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Social Psychiatry and Psychiatric Epidemiology

Published in:

01-01-2016 | Original Paper

A longitudinal study of suicidal ideation among homeless, mentally ill individuals

Authors: François Noël, Akm Moniruzzaman, Julian Somers, Jim Frankish, Verena Strehlau, Christian Schütz, Michael Krausz

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 1/2016

Abstract

Purpose

Previous cross-sectional studies have indicated that homeless individuals may present with high rates of suicidal ideation, which are strongly associated with completed suicide. We conducted the first known longitudinal study of suicidal ideation in the homeless.

Methods

We used data collected over 24 months in the Vancouver At Home project (N = 497), comprised two randomized-controlled trials of housing interventions for homeless individuals with mental disorders. Presence of suicidal ideation was determined using the Colorado symptom index.

Results

Suicidal ideation significantly decreased over time [odds ratio (OR) = 0.31 at 24 months, 95 % confidence interval (CI) 0.21–0.46]. Baseline diagnoses of mood (OR = 2.18, 95 % CI 1.48–3.21) and anxiety disorders (OR = 2.05, 95 % CI 1.42–2.97), as well as depressive mood (OR = 2.52, 95 % CI 1.90–3.33), use of any substance (OR = 1.59, 95 % CI 1.09–2.32), and polysubstance use (OR = 1.90, 95 % CI 1.40–2.60) were significantly associated with suicidal ideation in the multivariate model. Baseline diagnosis of a psychotic disorder (protective effect), daily substance use, intravenous drug use, recent arrest, multiple physical illnesses and history of traumatic brain injury were significantly associated with suicidal ideation in the unadjusted model only.

Conclusions

Interventions targeting depressive symptoms and substance use could help decrease suicide risk in homeless individuals. Mental health services need to be tailored to address the complex needs of socially marginalized individuals.

Trial registration

Current controlled trials: ISRCTN57595077 (Vancouver At Home study: Housing First plus Assertive Community Treatment versus congregate housing plus supports versus treatment as usual) and ISRCTN66721740 (Vancouver At Home study: Housing first plus intensive case management versus treatment as usual). Assigned 9 Oct. 2012.

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Title: A longitudinal study of suicidal ideation among homeless, mentally ill individuals
Authors: François Noël
Akm Moniruzzaman
Julian Somers
Jim Frankish
Verena Strehlau
Christian Schütz
Michael Krausz
Publication date: 01-01-2016
Publisher: Springer Berlin Heidelberg
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 1/2016
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-015-1142-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A longitudinal study of suicidal ideation among homeless, mentally ill individuals

Abstract

Purpose

Methods

Results

Conclusions

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Trial registration

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