The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #69663

Jeanette L. Gibbon, MPH, Epidemiology and Biodefense Preparedness and Response, Maricopa County Department of Public Health, 1825 E. Roosevelt, Phoenix, AZ 85006, 6025066801, jeanettegibbon@mail.maricopa.gov and Thomas O'Toole, MD, Department of Internal Medicine, Johns Hopkins University Medical School, 2024 Monument St., Room 2-513, Baltimore, MD 21202.

A community-based, cross-sectional survey of homeless adults in Pittsburgh and Philadelphia was conducted to describe characteristics unique to homeless persons who report a current mental illness that distinguishes them from other subgroups of homeless persons and identifies specific issues and needs in this population. Participants were selected using population proportionate sampling of 91 sites frequented by homeless persons in each city with random selection at each site. Outcome measures included standardized assessment of DSM-IIIR defined substance abuse/dependence, self-reported data on source of usual care, medical and psychiatric co-morbidities, reasons for homelessness, and arrest history. A total of 531 adults were interviewed in both cities. Overall, 240 (45.2%) reported at least one psychiatric co-morbidity. Individuals reporting psychiatric problems were significantly more likely to attribute their homelessness to psychiatric problems (55.0% vs. 6.2%, p<0.01) and family crisis (32.9% vs. 19.7%, p<0.01). Overall, 82.5% met DSM-IIIR criteria for substance abuse/dependence for alcohol, drugs, or a combination of alcohol and drugs. They also had significantly higher self-reported rates of medical co-morbidities (66.3% vs. 55.0%, p<0.01), prescribed medications (73.3% vs. 33.7%; p<0.01), health insurance (71.1% vs. 51.9%, p<0.01), and source of usual care (87.9% vs. 77.0%, p<0.01). Overall, 20.4% reported they had been arrested in the previous 12 months (54.2% directly related to drug and alcohol use). Homeless persons with co-morbid mental health conditions have higher rates of substance abuse, medical co-morbidities, and unstable pre-homeless family states those without a mental health condition. Tailoring dual diagnosis programs to address the needs of homeless persons along with intervening with individuals at-risk of becoming homeless are necessary steps to address this problem.

Learning Objectives:

• To describe characteristics unique to homeless persons with self-reported mental illnesses that may pre-dispose them to homelessness or serve as barriers to getting effective treatment and services once homeless. This is necessary to better modify homeless and pre-homeless substance abuse services and interventions and minimize the adverse consequences of homelessness.

Keywords: Homeless, Mental Illness

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.