The epidemiology of alcohol, drug, and mental disorders among homeless persons.

Abstract

This article describes recent research on the prevalence of alcohol, drug, and mental (ADM) disorders and the characteristics of homeless substance abusers and persons with mental illness. Methodological problems in homelessness research are reviewed, particularly in relation to definitions of homelessness and sampling- and case-ascertainment methods. Prevalence rates of ADM disorders are much higher in homeless groups than in the general population. As is true of homeless people in general, homeless substance abusers and mentally ill persons are characterized by extreme poverty; underutilization of public entitlements; isolation from family, friends, and other support networks; frequent contact with correctional agencies; and poor general health. Knowledge of these disadvantages should be used to advocate for better services to prevent homelessness and support homeless people.

The Prevalence and Correlates of Nonaffective Psychosis in the National Comorbidity Survey Replication (NCS-R)

“…Studies of people in non-household populations (e.g., homeless, prison, nursing home) document higher prevalence of NAP than in the household population (Fischer and Breakey 1991;Keith et al 1991). This does not introduce much bias into totalpopulation estimates, though, due to the small proportion of the population not in the Englishspeaking household population.…”

Preventing Homelessness among Substance Users in Europe

“…Nevertheless, the coincidence of homelessness and substance misuse has led some researchers to conclude that drug misuse, especially when co-related with mental illness, is a major factor in causing homelessness (e.g., Barnes and Burnes 1993). These findings have been challenged (e.g., Fischer and Breakey 1991) and more recently such an easy one-way association has been replaced by an awareness of more subtle and complex relationships. Thus, although addiction can be an indirect cause of homelessness (e.g., leading to job loss or relationship break-up), it is also clear that drug related problems are intensified by homelessness, especially rooflessness, and that the onset of substance misuse is frequently and closely linked with the onset of homelessness (Mojtabai 2005).…”

Drug use disorders and treatment contact among homeless adults in Alameda County, California.

“…[3][4][5][6][7][8][9][10][11][12][13] The disparity in prevalence rates is largely attributed to methodological differences including case ascertainment. '4 While some researchers use standardized diagnostic criteria to identify cases, others employ highly sensitive but nonspecific screening tools, recent use, treatment histories, or even the respondent's perception of drug problems.…”