Psychiatric Disorders in Hospitalized Homeless Individuals: A Nationwide Study

To compare the incidence of inpatient psychiatric admissions and evaluate the prevalence of psychiatric disorders among homeless individuals.

This cross-sectional study utilized the Nationwide Inpatient Sample dataset for the year 2016-2017. US adult homeless patients (age ≥ 18 years) admitted to the hospital were age and sex matched (1:1) with non-homeless individuals using the propensity score matching technique.

The study included a total of 614,390 homeless patients (mean age = 46.1 years, 71.9% male). Most of the homeless patients were Black (24.8% vs 17.3% of the non-homeless population). Mood, anxiety, and psychotic disorders were highly prevalent in homeless patients compared to those who were non-homeless (P < .001). Composite of psychiatric disorders was also significantly higher in the homeless group (64.9% vs 29.1%, P < .001). Suicidal ideation was present in 19.4% of the homeless individuals and in 2.9% of the non-homeless (P < .001). Hospital admissions related to any psychiatric condition were 33.9% in the homeless and 6.7% in the non-homeless (P < .001). Compared to the non-homeless, homeless patients admitted for psychiatric disorders had longer inpatient psychiatric admissions (8.7 vs 7.7 days, P < .001).

The results revealed a positive association between homelessness, comorbid psychiatric disorders, and suicidal ideations/attempts. Appropriate psychiatric screening measures are needed for the homeless. Homelessness is associated with longer inpatient psychiatric stay. The challenges faced in treating and preventing mental illness in the homeless should be investigated further.