Prevalence of mental illness among homeless men in the community -: Approach to a full census in a southern German university town

Aim Within the framework of a study of homeless men in the university town of Tubingen in southern Germany, the prevalence of psychiatric disorders and the existing help-seeking behavior, among other things, were to be recorded. Method A total of 151 men belonging to the target group were identified; 91 of them participated in the study. Besides the psychiatric diagnosis, the registered data included psychopathology, cognitive capacity, social functioning and satisfaction with life, as well as social history and case history. Results Of the probands, 73% were suffering from at least one ongoing psychiatric disorder (diagnosed according to ICD-10 and DSM-IV), primarily alcohol dependence (74%) and drug dependence (34%), 26% were suffering from an anxiety disorder, 15% from an affective disorder, and 11% from a disorder of the schizophrenic spectrum. Comorbidity was diagnosed in 67%. Targeted help-seeking behavior concerning the psychiatric or addictive symptoms was extremely rare. Emergency contacts existed with hospitals and general practitioners. Discussion This study represents the first attempt within Germany and Europe at a full census of homeless men. In international terms, the target region -a small town on the fringes of a conurbation - is a special case. However, compared with studies of help-seeking populations in large cities, virtually no differences were recorded with respect to the prevalence of psychiatric disorders or to help-seeking behavior concerning psychiatric problems and addictions. On the other hand, a substantial number of those concerned evade a resource-intensive, outreach-based study like the present one. Because of German data protection legislation, data on these subjects remain sparse. Concepts aimed at improving the health care system for this target group were found to be dependent in no small measure on the success of the initial contact.