Abstract
Measures Tri-morbidity was operationalized as meeting the following criteria: 1) probable mental illness or major psychiatric distress, based on reporting a diagnosis of post-traumatic stress disorder or schizophrenia, having ever taken psychiatric medication for a significant period of time, or a score of 30+ on the Colorado Symptom Index (range: 5– 70) [1]; 2) lifetime moderateor high-risk alcohol or illicit drug use, as measured using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) v. 3 [2]; and 3) reporting at least 1 of 14 physician-diagnosed chronic medical conditions. Primary care experience was measured using the Primary Care Quality-Homeless (PCQ-H) tool (range: 1–4) [3]. Social support was measured using the “strong ties” scale (range: 3–15) [4], which queries the degree to which persons are bothered by not having a close companion, enough friendships, or people to whom they feel close.
Highlights
Persons living with mental illness, substance use disorder, and medical conditions, or “tri-morbidity,” have complex health needs
Multiple linear regression tested whether tri-morbidity predicted lower social support, compared to those without tri-morbidity, controlling for characteristics associated with strong ties
Tri-morbidity was present in 39 percent of this sample of primary care-engaged, homeless, and formerly homeless persons (Table 1)
Summary
Persons living with mental illness, substance use disorder, and medical conditions, or “tri-morbidity,” have complex health needs. Measures Tri-morbidity was operationalized as meeting the following criteria: 1) probable mental illness or major psychiatric distress, based on reporting a diagnosis of post-traumatic stress disorder or schizophrenia, having ever taken psychiatric medication for a significant period of time, or a score of 30+ on the Colorado Symptom Index (range: 5– 70) [1]; 2) lifetime moderate- or high-risk alcohol or illicit drug use, as measured using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) v. Social support was measured using the “strong ties” scale (range: 3–15) [4], which queries the degree to which persons are bothered by not having a close companion, enough friendships, or people to whom they feel close.
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