Needs for mental health care and service provision in single homeless people.
BACKGROUND
Specific problems in sampling methodology, case-finding strategies and a standardised needs assessment in mentally ill homeless people have contributed to their being neglected as a mental health care clientele.


METHODS
We assessed a representative sample of homeless people (n=102) in the highly industrialised city of Mannheim (Germany) regarding their prevalence of mental disorders (using the SCID) and their needs for mental health care (using the NCA).


RESULTS
We found high prevalences, with 68.6% of all assessed homeless persons having a current mental disorder. Thus, needs for mental health care were very common, with unmet needs predominating in all problem areas, which was supported by a very weak service utilization. Thus, even in a region with a comprehensive community mental health care network, like the study area, mentally ill homeless people are widely under-provided.


CONCLUSIONS
Results suggest that the traditional shelter system for homeless people carries most of the mental health care burden for their clientele and must be supported by adequate interventions from community-based mental health care services. A closer connection of both sectors and a better co-ordination of the care offers seems to be a prerequisite for helping to reduce unmet mental health care needs in this specific high-risk group.
Salize
H J
HJ
Mental Health Services Research Unit, Central Institute of Mental Health, Mannheim, Germany. salize@as200.zi-mannheim.de
Horst
A
A
Dillmann-Lange
C
C
Killmann
U
U
Stern
G
G
Wolf
I
I
Henn
F
F
Rössler
W
W
D000293:Adolescent; D000328:Adult; D003156:Community Mental Health Services / Q000379:methods / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D005858:Germany / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012494:Sampling Studies; D012959:Socioeconomic Factors