Skip to main content
Erschienen in: Community Mental Health Journal 6/2015

01.08.2015 | Original Paper

Previous Homelessness as a Risk Factor for Recovery from Serious Mental Illnesses

verfasst von: Jennifer Castellow, Bret Kloos, Greg Townley

Erschienen in: Community Mental Health Journal | Ausgabe 6/2015

Einloggen, um Zugang zu erhalten

Abstract

This paper argues that the experience of homelessness is inherently traumatic and thus has the potential to affect the manifestation of mental illness. The experiences related to being homeless might act as specific and unique sources of vulnerability. This study included 424 people diagnosed with serious mental illnesses living in supported housing programs in South Carolina. Three hierarchical regression analyses measuring the impact of homelessness on three types of outcomes revealed the following: (1) ever experiencing homelessness as well as the amount of time spent homeless were related to higher levels of psychiatric distress, (2) ever experiencing homelessness was related to higher levels of reported alcohol use, and (3) total amount of time spent homeless was related to lower perceived recovery from mental illness. These findings suggest that experiencing homelessness might contribute to psychosocial vulnerability to negative mental health outcomes. Future investigations examining this concept of risk and vulnerability as a result of homelessness are in order.
Fußnoten
1
Serious mental illness is a term used to describe severe and persistent psychiatric disability that generally has a profound impact upon a person’s behavior, cognition, affect, and social functioning (Kloos 2010). Diagnoses that pertain to this definition tend to include psychotic disorders, such as schizophrenia, as well as debilitating mood disorders, including bipolar disorder, severe major depression, and depression with psychotic features.
 
2
The homelessness variables were entered as predictors in regression models, and therefore the results are described as such in this section; however, the authors acknowledge that the data were cross-sectional and therefore these results do not necessarily imply causation. The interpretation of these findings is clarified in the "Discussion" section.
 
