Chapter 9. The Homeless Mentally Ill

  1. Norman Sartorius2,
  2. Wolfgang Gaebel3,
  3. Juan José López-Ibor4 and
  4. Mario Maj5
  1. Viviane Kovess

Published Online: 29 APR 2002

DOI: 10.1002/0470846488.ch9

Psychiatry in Society

Psychiatry in Society

How to Cite

Kovess, V. (2002) The Homeless Mentally Ill, in Psychiatry in Society (eds N. Sartorius, W. Gaebel, J. J. López-Ibor and M. Maj), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846488.ch9

Editor Information

  1. 2

    University of Geneva, Switzerland

  2. 3

    University of Düsseldorf, Germany

  3. 4

    Complutense University of Madrid, Spain

  4. 5

    University of Naples, Italy

Author Information

  1. Public Health Research Department, MGEN, Paris V University, France

Publication History

  1. Published Online: 29 APR 2002
  2. Published Print: 30 APR 2002

ISBN Information

Print ISBN: 9780471496823

Online ISBN: 9780470846483



  • homeless;
  • mental illness;
  • psychiatry;
  • use of care;
  • epidemiology;
  • survey;
  • deprivation;
  • schizophrenia;
  • affective disorders;
  • substance use disorders


High rates of severe mental illness amongst homeless populations have been consistently reported in the literature, despite differences in health care systems and social benefits. This chapter first touches on the respective causes which have been held responsible mainly the process of de-institutionalization and the shortage of low price accommodation, along with the failure of the health system to prevent homelessness after people have been hospitalized. Then, world-large epidemiological data are presented with a special attention to methodological problems such as definition of homelessness, sampling methods, definition of cases. The diverse psychiatric disorders prevalence are presented and discussed including the frequent comorbidity with substance disorders. Diverse studies concerning use of care in the different health systems are presented and discussed along with the risk factors and pathway to homelessness for mentally ill people allowing conclusions in favour of better care organization and preventive measures.