Risk factors for homelessness among schizophrenic men: a case-control study.
OBJECTIVE
To identify risk factors for homelessness among the severely mentally ill, we conducted a case-control study of 100 indigent schizophrenic men meeting criteria for literal homelessness and 100 such men with no homeless history.


METHODS
Subjects were recruited from shelter, clinic, and inpatient psychiatric programs in Upper Manhattan. Clinical interviewers employed standardized research instruments to probe three domains of risk factors: severity of mental illness, family background, and prior mental health service use.


RESULTS
Homeless subjects showed significantly higher levels of positive symptoms, higher rates of a concurrent diagnosis of drug abuse, and higher rates of antisocial personality disorder. Homeless subjects experienced greater disorganization in family settings from birth to 18 years and less adequate current family support. Fewer homeless subjects than subjects in the never-homeless comparison group had a long-term therapist. These differences remained when demographic variables were adjusted statistically.


CONCLUSIONS
Homeless schizophrenic men differed from their domiciled counterparts in all three domains we investigated; family background, nature of illness, and service use history. Findings are discussed in relation to policy and programs for the severely mentally ill.
Caton
C L
CL
Department of Psychiatry and School of Public Health, College of Physicians and Surgeons, Columbia University, New York, NY 10032.
Shrout
P E
PE
Eagle
P F
PF
Opler
L A
LA
Felix
A
A
Dominguez
B
B
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005190:Family; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D009519:New York City / Q000453:epidemiology; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D012959:Socioeconomic Factors