Homelessness and severe mental illness in low- and middle-income countries: scoping review.

Journal: BJPsych open

Volume: 5

Issue: 4

Year of Publication: 

Affiliated Institutions:  PhD Student, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. Professor of Epidemiological Psychiatry and Assistant Principal for Global Health, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. NIHR ASSET Programme Coordinator, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. Co-Director, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine; and CBM International, London, UK. Associate Professor, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University; Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Ethiopia; and Professor of Global Mental Health, Global Health and Infection Department, Brighton and Sussex Medical School, UK. Reader in Global Mental Health, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Adjunct Associate Professor, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University; and Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Ethiopia.

Abstract summary 

Despite being a global problem, little is known about the relationship between severe mental illness (SMI) and homelessness in low- and middle-income countries (LMICs). Homeless people with SMI are an especially vulnerable population and face myriad health and social problems. In LMICs, low rates of treatment for mental illness, as well as differing family support systems and cultural responses to mental illness, may affect the causes and consequences of homelessness in people with SMI.To conduct a systematic, scoping review addressing the question: what is known about the co-occurrence of homelessness and SMI among adults living in LMICs?We conducted an electronic search, a manual search and we consulted with experts. Two reviewers screened titles and abstracts, assessed publications for eligibility and appraised study quality.Of the 49 included publications, quality was generally low: they were characterised by poor or unclear methodology and reporting of results. A total of 7 publications presented the prevalence of SMI among homeless people; 12 presented the prevalence of homelessness among those with SMI. Only five publications described interventions for this population; only one included an evaluation component.Evidence shows an association between homelessness and SMI in LMICs, however there is little information on the complex relationship and direction of causality between the phenomena. Existing programmes should undergo rigorous evaluation to identify key aspects required for individuals to achieve sustainable recovery. Respect for human rights should be paramount when conducting research with this population.None.

Authors & Co-authors:  Smartt Caroline C Prince Martin M Frissa Souci S Eaton Julian J Fekadu Abebaw A Hanlon Charlotte C

Study Outcome 

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Statistics
Citations :  Fazel S, Geddes JR, Kushel M. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet 2014; 384: 1529–40.
Authors :  6
Identifiers
Doi : e57
SSN : 2056-4724
Study Population
Male,Female
Mesh Terms
Other Terms
Psychotic disorders;homelessness;low- and middle-income countries
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England