Literatur
Zurück zum Zitat Aubry, T., & Myner, J. (1996). Community integration and quality of life: A comparison of persons with psychiatric disability in housing programs and community residents who are neighbors. Canadian Journal of Community Mental Health, 15(1), 5–20.PubMedCrossRef Aubry, T., & Myner, J. (1996). Community integration and quality of life: A comparison of persons with psychiatric disability in housing programs and community residents who are neighbors. Canadian Journal of Community Mental Health, 15(1), 5–20.PubMedCrossRef
Zurück zum Zitat Blum, R. W., McNeely, C., Nonnemaker, J., Fischhoff, B., Nightingale, E. O., & Iannotta, J. G. (2001). Vulnerability, risk, and protection. In B. Fischhoff, E. Nightingale, & J. Iannotta (Eds.), Adolescent risk and vulnerability: Concepts and measurement (pp. 50–72). Washington, DC: National Academy Press. Blum, R. W., McNeely, C., Nonnemaker, J., Fischhoff, B., Nightingale, E. O., & Iannotta, J. G. (2001). Vulnerability, risk, and protection. In B. Fischhoff, E. Nightingale, & J. Iannotta (Eds.), Adolescent risk and vulnerability: Concepts and measurement (pp. 50–72). Washington, DC: National Academy Press.
Zurück zum Zitat Breakey, W. R., & Fischer, P. J. (1995). Mental illness and the continuum of residential stability. Social Psychiatry and Psychiatric Epidemiology, 30(4), 147–151.PubMedCrossRef Breakey, W. R., & Fischer, P. J. (1995). Mental illness and the continuum of residential stability. Social Psychiatry and Psychiatric Epidemiology, 30(4), 147–151.PubMedCrossRef
Zurück zum Zitat Calsyn, R. J., & Winter, J. P. (2002). Social support, psychiatric symptoms, and housing: A causal analysis. Journal of Community Psychology, 30(3), 247–259.CrossRef Calsyn, R. J., & Winter, J. P. (2002). Social support, psychiatric symptoms, and housing: A causal analysis. Journal of Community Psychology, 30(3), 247–259.CrossRef
Zurück zum Zitat Carling, P. (1993). Housing and supports for persons with mental illness: Emerging approaches to research and practice. Hospital and Community Psychiatry, 44(5), 439–449.PubMed Carling, P. (1993). Housing and supports for persons with mental illness: Emerging approaches to research and practice. Hospital and Community Psychiatry, 44(5), 439–449.PubMed
Zurück zum Zitat Cohen, J., Cohen, P., West, S., & Aiken, L. (2003). Missing data. Applied multiple regression/correlation analysis for the bahavorial sciences, 3rd edition. Mahwah, NJ: Lawrence Earlbaum Associates, 431–450. Cohen, J., Cohen, P., West, S., & Aiken, L. (2003). Missing data. Applied multiple regression/correlation analysis for the bahavorial sciences, 3rd edition. Mahwah, NJ: Lawrence Earlbaum Associates, 431–450.
Zurück zum Zitat Corcoran, C., Walker, E., Huot, R., Mittal, V., Tessner, K., Kestler, L., & Malaspina, D. (2003). The stress cascade and schizophrenia: etiology and onset. Schizophrenia Bulletin, 29(4), 671–692.PubMedCrossRef Corcoran, C., Walker, E., Huot, R., Mittal, V., Tessner, K., Kestler, L., & Malaspina, D. (2003). The stress cascade and schizophrenia: etiology and onset. Schizophrenia Bulletin, 29(4), 671–692.PubMedCrossRef
Zurück zum Zitat Corrigan, P. W., Salzer, M., Ralph, R. O., Sangster, Y., & Keck, L. (2004). Examining the factor structure of the recovery assessment scale. Schizophrenia Bulletin, 30(4), 1035.PubMedCrossRef Corrigan, P. W., Salzer, M., Ralph, R. O., Sangster, Y., & Keck, L. (2004). Examining the factor structure of the recovery assessment scale. Schizophrenia Bulletin, 30(4), 1035.PubMedCrossRef
Zurück zum Zitat Deegan, P. (1988). Recovery: The lived experience of rehabilitation. Psychosocial Rehabilitation Journal, 11(4), 11–19.CrossRef Deegan, P. (1988). Recovery: The lived experience of rehabilitation. Psychosocial Rehabilitation Journal, 11(4), 11–19.CrossRef
Zurück zum Zitat Derogatis, L. (1993). Brief symptom inventory (BSI) administration, scoring, and procedures manual (4th ed.). Minneapolis: National Computer Systems. Derogatis, L. (1993). Brief symptom inventory (BSI) administration, scoring, and procedures manual (4th ed.). Minneapolis: National Computer Systems.
Zurück zum Zitat Dickey, B., Gonzalez, O., Latimer, E., Powers, K., Schutt, R., & Goldfinger, S. (1996). Use of mental health services by formerly homeless adults residing in group and independent housing. Psychiatric Services, 47(2), 152–158.PubMedCrossRef Dickey, B., Gonzalez, O., Latimer, E., Powers, K., Schutt, R., & Goldfinger, S. (1996). Use of mental health services by formerly homeless adults residing in group and independent housing. Psychiatric Services, 47(2), 152–158.PubMedCrossRef
Zurück zum Zitat Drake, R. E., & Wallach, M. A. (1989). Substance abuse among the chronic mentally ill. Hospital and Community Psychiatry, 40(10), 1041–1046.PubMed Drake, R. E., & Wallach, M. A. (1989). Substance abuse among the chronic mentally ill. Hospital and Community Psychiatry, 40(10), 1041–1046.PubMed
