Needs for mental health care and service provision in single homeless people

Soc Psychiatry Psychiatr Epidemiol. 2001 Apr;36(4):207-16. doi: 10.1007/s001270170065.


Background: Specific problems in sampling methodology, case-finding strategies and a standardised needs assessment in mentally ill homeless people have contributed to their being neglected as a mental health care clientele.

Method: We assessed a representative sample of homeless people (n=102) in the highly industrialised city of Mannheim (Germany) regarding their prevalence of mental disorders (using the SCID) and their needs for mental health care (using the NCA).

Results: We found high prevalences, with 68.6% of all assessed homeless persons having a current mental disorder. Thus, needs for mental health care were very common, with unmet needs predominating in all problem areas, which was supported by a very weak service utilization. Thus, even in a region with a comprehensive community mental health care network, like the study area, mentally ill homeless people are widely under-provided.

Conclusions: Results suggest that the traditional shelter system for homeless people carries most of the mental health care burden for their clientele and must be supported by adequate interventions from community-based mental health care services. A closer connection of both sectors and a better co-ordination of the care offers seems to be a prerequisite for helping to reduce unmet mental health care needs in this specific high-risk group.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Community Mental Health Services / methods
  • Community Mental Health Services / statistics & numerical data*
  • Family Characteristics
  • Female
  • Germany / epidemiology
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Needs and Demand / statistics & numerical data*
  • Homeless Persons / psychology*
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Mental Disorders / therapy
  • Middle Aged
  • Needs Assessment / statistics & numerical data
  • Prevalence
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Sampling Studies
  • Socioeconomic Factors