ABSTRACT
Most research on the homeless is coming from the US, where the prevalence of mental disorders concerning this population was pointed out. The surveys for the homeless in European countries focus on the mental state and community care of the homeless very early, since the 1980's. Homelessness is gradually developing in these countries, while in the countries of North America the phenomenon is much older. The prevalence of mental disorders in European countries is higher in the homeless population, with rates of 58% -100% compared with the general population. In countries like Germany, Spain, Holland, France, Switzerland, where the phenomenon of homelessness has been studied, one of the most striking features was the high prevalence of substance abuse disorders, emotional disorders, while small percentages were reported for psychotic disorders. The prevalence of alcohol abuse was very high in Germany, perhaps because it is easily accessible and less expensive than in other countries. Limited use by homeless of relevant health services was also very common in this country. The same observation was also recorded in Spain, France and the Netherlands. High rates in these countries was reported for comorbidity, most often concerning the combination of substance abuse disorder and emotional disorders. Another interesting finding in the European countries is the high prevalence of depressive and anxiety disorders and the low prevalence of schizophrenia and antisocial personality disorder. The low prevalence of schizophrenia and antisocial personality disorder is in contrast with studies from North America according to some authors who compared their samples with samples of homeless people in Los Angeles. The level of abuse of illegal substances was also found high in countries such as England. In Spain affective disorders was reported to be very high among the homeless population. The homeless population faces many complex mental health problems compared with those of the general population. What is a source of concern is that these problems are not adequately faced either by mental health services and rehabilitation programs, or the social services for the homeless. It is recommended that these services have to achieve integration in therapeutic and organizational level, in order to better meet the needs of this complex and heterogeneous population.