Zurück zum Zitat Drake, R. E., Wallach, M. A., & Hoffman, J. S. (1989). Housing instability and homelessness among aftercare patients of an urban state hospital. Psychiatric Services, 40(1), 46–51.CrossRef Drake, R. E., Wallach, M. A., & Hoffman, J. S. (1989). Housing instability and homelessness among aftercare patients of an urban state hospital. Psychiatric Services, 40(1), 46–51.CrossRef
Zurück zum Zitat Drake, R. E., Wallach, M. A., Teague, G. B., Freeman, D. H., Paskus, T. S., & Clark, T. A. (1991). Housing instability and homelessness among rural schizophrenic patients. The American Journal of Psychiatry, 148(3), 330–336.PubMedCrossRef Drake, R. E., Wallach, M. A., Teague, G. B., Freeman, D. H., Paskus, T. S., & Clark, T. A. (1991). Housing instability and homelessness among rural schizophrenic patients. The American Journal of Psychiatry, 148(3), 330–336.PubMedCrossRef
Zurück zum Zitat Folsom, D. P., Hawthorne, W., Lindamer, L., Gilmer, T., Bailey, A., Golshan, S., … & Jeste, D. V. (2005). Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system. American Journal of Psychiatry, 162(2), 370–376. Folsom, D. P., Hawthorne, W., Lindamer, L., Gilmer, T., Bailey, A., Golshan, S., … & Jeste, D. V. (2005). Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system. American Journal of Psychiatry, 162(2), 370–376.
Zurück zum Zitat Goodman, L., Saxe, L., & Harvey, M. (1991). Homelessness as psychological trauma. American Psychologist, 46(11), 1219–1225.PubMedCrossRef Goodman, L., Saxe, L., & Harvey, M. (1991). Homelessness as psychological trauma. American Psychologist, 46(11), 1219–1225.PubMedCrossRef
Zurück zum Zitat Greenberg, G., & Rosenheck, R. (2010). An evaluation of an initiative to improve coordination and service delivery of homeless services networks. The Journal of Behavioral Health Services and Research, 37(2), 184–196.PubMedCrossRef Greenberg, G., & Rosenheck, R. (2010). An evaluation of an initiative to improve coordination and service delivery of homeless services networks. The Journal of Behavioral Health Services and Research, 37(2), 184–196.PubMedCrossRef
Zurück zum Zitat Honaker, J., King, G., & Blackwell, M. (2011). Amelia II: A program for missing data. Journal of Statistical Software, 45(7), 1–47. Honaker, J., King, G., & Blackwell, M. (2011). Amelia II: A program for missing data. Journal of Statistical Software, 45(7), 1–47.
Zurück zum Zitat Ingram, R. E., & Luxton, D. D. (2005). Vulnerability-stress models (pp. 32–46). Development of psychopathology: A vulnerability-stress perspective. Ingram, R. E., & Luxton, D. D. (2005). Vulnerability-stress models (pp. 32–46). Development of psychopathology: A vulnerability-stress perspective.
Zurück zum Zitat Kloos, B. (2010). Creating new possibilities for promoting liberation, well-being, and recovery: Learning from experiences of psychiatric consumers/survivors. In G. Nelson & I. Prilleltensky (Eds.), Community psychology: In pursuit of well-being and liberation (2nd ed., pp. 453–476). London: MacMillan. Kloos, B. (2010). Creating new possibilities for promoting liberation, well-being, and recovery: Learning from experiences of psychiatric consumers/survivors. In G. Nelson & I. Prilleltensky (Eds.), Community psychology: In pursuit of well-being and liberation (2nd ed., pp. 453–476). London: MacMillan.
Zurück zum Zitat Koegel, P., Burnam, M. A., & Farr, R. K. (1988). The prevalence of specific psychiatric disorders among homeless individuals in the inner city of Los Angeles. Archives of General Psychiatry, 45(12), 1085.PubMedCrossRef Koegel, P., Burnam, M. A., & Farr, R. K. (1988). The prevalence of specific psychiatric disorders among homeless individuals in the inner city of Los Angeles. Archives of General Psychiatry, 45(12), 1085.PubMedCrossRef
Zurück zum Zitat Kosa, F. (2009). The homemakers. Miller-McCune, 2(2), 52–60. Kosa, F. (2009). The homemakers. Miller-McCune, 2(2), 52–60.
Zurück zum Zitat Kuhn, R., & Culhane, D. P. (1998). Applying cluster analysis to test a typology of homelessness by pattern of shelter utilization: Results from the analysis of administrative data. American Journal of Community Psychology, 26(2), 207–232.PubMedCrossRef Kuhn, R., & Culhane, D. P. (1998). Applying cluster analysis to test a typology of homelessness by pattern of shelter utilization: Results from the analysis of administrative data. American Journal of Community Psychology, 26(2), 207–232.PubMedCrossRef
Zurück zum Zitat Lehman, A., Kernan, E., DeForge, B., & Dixon, L. (1995). Effects of homelessness on the quality of life of persons with severe mental illness. Psychiatric Services, 46(9), 922–926.PubMedCrossRef Lehman, A., Kernan, E., DeForge, B., & Dixon, L. (1995). Effects of homelessness on the quality of life of persons with severe mental illness. Psychiatric Services, 46(9), 922–926.PubMedCrossRef
