The Prevalence of Psychiatric Disorders and Limitation of Healthcare Utilization among the Homeless Residing in Shelters in Bangkok
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Abstract
The objectives were to investigate the prevalence of psychiatric disorders and limitation in healthcare utilization among the homeless residing in shelters in Bangkok. The materials include Mini International Neuropsychiatric Interview - Thai version, demographic questionnaires, and semi-structural interview. The data was collected by an individual interview. The subjects were 116 homeless people. The descriptive statistical analysis was used for parametric data such as demographic characteristic and psychiatric diagnosis. Chi-square test was used to study the correlation between psychiatric diagnosis and subject's characteristics. The causes that prevented subjects from utilizing healthcare services were categorized. The result demonstrated 61.2% of the participants suffered from at least one psychiatric disorder. The common psychiatric problems were the psychotic disorder (22.4%), alcohol dependence (21.6%), and major depressive episode (20.7%). Those who were rough sleepers before utilizing the shelter were more likely to be diagnosed with psychotic disorders (p-value <0.001) and being diagnosed with more than one disorder (p-value 0.027). The thematic analysis suggested that half of the participants accepted that there were several causes that prevented them from using the healthcare services: 1) the issues of the expense of medical fees and healthcare coverage; 2) the problem of transportation and traveling costs to services; 3) quality of the service or the feeling of receiving substandard care; and 4) unwillingness to serve among the healthcare providers. To conclude, the prevalence rates of psychiatric disorders among sheltered homeless are greater than in the general population. An urgent improvement of healthcare as well as mental healthcare availability and accessibility for this population is required.
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Copyright: CC BY-NC-ND 4.0
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