Mental illness among 500 people living homeless and referred for psychiatric evaluation in Lisbon, Portugal

• Published in: CNS spectrums Vol. 27; no. 6; pp. 699 - 708
• Main Authors: Monteiro Fernandes, Ana, Gama Marques, João, Bento, António, Telles-Correia, Diogo
• Format: Journal Article
• Language: English
• Published: New York, USA Cambridge University Press 01.12.2022
• Subjects: Alcohol abuse; Cross-Sectional Studies; Domestic violence; Drug overdose; Emergency medical care; Health care; Health services; Homeless people; Hospitals; Humans; Ill-Housed Persons - psychology; Mental disorders; Mental Disorders - epidemiology; Mental Disorders - therapy; Mental health; Mortality; Original Research; Population; Portugal - epidemiology; Psychosis; Psychotic Disorders - diagnosis; Suicides & suicide attempts; Portugal; organic psychosis; Homeless; schizophrenia; schizoaffective; mental illness; psychosis
• ISSN: 1092-8529; 2165-6509
• DOI: 10.1017/S1092852921000547

Our goal was to identify the demographic profile of the people living homeless with mental illness in Lisboa, Portugal, and their relationship with the national healthcare system. We also tried to understand which factors contribute to the number and duration of psychiatric admissions among these homeless people. We used a cross-sectional design, collecting data for 4 years among homeless people, in Lisboa, Portugal, that were referred as possible psychiatric patients to (CHPL). In total, we collected data from 500 homeless people, then cross-checked these people in our CHPL hospital electronic database and obtained 467 patient matches. The most common psychiatric diagnosis in our sample was drug abuse (34%), followed by alcohol abuse (33%), personality disorder (24%), and acute stress reaction (23%). Sixty-two percent of our patients had multiple diagnoses, a subgroup with longer follow-ups, more psychiatric hospitalizations, and longer psychiatric hospitalizations. The prevalence of psychotic disorders was high: organic psychosis (17%), schizophrenia (15%), psychosis not otherwise specified (14%), and schizoaffective disorder (11%), that combined altogether were present in more than half (57%) of our homeless patients. The people living homeless with multiple diagnoses have higher mental health needs and worse determinants of general health. An ongoing effort is needed to identify and address this subgroup of homeless people with mental illness to improve their treatment and outcomes.