Spicer Bridget, Smith David I, Conroy Elizabeth, Flatau Paul R, Burns Lucy
School of Health Sciences, RMIT University, Bundoora, Australia.
Centre for Health Research, University of Western Sydney, Penrith, Australia
Aust N Z J Psychiatry. 2015 May;49(5):471-80. doi: 10.1177/0004867414563187. Epub 2014 Dec 19.
The over-representation of mental illness among homeless people across the globe is well documented. However, there is a dearth of Australian literature on the mental health needs of homeless individuals. Furthermore, longitudinal research examining the factors that contribute to better housing outcomes among this population is sparse. The aim of this research is to describe the mental illness profile of a sample of homeless men in an Australian urban centre (in Sydney) and examine the factors associated with better housing outcomes at 12-month follow-up.
A longitudinal survey was administered to 253 homeless men who were involved in the Michael Project: a 3-year initiative which combined existing accommodation support services with assertive case management and access to coordinated additional specialist allied health and support services. A total of 107 participants were followed up 12 months later. The survey examined the demographics of the sample and lifetime mental disorder diagnoses, and also included psychological screeners for current substance use and dependence, psychological distress, psychosis, and post-traumatic stress.
Consistent with existing literature, the prevalence of mental illness was significantly greater amongst this sample than the general Australian population. However, mental illness presentation was not associated with housing situation at 12-month follow-up. Instead, type of support service at baseline was the best predictor of housing outcome, wherein participants who received short to medium-term accommodation and support were significantly more likely to be housed in stable, long-term housing at the 12-month follow-up than participants who received outreach or emergency accommodation support.
This study provides evidence to support an innovative support model for homeless people in Australia and contributes to the limited Australian research on mental illness in this population.
全球范围内,无家可归者中精神疾病的比例过高,这已得到充分证明。然而,澳大利亚关于无家可归者心理健康需求的文献匮乏。此外,针对这一人群中有助于改善住房状况的因素进行的纵向研究也很少。本研究的目的是描述澳大利亚一个城市中心(悉尼)无家可归男性样本的精神疾病概况,并在12个月的随访中检查与更好的住房结果相关的因素。
对参与迈克尔项目的253名无家可归男性进行了纵向调查,该项目为期3年,将现有的住宿支持服务与积极的个案管理以及获得协调的额外专业联合健康和支持服务相结合。12个月后对107名参与者进行了随访。该调查考察了样本的人口统计学特征和终生精神障碍诊断情况,还包括针对当前物质使用和依赖、心理困扰、精神病和创伤后应激的心理筛查。
与现有文献一致,该样本中精神疾病的患病率明显高于澳大利亚普通人群。然而,在12个月的随访中,精神疾病表现与住房状况无关。相反,基线时的支持服务类型是住房结果的最佳预测因素,其中接受短期至中期住宿和支持的参与者在12个月的随访中比接受外展或紧急住宿支持的参与者更有可能入住稳定的长期住房。
本研究为支持澳大利亚无家可归者的创新支持模式提供了证据,并为澳大利亚关于这一人群精神疾病的有限研究做出了贡献。