TY - JOUR

T1 - The bidirectional association between psychiatric disorders and sheltered homelessness

AU - Nilsson, Sandra Feodor

AU - Wimberley, Theresa

AU - Speyer, Helene

AU - Hjorthøj, Carsten

AU - Fazel, Seena

AU - Nordentoft, Merete

AU - Laursen, Thomas Munk

PY - 2024

Y1 - 2024

N2 - BackgroundPsychiatric disorders and homelessness are related, but temporal associations are unclear. We aimed to explore the overlap between hospital-based psychiatric disorders and sheltered homelessness.MethodsThis population-based cohort study was conducted using the Danish registers e.g., the Danish Homeless Register and the Danish National Patient Register. The study cohort included all individuals aged 15 years or older, living in Denmark at least one day during 2002–2021 (born 1984–2006). First psychiatric diagnosis was used to define psychiatric disorder and first homeless shelter contact to define homelessness. Adjusted incidence rate ratios (IRRs) and cumulative incidences were estimated.ResultsAmong 1 530 325 individuals accounting for 16 787 562 person-years at risk aged 15–38 years, 11 433 (0.8%) had at least one homeless shelter contact. Among 1 406 410 individuals accounting for 14 131 060 person-years at risk, 210 730 had at least one psychiatric disorder. People with any psychiatric disorder had increased risk of sheltered homelessness relative to individuals with no psychiatric disorder [IRR 9.2, 95% confidence interval (CI) 8.8–9.6]. Ten years after first psychiatric disorder, 3.0% (95% CI 2.9–3.1) had at least one homeless shelter contact. Individuals experiencing homelessness had increased risk of any psychiatric disorder compared to individuals with no homeless shelter contact (IRR 7.0, 95% CI 6.7–7.4). Ten years after first homeless shelter contact, 47.1% (45.3–48.0) had received a hospital-based psychiatric diagnosis.ConclusionStrong bidirectional associations between psychiatric disorders and homelessness were identified. Health and social care professionals should be aware of and address these high risks of accumulated psychiatric and social problems.

AB - BackgroundPsychiatric disorders and homelessness are related, but temporal associations are unclear. We aimed to explore the overlap between hospital-based psychiatric disorders and sheltered homelessness.MethodsThis population-based cohort study was conducted using the Danish registers e.g., the Danish Homeless Register and the Danish National Patient Register. The study cohort included all individuals aged 15 years or older, living in Denmark at least one day during 2002–2021 (born 1984–2006). First psychiatric diagnosis was used to define psychiatric disorder and first homeless shelter contact to define homelessness. Adjusted incidence rate ratios (IRRs) and cumulative incidences were estimated.ResultsAmong 1 530 325 individuals accounting for 16 787 562 person-years at risk aged 15–38 years, 11 433 (0.8%) had at least one homeless shelter contact. Among 1 406 410 individuals accounting for 14 131 060 person-years at risk, 210 730 had at least one psychiatric disorder. People with any psychiatric disorder had increased risk of sheltered homelessness relative to individuals with no psychiatric disorder [IRR 9.2, 95% confidence interval (CI) 8.8–9.6]. Ten years after first psychiatric disorder, 3.0% (95% CI 2.9–3.1) had at least one homeless shelter contact. Individuals experiencing homelessness had increased risk of any psychiatric disorder compared to individuals with no homeless shelter contact (IRR 7.0, 95% CI 6.7–7.4). Ten years after first homeless shelter contact, 47.1% (45.3–48.0) had received a hospital-based psychiatric diagnosis.ConclusionStrong bidirectional associations between psychiatric disorders and homelessness were identified. Health and social care professionals should be aware of and address these high risks of accumulated psychiatric and social problems.

U2 - 10.1017/S0033291723002428

DO - 10.1017/S0033291723002428

M3 - Journal article

C2 - 37679023

VL - 54

SP - 742

EP - 752

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

IS - 4

ER -