[Utilization of medical and psychosocial services by mentally ill homeless persons. Results of an epidemiological study].

The aim of this study was to ascertain to what extent homeless, mentally ill subjects in Munich take advantage of available psychosocial services. To obtain a representative picture of the situation, the first step was to ascertain how many people in Munich are actually homeless. The next step was to ascertain what proportion of them are in need of psychotherapy. Using the standardized Diagnostic Interview Schedule (DIS), 146 men and 32 women were interviewed. The results according to the DSM-III demonstrated high lifelong and 6-month prevalence of psychic disturbances. Medical and social services were often enjoyed, but mostly over a short period of time in particularly critical situations. Continued treatment rarely followed. Women were treated more often than men. Elements such as age and level of education hardly influenced patients' seeking help. Despite a high prevalence of addictive disease, alcohol and drug clinics were rarely consulted. The increase in the number of diagnoses was paralleled by an increase in the number of patients seeking help. Most treatments involved schizophrenia and anxiety. By means of logistic regression models, predictors of the extent to which these services were used were analysed. We conclude that new clinical models are needed and that the aversion to the present care system is too great. Continued treatment occurs only rarely.