Acceptance of medical and social services by the homeless mentally ill

The aim of this study was to ascertain to what extent homeless, mentally il l subjects in Munich take advantage of available psychosocial services. To obtain a representative picture of the situation, the first step was to asc ertain how many people in Munich are actually homeless. The next step was t o ascertain what proportion of them are in need of psychotherapy. Using the standardized Diagnostic Interview Schedule (DIS), 146 men and 32 women wer e interviewed. The results according to the DSM-III demonstrated high lifel ong and 6-month prevalence of psychic disturbances. Medical and social serv ices were often enjoyed, but mostly over a short period of time in particul arly critical situations. Continued treatment rarely followed. Women were t reated more often than men. Elements such as age and level of education har dly influenced patients' seeking help. Despite a high prevalence of addicti ve disease, alcohol and drug clinics were rarely consulted. The increase in the number of diagnoses was paralleled by an increase in the number of pat ients seeking help. Most treatments involved schizophrenia and anxiety. By means of logistic regression models, predictors of the extent to which thes e services were used were analysed. We conclude that new clinical models ar e needed and that the aversion to the present care system is too great. Con tinued treatment occurs only rarely.