Recently published research aimed to determine the prevalence of mental illness among residents of a homeless hostel in inner-city Dublin.¹ The Structured Clinical Interview for DSM-IV Axis 1 Disorders (SCID-1) Clinical Version was used to collect data from study participants over an eight-week period in June–August 2010. Of 97 men considered as ‘residents’ for the purpose of the study, 38 agreed to be interviewed, representing a response rate of 39.2%.

Of the 38 participants: 

• 47.4% were in the 40–54-year age group, 31.6% in the 26–39-year age group and 21% were aged 55 or over.
• Over half (57.9%) had never married.
• 68.4% had children.
• 73.7% reached secondary level education without graduating.
• 92% were unemployed.

A total of 81.6% had a current (last 30 days) Axis 1 diagnosis; the rate increased to 89.5% for lifetime prevalence, when current and past Axis 1 diagnoses were combined. Regarding lifetime diagnoses, the rates were as follows: 42% depressive disorder, 78.9% substance use disorder, 18.4% anxiety/adjustment disorder and 5.3% psychotic disorder. The most common current and past diagnosis was alcohol dependence, with 52.6% of participants meeting the criteria for dependence. The most common disorders during the past 30 days were alcohol dependence 23.7%, opioid dependence and major depressive disorder both 18.4% and opioid abuse and alcohol-induced depression both 7.9%. According to the authors ‘there was considerable comorbidity between disorders, with a significant number of residents experiencing both mental illness and substance use problems’ (p. 25).

Of those interviewed, 31.6% had been admitted to a psychiatric hospital at least once during their lifetime and only 23.7% were currently attending an outpatient psychiatric or addiction service. The authors note that ‘the low number of residents attending services is cause for concern’ (p. 25).

The authors acknowledge the relatively low response rate to the study, and report that information provided to the research team by the specialist support worker at the hostel suggested that some of the 59 men who did not agree to be interviewed may have had experience of mental illness. They also acknowledge the possibility of selection bias, given that the specialist mental health worker at the hostel encouraged the men who had mental health problems to be interviewed for the study. However, the authors also note that, to the best of their knowledge, this was the first study undertaken in Ireland to assess the complete spectrum of Axis 1 disorders.

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1. Prinsloo B, Parr C and Fenton J (2012) Mental illness among the homeless: prevalence study in a Dublin homeless hostel. Irish Journal of Psychological Medicine, 29(1): 22–26. www.drugsandalcohol.ie/18235