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Risk of homelessness after discharge from psychiatric wards in Denmark: a nationwide register‐based cohort study
Author(s) -
Nilsson S.F.,
Laursen T.M.,
Hjorthøj C.,
Nordentoft M.
Publication year - 2019
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.13082
Subject(s) - cohort , register (sociolinguistics) , psychiatry , medicine , hospital discharge , cohort study , patient discharge , medline , intensive care medicine , philosophy , linguistics , pathology , political science , law
Objective To examine the absolute and relative risk of homelessness following discharge from psychiatric wards in Denmark. Methods A nationwide, register‐based, cohort study including people aged 18+ years discharged from psychiatric wards in Denmark between 1 January 2001 and 31 December 2015. We analysed associations between psychiatric diagnoses and risk of homelessness using survival analysis. Results A total of 126 848 psychiatric in‐patients were included accounting for 94 835 person‐years. The incidence of homelessness one year following discharge was 28.18 (95% CI 26.69−29.75) and 9.27 (95% CI 8.45−10.16) per 1000 person‐years at risk in men and women respectively. The one‐year cumulative probability of first homelessness after discharge from psychiatric wards was 1.58% (95% CI 1.48−1.68) in males and 0.55% (95% CI 0.50−0.61) in females. Substance use disorders increased the risk of homelessness after discharge with adjusted incidence rate ratios of 6.60 (95% CI 5.19−8.40) (men) and 13.06 (95% CI 9.31−18.33) (women), compared with depressive disorders. Prior history of homelessness was an important predictor for homelessness following discharge. Conclusions The first year following discharge from psychiatric wards is a high‐risk period of homelessness, especially when having a substance use disorder or a prior history of homeless shelter contact. Improved efforts to prevent homelessness are needed.