Recent research has shown that the number of emergency hospitalisations among those experiencing homelessness in Ireland has increased significantly in the last 10 years.1 The profile of those using emergency department services suggests that they are, in the main, chronically or episodically homeless and thus represent a relatively small proportion of the overall homeless population. Nevertheless, these subjects are heavy users of various costly services. Furthermore, a number of Irish studies have suggested that homeless people exhibit relatively high levels of mental health difficulties and may be over-represented in psychiatric settings.1,2

Recent Irish research aimed to examine the profile of psychiatric admissions for subjects with no fixed abode.3 In this study, published in the Irish Medical Journal, the authors retrospectively evaluated the Health Research Board’s National Psychiatric Inpatient Reporting System (NPIRS) data to develop an overview of admissions with no fixed abode recorded for the years 2007–2016 (n=2176). 

Results

It was found that in the 10-year period there was a 44% increase in admissions with no fixed abode from 188 in 2007 to 271 in 2016. The analysis demonstrated that the characteristics of this cohort have remained largely unchanged in the 10 years; almost three-quarters (1,598; 73.4%) were male, almost one-half (1,068; 49.1%) were less than 35 years of age, and three-quarters (1,638; 75.2%) were less than 45 years. Other characteristics of psychiatric inpatients with no fixed abode included the following:

• Three-quarters (1,643; 75.5%) were single and a similar proportion were unemployed (1,640; 75.4%). 
• 621 (28.5%) had a diagnosis of schizophrenia, 258 (11.9%) had a depressive disorder, while 212 (9.7%) had a personality/behavioural disorder.
• 257 (11.8%) had an alcohol disorder, while 333 (15.3%) had other drug disorders.

Conclusions

The authors noted that these characteristics are consistent with the single ‘chronically homeless’ people described in the literature. In addition, it was observed that the prevalence of schizophrenia and alcohol and drug disorders differed from the national profile of psychiatric admissions.4 The authors concluded that there is a need to use routinely collected data to help understand and address the need of specific homeless subgroups. In particular, those on institutional circuits that include psychiatric inpatient facilities.

1    O’Sullivan E (2008) Researching homelessness in Ireland: explanations, themes and approaches. In Downey D (ed) Perspectives on Irish homelessness: past, present and future. Dublin: Homeless Agency. https://www.drugsandalcohol.ie/11723/

2    Keogh C, O’Brien KK, Hoban A, O’Carroll A and Fahey T (2015) Health and use of health services of people who are homeless and at risk of homelessness who receive free primary health care in Dublin. BMC Health Serv Res, 15(1): 58. https://www.drugsandalcohol.ie/23533/

3    Daly A, Craig S and O’Sullivan E (2019) A profile of psychiatric in-patient admissions with no fixed abode (NFA) 2007–2016. Ir Med J, 112(1): 853. https://www.drugsandalcohol.ie/30179/

4    Daly A and Craig S (2017) Irish psychiatric units and hospitals census 2016: main findings. Dublin: Health Research Board. https://www.drugsandalcohol.ie/26559/