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

Int J Soc Psychiatry. 2014 Sep;60(6):544-53. doi: 10.1177/0020764013503150. Epub 2013 Oct 1.

Abstract

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.

Keywords: Athens; Greece; Homeless persons; mental health delivery care; psychiatric disorders.

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Greece / epidemiology
  • Health Services Needs and Demand / statistics & numerical data*
  • Humans
  • Ill-Housed Persons / psychology*
  • Ill-Housed Persons / statistics & numerical data
  • Male
  • 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*
  • Urban Population / statistics & numerical data