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Profiles of Clinical Need Among Homeless Individuals with Dual Diagnoses

Community Mental Health Journal volume 55, pages 1305–1312 (2019)Cite this article

Abstract

This study explored patterns of clinical need among homeless individuals with dual diagnoses, and explored whether certain profiles are characteristic of different demographic groups. Data were drawn from two larger studies conducted with dually diagnosed, homeless individuals (n = 373). Hierarchical cluster analysis identified four subgroups: (1) Clinically least severe, characterized by less frequent psychological symptoms and no history of physical or sexual abuse; (2) Moderate clinical needs, including shorter history of substance use and less frequent psychological symptoms, but symptoms consistent with severe mental illness; (3) Clinically severe, with frequent anxiety, depression, past and recent physical or sexual abuse, and long history of substance use; (4) Least frequent psychological symptoms, but frequent history of physical or sexual abuse and long history of drug use. Women veterans were mostly likely to be classified in cluster 3, and male civilians in cluster 2. Subgroups of homeless individuals with dual diagnoses demonstrated different clusters of clinical needs, having implications for service delivery to the population.

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Funding

This research was funded by the Substance Abuse and Mental Health Service Administration Cooperative Agreement to Benefit Homeless Individuals, Grants TI16576 and TI023562.

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Authors and Affiliations

  1. Department of Psychiatry, University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA, 01605, USA

    Cathryn Glanton Holzhauer, David Smelson & Elizabeth E. Epstein

  2. School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA

    Thomas Byrne & Molly M. Simmons

  3. VA National Center on Homelessness Among Veterans, 200 Springs Rd, Bedford, MA, 01730, USA

    Molly M. Simmons, David Smelson & Elizabeth E. Epstein

  4. Center of Alcohol Studies, Rutgers University, 607 Allison Road, Piscataway, NJ, 08854, USA

    Elizabeth E. Epstein

  5. Center for Health Organization and Implementation Research, 200 Springs Rd, Bedford, MA, 01730, USA

    Molly M. Simmons & David Smelson

Authors
  1. Cathryn Glanton Holzhauer
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  2. Thomas Byrne
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  3. Molly M. Simmons
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  4. David Smelson
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  5. Elizabeth E. Epstein
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Corresponding author

Correspondence to Cathryn Glanton Holzhauer.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments, or comparable ethical standards. Study one was approved by the VA New Jersey Health Care System and by the Universities of Massachusetts and of Medicine and Dentistry of New Jersey IRBs; Study two was approved by the University of Massachusetts, Worcester and Boston campus, IRBs.

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Holzhauer, C.G., Byrne, T., Simmons, M.M. et al. Profiles of Clinical Need Among Homeless Individuals with Dual Diagnoses. Community Ment Health J 55, 1305–1312 (2019). https://doi.org/10.1007/s10597-019-00432-6

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  • DOI: https://doi.org/10.1007/s10597-019-00432-6

Keywords

  • Homeless
  • Cluster analysis
  • Women
  • Veterans
  • Substance use