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无家可归者的进出是否与心理健康问题有关?一个极端弱势群体的纵向分析。

Do transitions in and out of homelessness relate to mental health episodes? A longitudinal analysis in an extremely disadvantaged population.

机构信息

Melbourne Institute, Applied Economic & Social Research, University of Melbourne, Australia; IZA, Bonn, Germany.

IZA, Bonn, Germany; Erasmus School of Economics and Tinbergen Institute, Erasmus University Rotterdam, the Netherlands; Department of Economics, University of Melbourne, Australia; CEPR, London, United Kingdom.

出版信息

Soc Sci Med. 2021 Jun;279:113667. doi: 10.1016/j.socscimed.2020.113667. Epub 2020 Dec 31.

Abstract

This paper studies the association between homelessness and mental health episodes focusing on episodes of depression, anxiety and other conditions (bipolar affective disorder, schizophrenia, and post-traumatic stress disorder). Using panel data from the Australian Journeys Home survey, we investigate the extent to which this association is due to common determinants of homelessness and mental health episodes, or whether there is a causal link between them. The results indicate that episodes of depression increase the probability that a person becomes homeless. This is not the case for other mental health conditions. We find no evidence that becoming homeless causes a person to have a mental health episode. Instead, respondents are less likely to be diagnosed with depression in the 6 months after being precariously housed. Overall, our results indicate that, except for depression, the links between mental health episodes and homelessness are complex and are mostly unlikely to be causal. Using information on service usage, we find suggestive evidence that people use mental health services when they need to but that more coordination with housing services is required to protect them from becoming precariously housed.

摘要

本文研究了无家可归与心理健康问题之间的关联,重点关注抑郁、焦虑和其他疾病(双相情感障碍、精神分裂症和创伤后应激障碍)的发作情况。本研究利用澳大利亚归家之旅调查的面板数据,探讨了这种关联在多大程度上是由于无家可归和心理健康问题的共同决定因素造成的,或者它们之间是否存在因果关系。结果表明,抑郁发作会增加一个人无家可归的可能性。其他心理健康状况则并非如此。我们没有发现任何证据表明无家可归会导致一个人出现心理健康问题。相反,在不稳定居住的 6 个月后,受访者被诊断患有抑郁症的可能性较低。总的来说,我们的研究结果表明,除了抑郁之外,心理健康问题和无家可归之间的联系是复杂的,而且极不可能是因果关系。通过使用服务使用信息,我们发现有一些证据表明,人们在需要时会使用心理健康服务,但需要更多地协调住房服务,以保护他们免受不稳定居住的影响。

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