The Myth of Pervasive Mental Illness among the Homeless

Obtaining representative samples of homeless persons: A two-city study

“…The area of mental health assessment has been particularly problematic for researchers and the wide range of estimates produced across studies has created some controversy (e.g., Snow, Baker, Anderson, & Martin, 1986;Susser et al, 1989). Estimates for severe mental disorder have ranged from as low as 1-5%, based on a positive diagnosis of schizophrenia obtained in a structured diagnostic interview (e.g., Fischer, Shapiro, Breakey, Anthony, & Kramer, 1986;North & Smith, 1993;Toro & Wall, 1991), to as high as 75-90%, based on unstructured psychiatric interviews and other methods, often in combination with poorly documented or nonrepresentative sampling designs (e.g., Arce, Tadlock, & Vergare, 1983;Bassuk, Rubin, & Lauriat, 1984;Gelberg & Linn, 1989).…”

Prevalence of treated behavioral disorders among adult shelter users: A longitudinal study.

“…hospitalizations), and on single-encounter interviews using diagnostic instruments that, like the DIS, were developed for domiciled populations (Koegel et al, 1988;Ropers, 1988;. Also, studies have typically failed to seek validation of diagnosis or treatment history via treatment records (Snow, Baker, & Anderson, 1986), even though research has found that the DIS alone may overestimate the prevalence rate of serious mental illness (Anthony et al, 1985), particularly lifetime rates (Warner & de Girolamo, 1995). Reviewers have also observed that samples were obtained and measured cross-sectionally, and, therefore, probably over-represented the number of long-term homeless people and people with disabilities relative to their proportion of the population over time (Culhane, Dejowski, Ibanez, Needham, & Macchia, 1994;Fischer & Breakey, 1991;Tessler& Dennis, 1992).…”

Comparing the Characteristics of Homeless Adults in Poland and the United States

“…Another weakness of existing studies involves the use of measures without documented reliability and validity among homeless populations. The assessment of mental disorders has been especially difficult and early studies produced a wide range of estimates amid considerable controversy (e.g., Snow, Baker, Anderson, & Martin, 1986;; Susser et al, 1989). More recent studies have used structured diagnostic interviews with documented psychometric properties (e.g., North & Smith, 1993;.…”