A comparison of the needs of homeless and never homeless patients with psychotic disorders

Abstract

Although the large number of people with psychotic disorders who are homeless has triggered the development of targeted outreach services, it is uncertain whether, aside from their social circumstances, the needs of these patients differ from those of their residentially stable counterparts. A matched case control study of homeless and never homeless patients with psychotic disorders is reported ( n = 39 pairs). Patients were recruited from psychiatric services and data collected through interviews with patients and their key workers as well as a review of their case notes. Homeless patients were more symptomatic and behaviourally disturbed than controls. They were significantly more likely to have a criminal history and to be identified by key workers as having problems related to substance use. Homeless patients were less likely to have been born in Birmingham and to have ongoing contact with childhood carers but despite being less aware of the need for treatment, uptake of psychiatric care was comparable with that of controls. The implications for the development of dedicated mental health services for this population are discussed.