Homeless families in England report high levels of depression
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7453.1396-c (Published 10 June 2004) Cite this as: BMJ 2004;328:1396All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Sir:
Homelessness is a man-made social evil. This inhuman phenomenon is
common in developing countries but its ugly faces could be seen in rich
developed nations where its presence is not acceptable by any means rather
it should be abhorred by all people alike and moreover responsible
individuals should be accountable for nearly ignoring homelessness.
All industrialized nations and their political machineries boast for
their economic developments, democratic ways of life, and civil liberties
but in fact they are far behind in equalizing economic disparities found
among people of their own countries. There is a wide gulf between rich and
poor in developed nations and therefore homelessness is not an exception
there. It is a pity that the political leaders of those countries could
not utilize the huge financial resources to alleviate the sufferings of
homeless population, which they have wasted in waging and fighting wars in
Iraq and Afghanistan and also elsewhere and in specific term war against
terror and imagined WMD. The political concept underlying stigmatize a
group of people as terrorists and strike them in their own homeland has
failed completely. These political leaders are free to strike anybody at
any time because nobody can challenge them as they are the most arrogant
people and ruthless rulers of the superpowers of the world.
Now I will focus on the biopsychosocial devastating effects of
homelessness which include depression, alcohol abuse and other substance
use disorders such as cannabis and opioids, psychopathy, childhood conduct
disorders, severe mental disorders such as schizophrenia, and heavy
smoking. These mental disorders and their comorbidities are four times
more common in homeless population as compared to general population.
Homeless people also have high rate of crimes and incarceration. Medical
consequences of homelessness are bacterial infections, obesity, frequent
pregnancy, lower back pain, high blood pressure, chronic hepatitis C virus
infection, fungal infections, traumas and dental diseases.
Finally despite some political efforts to improve the living
conditions of homeless people, there are still millions of homeless
people in the USA and the UK who need priority from all perspectives
including provisions of health care and proper accomodation. Otherwise
their political leaders are living in shame.
Reference:
Tiago Villanueva. Homeless families in England report high levels of
depression. BMJ 2004; 328: 1396-c-0-c.
Competing interests:
Psychiatrist-cum-social reformer
Competing interests: No competing interests
Editor,
It is well known that poor housing is one of the social causes for
depression.Poor quality housing tends to be on deprived estates which are
a convergence point for many other psychosocial factors that can conspire
to cause mental health problems. At the current time , the national
average house price is roughly 6 times the national average salary and
continues to rise. If the present trends in house prices are to continue,
we are likely to see more people become homeless or move into poor quality
housing, resulting in a greater number of cases of psychiatric
morbidity.With the NHS stretched for resources in psychiatric care as it
is for many other specilaities,common sense dictates that,as prevention is
better than cure, the provision of cheap but good quality housing must be
made an urgent national priority.The government must be able to see the
societal and psychological consequences upon the vulnerable sections of
the population beyond just the economic ramifications of the housing
situation.Hopefully, this report should facilitate this and spur the
government into remedial action.
Competing interests:
None declared
Competing interests: No competing interests
Re: Things will only get worse
The findings of this report will come as no great surprise to anyone
with any level of involement with health and social care in England - or
the rest of the United Kingdom for that matter.
Perhaps more alarming is the fact that in this case the respondents
were those with the "luxury" of living in temporary accomodation or in run
down council acommodation, a fact that raises even greater concern for the
thousands of others not afforded the same "luxury".
It is without a doubt fact that prevention is better than cure, and
if the findings of this report raise concerns then the reality should
raise even greater ones. The Government must indeed address the housing
issues previously mentioned or the demands on the already overstretched
mental health services within the NHS will reach the same crisis point and
public confidence in both the Government and the NHS will collapse
completely.
Competing interests:
None declared
Competing interests: No competing interests