Homelessness is a global and local social problem with underestimated prevalence. It has been shown to increase the risk of mental illness, raising concerns from mental health providers about the need for effective interventions targeting this population.
The aim of this paper is to describe the mental health status of the homeless people in two urban setting in a low-income country, through using standardised clinical and socio-demographic assessments as well assessing potential predictors of family integration versus non-family integration among a group of homeless individuals receiving psychiatric and psychosocial treatment.
A descriptive study was performed in Maputo and Matola cities between 2008 and 2010. Homeless people with apparent mental illness were mapped and recruited. The participants were referred from community to hospital, using a multidisciplinary treatment model, according to their clinical condition and later entered a family reintegration process.
Seventy-one homeless people were recruited (93.0% male; 80.3% unemployed). The most common diagnosis was schizophrenia and other psychosis (46; 64.8%), followed by mental and behaviour disorder related to substance misuse (21; 29.6%), and intellectual disability (4; 5.6%). Family reintegration was achieved for 53.5% (38 patients). Patients with intellectual disability were less reintegrated and those with disorders related to substance use had better reinsertion in their families (Chi square (2) = 6.1; p = 0.047).
Family reintegration was achieved in more than half of participants after hospitalization. Integration was higher in cases of substance misuse, with those with associated intellectual disability being more difficult to reintegrate.
Trial registration Trial Registration Number: NCT02936141, date of registration: 14/10/2016, retrospectively registered.
Patra S, Anand K. Homelessness: a hidden public health problem. Indian J Public Health. 2008;52(3):164–70. PubMed
Shipley SL, Tempelmeyer TC. Reflections on homelessness, mental illness, and crime. J Forensic Psychol Pract. 2012;12(5):409–23. CrossRef
Crane M. The associations between mental illness and homelessness among older people: an exploratory study. Aging Ment Health. 1998;2(3):171–80. CrossRef
Marshall M, Lockwood A. Assertive community treatment for people with severe mental disorders. Cochrane Database Syst Rev. 2000;2:CD001089.
Siqueira AC, Zoltowski AP, Giordani JP, Otero TM, Dell’Aglio DD. Processo de reinserção familiar: estudo de casos de adolescentes que viveram em instituição de abrigo. Estud Psicol. 2010;15(1):07–15. CrossRef
Sheehan DV, et al. The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability. Eur Psychiatry. 1997;12:232–41. CrossRef
Bandeira M. Escala de Avaliação da Competência Social de Pacientes Psiquiátricos através de Desempenho de Papéis. Aval Psicol. 2002;1:159–71.
Tilahun D, Hanlon C, Fekadu A, Tekola B, Baheretibeb Y, Hoekstra RA. Stigma, explanatory models and unmet needs of caregivers of children with developmental disorders in a low-income African country: a cross-sectional facility-based survey. BMC Health Serv Res. 2016;16(1):152. CrossRefPubMedPubMedCentral
Marjorie J, Winkleby M. Mental health problems of homeless women and differences across subgroups. Amti Rev Public Health. 1996;17:311–36. CrossRef
Rich A, Clark C. Gender differences in response to homelessness services. Eval Program Plan. 2005;28:69. CrossRef
Foster A, Gable J, Buckley J. Homelessness in Schizophrenia. Psychiatr Clin N Am. 2012;35:717–34. CrossRef
- Family reintegration of homeless in Maputo and Matola: a descriptive study
Ana Olga Mocumbi
Jair de Jesus Mari
- BioMed Central