The mental hell of the homeless

It is a problem of society as serious - not to say tragic - as rarely discussed: the mental health of the homeless. A study published in science direct has just shed some light. And it is uplifting. As part of the “A home first” project aimed at providing homeless people with housing to improve the quality of psychiatric care, this study included more than 700 homeless people suffering from schizophrenia or bipolar disorders.

Aged on average 38 years and made up of 83% men, these street patients were divided into 70% of schizophrenia cases and 30% of bipolar disorders. The objective of the study was to find out if they were receiving appropriate drug therapy. Almost nine out of ten patients are not treated properly.

Untreated depression

In particular, 386 (54.9%) patients had an inappropriate prescription of antipsychotic (43.4%) or mood stabilizer (81.9%). In addition, the same percentage also suffered from untreated depression. Let us add that some 45% of them, on the other hand, received long-term anxiolytics and 15% received long-term hypnotics, which is not recommended because of the risks of dependence and impairment of cognitive functions.

If the absence of basic treatment remains a problem often linked to the patient's refusal to treat himself, the law does not authorize psychiatrists to administer treatment without the patient's consent outside the context of the emergency, others factors are added which further aggravate the lack of care. For example, the consumption of alcohol or drugs can mask depression and thus prevent the detection of depression; it is also possible that certain psychiatrists prefer not to prescribe antidepressants, for fear of worsening the main pathology, in particular by causing a “manic turn” in bipolar.