Abstract
Background and Aims
Rates of psychosis in the homeless population are markedly higher compared to the general population. Understanding potential psychological mechanisms underpinning links between psychosis and homelessness is important for the development of effective care pathways for this highly marginalised group. This study aimed to examine the housing status of a sample of people with psychosis admitted to psychiatric inpatient hospital in one UK mental health trust. We further aimed to examine the presence and relevance of symptoms which were directly related to housing (e.g., persecutory beliefs about neighbours).
Methods
A cross-sectional study was conducted using an electronic healthcare database, containing anonymised patient records (Clinical Record Interactive Search). Information on housing status, symptoms, and content of symptoms relating to housing were extracted and independently double-coded from clinical notes at the person's admission.
Results
351 service users were in the sample, which covered discharges over a 12-month period (1st April 2021 to 31st March 2022). There was a higher proportion of individuals living without a fixed address in the sample (10%) compared to population estimates (1%–2%). Housing-related thematic content of symptoms was evident in 34% of the sample (e.g., attributing voices to neighbours, feeling under surveillance at home). The only variable significantly associated with housing status was gender, with men at higher odds of unstable housing compared to women. Individuals with concerns directly related to their housing or housing instability were no more likely to have a longer length of admission than those without housing-related concerns.
Conclusion
A significant proportion of individuals with psychosis admitted for psychiatric inpatient treatment, experienced housing instability. For some of the sample, symptom content directly related to housing. This raises important considerations for how social needs are assessed on admission to psychiatric hospital. Further research in this area is encouraged.
Rates of psychosis in the homeless population are markedly higher compared to the general population. Understanding potential psychological mechanisms underpinning links between psychosis and homelessness is important for the development of effective care pathways for this highly marginalised group. This study aimed to examine the housing status of a sample of people with psychosis admitted to psychiatric inpatient hospital in one UK mental health trust. We further aimed to examine the presence and relevance of symptoms which were directly related to housing (e.g., persecutory beliefs about neighbours).
Methods
A cross-sectional study was conducted using an electronic healthcare database, containing anonymised patient records (Clinical Record Interactive Search). Information on housing status, symptoms, and content of symptoms relating to housing were extracted and independently double-coded from clinical notes at the person's admission.
Results
351 service users were in the sample, which covered discharges over a 12-month period (1st April 2021 to 31st March 2022). There was a higher proportion of individuals living without a fixed address in the sample (10%) compared to population estimates (1%–2%). Housing-related thematic content of symptoms was evident in 34% of the sample (e.g., attributing voices to neighbours, feeling under surveillance at home). The only variable significantly associated with housing status was gender, with men at higher odds of unstable housing compared to women. Individuals with concerns directly related to their housing or housing instability were no more likely to have a longer length of admission than those without housing-related concerns.
Conclusion
A significant proportion of individuals with psychosis admitted for psychiatric inpatient treatment, experienced housing instability. For some of the sample, symptom content directly related to housing. This raises important considerations for how social needs are assessed on admission to psychiatric hospital. Further research in this area is encouraged.
| Original language | English |
|---|---|
| Article number | e70189 |
| Journal | Health Science Reports |
| Volume | 7 |
| Issue number | 11 |
| Early online date | 6 Nov 2024 |
| DOIs | |
| Publication status | Published - 30 Nov 2024 |
Data Availability Statement
This study was supported by CRIS Powered by Akrivia Health, using data, systems and support from the NIHR Oxford Health Biomedical Research Centre (NIHR203316) Research Informatics Team. The source data for this work is owned by Oxford Health NHS Foundation Trust using anonymised patient records via CRIS Powered by Akrivia Health. The data cannot be made publicly available but can be accessed with permissions from Oxford Health NHS Foundation Trust for UK NHS staff and UK academics within a secure firewall, in the same manner as the authors.Keywords
- hallucinations
- homeless
- paranoia
- psychosis
- schizophrenia
- unstable housing
ASJC Scopus subject areas
- General Medicine
