Mental illness in homeless men and women in Munich, Germany

Purpose: Mental illness appears to be overrepresented among homeless individuals. The purpose of this study was the standardised assessment of mental illness in a representative sample of homeless men and of homeless women in the city of Munich, Germany. Methods: In order to get a very good estimate of the population of homeless individuals in Munich, a pre-sampling survey was conducted. On the basis of this pre-sampling survey the size and relevant characteristics of the total population of homeless individuals in Munich were defined. Individuals of the sample were randomly selected from the population. 146 men and 32 women were interviewed using the Diagnostic Interview Schedule (DIS). Results: Homeless men were on the average 43 years of age, most of them unmarried or divorced, had a relatively low degree-of school education and a relatively long duration of homelessness, The prevalence of mental illness (lifetime) was very high: 91,8% had a substance abuse disorder (82,9% alcohol dependence), 41,8% had an affective disorder, 22,6% had an anxiety disorder and 12,4% suffered from schizophrenia. Of the homeless men in Munich 94,5% had at least one DIS/DSM-III axis I diagnosis 6- month prevalence data is also presented. Conclusions: The results confirm the findings of other studies in other countries of high rates of mental illness among homeless individuals. In comparison to a study in Los Angeles using the same methodology, prevalence rates were even higher in Munich. Implications for health care planning are discussed.