Homeless mentally ill in Athens area: A cross-sectional study on unmet needs and help-seeking

• Published in: International journal of social psychiatry 2014-09, Vol.60 (6), p.544-553
• Main Authors: Chondraki, Paraskevi, Madianos, Michael G, Dragioti, Elena, Papadimitriou, George N
• Format: Article
• Language: English
• Subjects: Cross-Sectional Studies; Female; Greece - epidemiology; Health Services Needs and Demand - statistics & numerical data; Homeless people; Homeless Persons - psychology; Homeless Persons - statistics & numerical data; Humans; Male; Mental disorders; Mental Disorders - epidemiology; Mental Disorders - rehabilitation; Mental Disorders - therapy; Middle Aged; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Regression analysis; Urban Population - statistics & numerical data
• ISSN: 0020-7640; 1741-2854
• DOI: 10.1177/0020764013503150

Background: Homelessness, a worldwide psychosocial phenomenon, is now also prevalent in Greece, mainly in Athens area. Methods: The possible psychiatric morbidity related to help-seeking and the underlying factors were explored in a sample of 254 homeless people from Greater Athens area, using the Mini International Neuropsychiatric Interview (M.I.N.I.). Results: The sample was predominantly male (74%) with mean age of 51 years, being in their majority homeless for over 25 months, 34.3% of them living in rough sleeping places. Overall, 56.7% of the sample met the criteria for a current Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition (DSM-IV) psychiatric disorder with 20.8% comorbidity. Only 36.2% of the identified psychiatric cases had any recent psychiatric care, while 44.4% were taking non-prescribed medication and 20.2% have been hospitalized in the last year. On the contrary, 70% of alcohol- and drug-dependent persons have been treated in a psychiatric agency, while 60.0% of them participated in rehabilitation program the last year. Logistic regression analysis revealed that being older, more educated with longer duration of homelessness, recognizing the suffering from a psychiatric problem as well as being diagnosed as ‘psychotic’ increased the likelihood to seek help. Conclusions: The vast majority of the homeless mentally ill persons were lacking any current psychiatric care. The planning of a mental health–care delivery parallel to the existing social welfare system is needed to serve the unmet mental health needs of this population.