title: Homeless and incarcerated: an epidemiological study from Canada.
abstract: BACKGROUND
  Incarceration and homelessness are closely related yet studied rarely. This article aimed to study the incarcerated homeless and identify specific vulnerabilities, which rendered them different from the nonincarcerated homeless. It also aimed to describe the homeless population and its significant involvement with the criminal justice and enforcement system.
  
  
  METHODS
  Data were derived from the British Columbia Health of the Homeless Study (BCHOHS), carried out in three cities in British Columbia, Canada: the large urban center Vancouver (n = 250), Victoria (n = 150) and Prince George (n = 100). Measures included socio-demographic information, the Maudsley Addiction Profile (MAP), the Childhood Trauma Questionnaire (CTQ) and the Mini International Neuropsychiatric Interview (MINI) Plus.
  
  
  RESULTS
  Incarcerated homeless were more often male (66.6%), were in foster care (56.4%) and had greater substance use especially of crack cocaine (69.6%) and crystal methamphetamine (78.7%). They also had greater scores on emotional and sexual abuse domains of CTQ, indicating greater abuse. A higher prevalence of depression (57%) and psychotic disorders (55.3%) was also observed. Risk factors identified which had a positive predictor value were male gender (p < .001; odds ratio (OR) = 2.8; 95% confidence interval (CI): 1.7-4.4), a diagnosis of depression (p = .02; 95% CI: 1.1-4.4) and severe emotional neglect (p = .02; 95% CI: 1.1-3.2) in the childhood.
  
  
  CONCLUSIONS
  Homeless individuals may be traumatized at an early age, put into foster care, rendered homeless, initiated into substance use and re-traumatized on repeated occasions in adult life, rendering them vulnerable to incarceration and mental illness.
authors.affiliation: Department of Psychiatry, Melbourne Health, Melbourne, VIC, Australia saddichha@gmail.com.
authors.forename: Sahoo
authors.initials: S
authors.lastname: Saddichha
authors.affiliation: Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Joelle M
authors.initials: JM
authors.lastname: Fliers
authors.affiliation: School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada.
authors.forename: Jim
authors.initials: J
authors.lastname: Frankish
authors.affiliation: Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.
authors.forename: Julian
authors.initials: J
authors.lastname: Somers
authors.affiliation: Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada.
authors.forename: Christian G
authors.initials: CG
authors.lastname: Schuetz
authors.affiliation: Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Krausz
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D001955:British Columbia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D003416:Criminal Law; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Homeless; incarceration; mental health