Zurück zum Zitat Link, B. G., Cullen, F. T., Struening, E., Shrout, P. E., & Dohrenwend, B. P. (1989). A modified labeling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54(3), 400–423.CrossRef Link, B. G., Cullen, F. T., Struening, E., Shrout, P. E., & Dohrenwend, B. P. (1989). A modified labeling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54(3), 400–423.CrossRef
Zurück zum Zitat Link, B., & Phelan, J. (2001). Conceptualizing stigma. Annual Review of Sociology, 27(1), 363–385.CrossRef Link, B., & Phelan, J. (2001). Conceptualizing stigma. Annual Review of Sociology, 27(1), 363–385.CrossRef
Zurück zum Zitat Pasi, E. (2011). HUID Releases 2010 Annual Homeless Assessment Report to Congress. Journal of Housing and Community Development, 68(4), 19. Pasi, E. (2011). HUID Releases 2010 Annual Homeless Assessment Report to Congress. Journal of Housing and Community Development, 68(4), 19.
Zurück zum Zitat Phelan, J., & Link, B. (1999). Who are “the homeless”? Reconsidering the stability and composition of the homeless population. American Journal of Public Health, 89(9), 1334–1338.PubMedCentralPubMedCrossRef Phelan, J., & Link, B. (1999). Who are “the homeless”? Reconsidering the stability and composition of the homeless population. American Journal of Public Health, 89(9), 1334–1338.PubMedCentralPubMedCrossRef
Zurück zum Zitat Phillips, L. J., McGorry, P. D., Yung, A. R., McGlashan, T. H., Cornblatt, B., & Klosterkötter, J. (2005). Prepsychotic phase of schizophrenia and related disorders: recent progress and future opportunities. The British Journal of Psychiatry, 187(48), s33–s44.CrossRef Phillips, L. J., McGorry, P. D., Yung, A. R., McGlashan, T. H., Cornblatt, B., & Klosterkötter, J. (2005). Prepsychotic phase of schizophrenia and related disorders: recent progress and future opportunities. The British Journal of Psychiatry, 187(48), s33–s44.CrossRef
Zurück zum Zitat R Development Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. Retrieved March 30, 2011, from http://www.R-project.org R Development Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. Retrieved March 30, 2011, from http://​www.​R-project.​org
Zurück zum Zitat Rhoades, H., Wenzel, S. L., Golinelli, D., Tucker, J. S., Kennedy, D. P., Green, H. D., & Zhou, A. (2011). The social context of homeless men’s substance use. Drug and Alcohol Dependence, 118(2), 320–325.PubMedCentralPubMedCrossRef Rhoades, H., Wenzel, S. L., Golinelli, D., Tucker, J. S., Kennedy, D. P., Green, H. D., & Zhou, A. (2011). The social context of homeless men’s substance use. Drug and Alcohol Dependence, 118(2), 320–325.PubMedCentralPubMedCrossRef
Zurück zum Zitat Ridgway, P., & Zipple, A. (1990). The paradigm shift in residential services: From linear continuum to supported housing approaches. Psychosocial Rehabilitation Journal, 13(4), 11–31.CrossRef Ridgway, P., & Zipple, A. (1990). The paradigm shift in residential services: From linear continuum to supported housing approaches. Psychosocial Rehabilitation Journal, 13(4), 11–31.CrossRef
Zurück zum Zitat Rosenberg, S. D., Drake, R. E., Wolford, G. L., Mueser, K. T., Oxman, T. E., Vidaver, R. M., … & Luckoor, R. (1998). Dartmouth Assessment of Lifestyle Instrument (DALI): A substance use disorder screen for people with severe mental illness. American Journal of Psychiatry, 155(2), 232–238. Rosenberg, S. D., Drake, R. E., Wolford, G. L., Mueser, K. T., Oxman, T. E., Vidaver, R. M., … & Luckoor, R. (1998). Dartmouth Assessment of Lifestyle Instrument (DALI): A substance use disorder screen for people with severe mental illness. American Journal of Psychiatry, 155(2), 232–238.
Zurück zum Zitat Rosenfield, S. (1991). Homelessness and rehospitalization: The importance of housing for the chronic mentally ill. Journal of Community Psychology, 19(1), 60–69.CrossRef Rosenfield, S. (1991). Homelessness and rehospitalization: The importance of housing for the chronic mentally ill. Journal of Community Psychology, 19(1), 60–69.CrossRef
Zurück zum Zitat Rosenfield, S. (1997). Labeling mental illness: The effects of received services and perceived stigma on life satisfaction. American Sociological Review, 62, 660–672. Rosenfield, S. (1997). Labeling mental illness: The effects of received services and perceived stigma on life satisfaction. American Sociological Review, 62, 660–672.
Zurück zum Zitat Rosenheck, R. A., Lam, J., Morrissey, J. P., Calloway, M. O., Stolar, M., & Randolph, F. (2002). Service systems integration and outcomes for mentally ill homeless persons in the ACCESS program. Psychiatric Services, 53(8), 958–966.PubMedCrossRef Rosenheck, R. A., Lam, J., Morrissey, J. P., Calloway, M. O., Stolar, M., & Randolph, F. (2002). Service systems integration and outcomes for mentally ill homeless persons in the ACCESS program. Psychiatric Services, 53(8), 958–966.PubMedCrossRef
