Socio-Demographic and Clinical Variables Associated with Chronic Homelessness among the Street Homeless People / 신경정신의학

OBJECTIVES: This exploratory study was designed to estimate the socio-demographic characteristics, course of homelessness, adverse childhood experiences, and prevalence of mental disorders among the street homeless people in Seoul, Korea. In addition, we examined the associations between chronic homelessness and study variables. METHODS: The study subjects were 75 homeless people dwelling in the street around Seoul Station. Questionnaires related to socio-demographic data and the course of homelessness were provided to each subject. The subjects' Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) mental disorder diagnoses were made by using Mini International Neuropsychiatric Interview-Plus interviews. RESULTS: Most subjects exhibited chronic homelessness and the prevalence of DSM-IV mental disorders among the homeless subjects was higher than that among the Korean general population. There was a statistically significant association between chronic homelessness and adverse childhood experiences. Compared to those with no history of childhood adversity, homeless people with a history of childhood adversity had a younger age of first homeless episode and a higher prevalence of DSM-IV major mental disorders. The association between DSM-IV diagnosis and chronic homelessness was not significant, but the group with mental disorders had more prevalent re-housing and homeless recurrent histories. CONCLUSION: Street homeless people were often involved in chronic homelessness. Results of this study suggest that homeless people who were never married and had adverse childhood experiences were more vulnerable to chronic homelessness. In addition, we detected a possible relationship between the recurrence of homelessness and the presence of mental disorders.

Comparison between Users of Community Mental Health Services and Psychiatric Patients in Mental Health Related Facilities in Korea / 대한정신분열병학회지

OBJECTIVES: This study was conducted to compare the characteristics of psychiatric inpatients in mental health related facilities and community mental health services-utilizing patients by diverse factors in Korea. METHODS: Questionnaires were sent via mail to 140 standard mental health centers from October to December of 2008. 64 facilities responded and data of 461 mentally disabled who are registered at and utilize the services of these mental health centers were analyzed. T-test and cross-analysis were performed to determine the differences in the averages of the variables and the discrepancy in ratios, respectively. RESULTS: Differences between long-term psychiatric inpatients and community mental health services-utilizing patients were seen in characteristics such as gender, age, type of medical coverage, family support systems, diagnosis, age of onset, duration of hospitalization, community-dwelling period, and clinical symptoms and functions. It was significantly short in length of stay in facilities in users of community mental health services with comparison to institutionalized patients. CONCLUSION: The results of this study suggest that invigoration of community mental health services is an alternative that can help deter long-term hospitalization.