Among homeless population, 25-30% have serious mental problems. This percentage increases to 60% in chronic homelessness. Most common disorders are major depression, bipolar disorder, schizophrenia and anxiety. Drug use is also prevalent in this population, where “dual diagnosis” or “co-occurring disorders” with comorbid mental illness and substance use disorders. This “dual diagnosis” presents the challenge of managing the mental illness in the setting of drug use, and may affect patient’s adherence to appointments due to various treatment barriers.
One of the effective ways to manage this complicated situation is to form teams consisting of mental health, addiction, professional case managers and social workers who can work together on the medical and social aspects of the problem. As physicians, we need to understand that treating just an illness would not be sufficient to improve this populations’ general health and wellbeing. Each piece is integral for the ultimate purpose of managing homeless population.
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