Santé mentale des mères et des enfants de familles sans logement en Île-de-France. Résultats de l’enquête ENFAMS

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IntroductionThe number of homeless families in the Greater Paris region has increased over time and given their vulnerability, it is necessary to better know their characteristics, especially in terms of mental health. Our objective was to study the prevalence of mental health difficulties among homeless women and their children and associated factors. MethodsThis study was based on the ENFAMS survey, conducted during the winter of 2012–2013 among 801 homeless families in the Greater Paris region, by trained interviewers and psychologists. Mothers’ depression was assessed by the Composite International Diagnostic Interview (CIDI) and their Post Traumatique Stress Disorders was assessed by the Mini International Neuropsychiatric Interview (MINI). Depression and PTSD of the mothers were studied in weighted Poisson regression models with robust error variance. The emotional and behavioural difficulties of children were assessed by the Strengths and Difficulties Questionnaire (SDQ) and studied by linear regression. ResultsHomeless women have a high prevalence of depression (28.8 %) and Post Traumatic Stress Disorder (PTSD) (18.9 %); their children have high levels of emotional and behavioral difficulties (20.8 %). Factors associated with maternal depression include fluency in French, suicidal risk, PTSD, and unmet medical needs. The risk of PTSD in mothers was associated with departure from the country of origin for a violent cause, depression and residential instability. Children's emotional and behavioral difficulties were associated with parents’ birth region, residential mobility, children's health and overweight, children's sleep patterns, mother's suicidal risk, the fact that children do not like their housing or are victim of school bullying. ConclusionThe standard health care system and primary care professionals must take advantage of the opportunity offered by each contact with homeless families to detect mental health disorders, which have a high prevalence in both mothers and their children, and refer them to existing structures to facilitate their access to health care.