PMH28: DEPRESSION AND HOMELESSNESS, A FRENCH INITIATIVE

Abstract

CONTEXT: So-called chronic depression, a limiting factor in terms of social reinsertion, must be diagnosed to enable its management and to prevent a decline towards a profound, desocialised state. OBJECTIVE: To determine the incidence of depression in populations of the homeless, who are users of the Samu Social de Paris—Paris Social Emergencies Unit—(SSP). METHOD: Once an individual had been assessed and a response found to his or her need, it was suggested that patients calling the SSP free-phone number should agree to complete the CES-D questionnaire. Developed in the US by Randloff (1977), this questionnaire enables the detection of depressive symptoms in a given population. Its use over the telephone has been validated. RESULTS: Mean age: 43 years. Sex ratio: 84% men, 16% women, this being in line with the ratio of users of the SSP. In 54% of our sample, the period of homelessness was longer than 2 years; 92% were single, 64% had maintained contacts with their family and 36% declared they had no income. 70% of those questioned had a score of 17 or higher on the CES-D scale, indicative of depressive symptoms, mean score: 22.4; the prevalence of possible depression was 69% and that of probable was 60%. Although no significant difference was seen in terms of the duration of homelessness, two peaks were nonetheless observed: at 28 for those on the street for more than one month and less than 6 months, and 22.8 for those homeless for more than two years. CONCLUSION: By “turning the spotlight” on a poorly understood population, this study provides relevant results, which demonstrate the need to act very rapidly to help these populations living in considerable need, before the homeless sink into a state of permanent poverty.