CHARACTERISTICS OF HOMELESS MENTALLY-ILL PEOPLE WHO LOSE CONTACT WITHCARING AGENCIES

Objective: To discover whether (as predicted in the literature) loss o f contact with caring agencies is related to age, substance dependence , a history of law-breaking, or a diagnosis of schizophrenia. Method: A consecutive series of 71 homeless people with mental disorders was r ecruited over a period of 18 months, The subjects were new referrals t o psychiatrists working in a primary health care clinic for the homele ss, The subjects were then followed up for a further 18 months (maximu m follow up time 36 months, minimum follow up time 18 months) to deter mine duration of contact with Oxford services for helping the homeless (survival time). Results: Survival analyses indicated that early loss of contact with Oxford services for helping the homeless was strongly predicted by substance (mainly alcohol) dependence in the month befor e first attendance at the clinic (generalised Wilcoxon 15.8, p<0.0001) , Homeless people with mental disorders who are also alcohol dependent , were five times more likely to lose contact with caring agencies tha n homeless people with mental disorders who were not alcohol dependent (hazard ratio 5.05, 95% confidence limits 14.9-3.0). Conclusions: Amo ngst homeless people with mental disorder, there appears to be an asso ciation between substance (mainly alcohol) dependence and loss of cont act with caring agencies, This may be because homeless people with a d ual diagnosis of mental disorder and substance dependence, tend to be more mobile than those who are not substance dependent.