The Prevalence of Mental Illness in Homeless People in Germany.

BACKGROUND: The number of homeless people in Germany is increasing. Studies from multiple countries have shown that most homeless people suffer from mental illnesses that require treatment. Accurate figures on the prevalence of mental illness among the homeless in Germany can help improve care structures for this vulnerable group.

METHODS: We carried out a systematic review and meta-analysis on the prevalence of mental illness among homeless people in Germany.

RESULTS: 11 pertinent studies published from 1995 to 2013 were identified. The overall study population consisted of 1220 homeless people. The pooled prevalence of axis I disorders was 77.4%, with a 95% confidence interval [95% CI] of [71.3; 82.9]. Substance-related disorders were the most common type of disorder, with a pooled prevalence of 60.9% [53.1; 68.5]. The most common among these was alcoholism, with a prevalence of 55.4% [49.2; 61.5]. There was marked heterogeneity across studies.

CONCLUSION: In Germany, the rate of mental illness requiring treatment is higher among the homeless than in the general population. The development and implementation of suitable care models for this marginalized and vulnerable group is essential if their elevated morbidity and mortality are to be reduced.