Zurück zum Zitat Salyers, M., & Tsemberis, S. (2007). ACT and recovery: Integrating evidence-based practice and recovery orientation on assertive community treatment teams. Community Mental Health Journal, 43(6), 619–641.PubMedCrossRef Salyers, M., & Tsemberis, S. (2007). ACT and recovery: Integrating evidence-based practice and recovery orientation on assertive community treatment teams. Community Mental Health Journal, 43(6), 619–641.PubMedCrossRef
Zurück zum Zitat Schafer, J. L., & Olsen, M. K. (1998). Multiple imputation for multivariate missing-data problems: A data analyst’s perspective. Multivariate Behavioral Research, 33(4), 545–571.CrossRef Schafer, J. L., & Olsen, M. K. (1998). Multiple imputation for multivariate missing-data problems: A data analyst’s perspective. Multivariate Behavioral Research, 33(4), 545–571.CrossRef
Zurück zum Zitat Shinn, M. (2007). International homelessness: Policy, socio-cultural, and individual perspectives. Journal of Social Issues, 63(3), 657–677.CrossRef Shinn, M. (2007). International homelessness: Policy, socio-cultural, and individual perspectives. Journal of Social Issues, 63(3), 657–677.CrossRef
Zurück zum Zitat Sosin, M., Colsin, P., & Grossman, S. (1988). Homelessness in Chicago: Poverty and pathology, social institutions, and social change. Chicago: University of Chicago, School of Social Service Administration. Sosin, M., Colsin, P., & Grossman, S. (1988). Homelessness in Chicago: Poverty and pathology, social institutions, and social change. Chicago: University of Chicago, School of Social Service Administration.
Zurück zum Zitat Susser, E., Valencia, E., Conover, S., Felix, A., Tsai, W. Y., & Wyatt, R. J. (1997). Preventing recurrent homelessness among mentally ill men: A” critical time” intervention after discharge from a shelter. American Journal of Public Health, 87(2), 256–262.PubMedCentralPubMedCrossRef Susser, E., Valencia, E., Conover, S., Felix, A., Tsai, W. Y., & Wyatt, R. J. (1997). Preventing recurrent homelessness among mentally ill men: A” critical time” intervention after discharge from a shelter. American Journal of Public Health, 87(2), 256–262.PubMedCentralPubMedCrossRef
Zurück zum Zitat Torchalla, I., Strehlau, V., Li, K., & Krausz, M. (2011). Substance use and predictors of substance dependence in homeless women. Drug and Alcohol Dependence, 118(2), 173–179.PubMedCrossRef Torchalla, I., Strehlau, V., Li, K., & Krausz, M. (2011). Substance use and predictors of substance dependence in homeless women. Drug and Alcohol Dependence, 118(2), 173–179.PubMedCrossRef
Zurück zum Zitat Toro, P. A., Tompsett, C. J., Lombardo, S., Philippot, P., Nachtergael, H., Galand, B.,… & Harvey, K. (2007). Homelessness in Europe and the United States: A comparison of prevalence and public opinion. Journal of Social Issues, 63(3), 505–524. Toro, P. A., Tompsett, C. J., Lombardo, S., Philippot, P., Nachtergael, H., Galand, B.,… & Harvey, K. (2007). Homelessness in Europe and the United States: A comparison of prevalence and public opinion. Journal of Social Issues, 63(3), 505–524.
Zurück zum Zitat Townley, G., & Kloos, B. (2011). Examining the psychological sense of community for individuals with serious mental illness residing in supported housing. Community Mental Health Journal, 47(4), 436–446.PubMedCrossRef Townley, G., & Kloos, B. (2011). Examining the psychological sense of community for individuals with serious mental illness residing in supported housing. Community Mental Health Journal, 47(4), 436–446.PubMedCrossRef
Zurück zum Zitat Tsemberis, S., Gulcur, L., & Nakae, M. (2004). Housing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health, 94(4), 651–656.PubMedCentralPubMedCrossRef Tsemberis, S., Gulcur, L., & Nakae, M. (2004). Housing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health, 94(4), 651–656.PubMedCentralPubMedCrossRef
Zurück zum Zitat Whitley, R., & Drake, R. (2010). Recovery: A dimensional approach. Psychiatric Services, 61(12), 1248–1250.PubMedCrossRef Whitley, R., & Drake, R. (2010). Recovery: A dimensional approach. Psychiatric Services, 61(12), 1248–1250.PubMedCrossRef
Metadaten
Titel
Previous Homelessness as a Risk Factor for Recovery from Serious Mental Illnesses
verfasst von
Jennifer Castellow
Bret Kloos
Greg Townley
Publikationsdatum
01.08.2015
Verlag
Springer US
Erschienen in
Community Mental Health Journal / Ausgabe 6/2015
Print ISSN: 0010-3853
Elektronische ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-014-9805-9

Weitere Artikel der Ausgabe 6/2015

Community Mental Health Journal 6/2015 Zur Ausgabe

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.