common mental disorders were alcohol dependence, which ranged from 8.1% to 58.5%, and drug dependence, which ranged from 4.5% to 54.2%. For psychotic illness, the prevalence ranged from 2.8% to 42.3%, with similar findings for major depression. The prevalence of alcohol dependence was found to have increased over recent decades.ConclusionsHomeless people in Western countries are substantially more likely to have alcohol and drug dependence than the age-matched general population in those countries, and the prevalences of psychotic illnesses and personality disorders are higher. Models of psychiatric and social care that can best meet these mental health needs requires further investigation.

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St. Louis’ homeless: Mental health needs, services, and policy implications.

Cited by 14 publications

References 10 publications

Development and cross-validation of a system for classifying homeless persons

Development and cross-validation of a system for classifying homeless persons

The Combined Effects of Measurement Error and Omitting Confounders in the Single-Mediator Model

The Prevalence of Mental Disorders among the Homeless in Western Countries: Systematic Review and Meta-Regression Analysis

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