Homeless shelter users in the postdeinstitutionalization era

Objective: To describe the psychiatric symptomatology and mental health ser vice needs of homeless shelter users in Calgary, Alberta. Data were collect ed as part of a broad-based community action initiative designed to reduce the problem of homelessness. Methods: A semistructured interview was conducted with a representative sam ple of 250 emergency shelter users. Mental health problems were measured th rough self-reports of 9 psychiatric symptoms known to be related to illness es prevalent among homeless populations (depression, anxiety, and psychoses ). The CAGE alcohol screen was also used. Results: Three-quarters of the sample expressed some symptomatology. About one-third were estimated to have a significant mental health problem. The l ifetime-prevalence of alcohol abuse was 33.6%. Higher levels of psychiatric symptomatology appeared to relate to a wide range of hardships, personal a nd public health risks, addictive behaviours, victimization, economic and i nterpersonal life events, dissatisfaction, and stress. Also, those with sig nificant symptomatology frequently needed mental health care services but o ften did not know where to access them. Conclusions: The prevalence of mental health and substance abuse problems w ithin homeless populations is significant and associated with considerable hardship as well as personal andpublic health risks.