Theme 1 | (COVID-19 related) mental health care

Health patterns reveal interdependent needs of Dutch Homeless Service Users. 

Coline van Everdingen

Coline van Everdingen MD1*, Peter Bob Peerenboom PhD2, Koos van der Velden PhD3, Philippe Delespaul PhD1,4

Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
2 Tangram zorgadviseurs, Doetinchem, The Netherlands
3 Department of Primary and Community Care, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
4 Department of Adult Psychiatry, Mondriaan Mental Health Trust, Heerlen, the Netherlands

Homelessness is an increasing problem in Western European countries. Dutch local authorities initiated cross-sectional reviews to obtain accurate health and needs information on Homeless Service (HS) users.

The Homeless People Treatment and Recovery (HOP-TR) study uses a comprehensive assessment approach to obtain health data. Using a naturalistic meta-snowball sampling in 2015-2017, 436 Dutch HS users were assessed. The lived experience of HS users was the primary data source and was enriched with professional assessments. The InterRAI Community Mental Health questionnaire and “Homelessness Supplement” provided information in different areas of life. The approach for mental health assessments was transdiagnostic. Raw interview data were recoded to assess health and needs. The positive health framework structured symptomatic, social, and existential health domains relevant to recovery.

Most subjects were males, low educated, with a migration background. The majority were long-term or intermittently homeless. Concurrent health problems were related to two domains in most (94.7%) subjects. Almost all participants showed mental health problems (98.6%); for a significant share severe (72.5%). Frequent comorbid conditions were addiction (78%), chronic physical conditions (59.2%), and intellectual impairments (39.9%).

The HOP-TR study reveals significant concurrent health problems among Dutch HS users. The interdependent character of different needs requires an integrated 3-D public health approach to comprehensively serve symptomatic, social, and existential dimensions, required to facilitate recovery.

The School for Mental Health and Neuroscience (MHeNs) strives to advance our understanding of brain-behaviour relationships by using an approach integrating various disciplines in neuro- and behavioural science, medicine, and the life sciences more widely. MHeNs performs high-impact mental health and neuroscience research and educates master's students and PhD researchers. MHeNs performs translational research, meaning practical collaboration between researchers in the lab and in the hospital. MHeNs is one of six graduate schools of the Faculty of Health, Medicine and Life Sciences (FHML) aligned to the Maastricht University Medical Centre+ (MUMC+).