Guru S Gowda1, G Gopika2, Channaveerachari Naveen Kumar3, Narayana Manjunatha3, Ravi Yadav4, Dwarakanath Srinivas5, Bharath Rose Dawn6, Suresh Bada Math3. 1. Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore - 560029, India. Electronic address: drgsgowda@gmail.com. 2. Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore - 560029, India. 3. Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore - 560029, India. 4. Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore - 560029, India. 5. Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore - 560029, India. 6. Department of Neuro Imaging and Interventional Radiology (NIIR), National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore - 560029, India.
Abstract
OBJECTIVES: Homeless Mentally Ill (HMI) patients represent a unique global problem and pose a challenge in treatment, management and rehabilitation services. There is sparse data on HMI patients in India. The objective of this paper is to study the clinical outcome and rehabilitation of HMI patients. METHODS: We performed a retrospective chart review of 'HMI' patients from 1st January 2002 to 31st December 2015, who were admitted under Department of Psychiatry at National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India. Clinical outcomes were analysed by descriptive statistics and predictors of family reintegration were analysed by logistic regression model. RESULTS: Seventy-eight HMI (unknown) patients were admitted in fourteen years period. 64(82%) were improved at discharge, 40(51.3%) were reintegrated to the family; 15(19.2%) were sent to state home for women, and 17(21.8%) were sent to Non-Governmental Organization (NGO)/Rehabilitation Centre and 6 (7.8%) required multispecialty care in general hospital or absconded from the hospital during inpatient care. The logistic regression model showed that mental retardation (B=-2.204, P=0.002) was negatively correlated with family reintegration and clinical improvement at discharge (B=2.373, P=<0.001) was positively correlated with family reintegration. CONCLUSIONS: In our study majority of HMI patients improved at the time of discharge. Family reintegration was possible in about half of HMI patients after treatment. Mental retardation and clinical improvement are important predictors of family reintegration of HMI patients.
OBJECTIVES: Homeless Mentally Ill (HMI) patients represent a unique global problem and pose a challenge in treatment, management and rehabilitation services. There is sparse data on HMIpatients in India. The objective of this paper is to study the clinical outcome and rehabilitation of HMIpatients. METHODS: We performed a retrospective chart review of 'HMI' patients from 1st January 2002 to 31st December 2015, who were admitted under Department of Psychiatry at National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India. Clinical outcomes were analysed by descriptive statistics and predictors of family reintegration were analysed by logistic regression model. RESULTS: Seventy-eight HMI (unknown) patients were admitted in fourteen years period. 64(82%) were improved at discharge, 40(51.3%) were reintegrated to the family; 15(19.2%) were sent to state home for women, and 17(21.8%) were sent to Non-Governmental Organization (NGO)/Rehabilitation Centre and 6 (7.8%) required multispecialty care in general hospital or absconded from the hospital during inpatient care. The logistic regression model showed that mental retardation (B=-2.204, P=0.002) was negatively correlated with family reintegration and clinical improvement at discharge (B=2.373, P=<0.001) was positively correlated with family reintegration. CONCLUSIONS: In our study majority of HMIpatients improved at the time of discharge. Family reintegration was possible in about half of HMIpatients after treatment. Mental retardation and clinical improvement are important predictors of family reintegration of HMIpatients.
Authors: Karishma R Kulkarni; R P S Shyam; Virupakshappa Irappa Bagewadi; Guru S Gowda; B R Manjunatha; Harihara N Shashidhara; Vinay Basavaraju; Narayana Manjunatha; Sydney Moirangthem; Channaveerachari Naveen Kumar; Suresh Bada Math Journal: Indian J Med Res Date: 2020-10 Impact factor: 2.375