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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S6–S7


State of the art: identifying and managing mental

health needs of homeless individuals


Identifying and managing mental

health needs of homeless individuals

D. Bhugra

Institute of Psychiatry, Psychology and Ne, London, United Kingdom

The economic downturn worldwide since 2008 has raised many

issues, including an increase in homelessness. Individuals who are

homeless are visible across the globe. Definitions of homelessness

also vary. Living on the streets in all kinds of inclement weather,

brings a different set of issues and problems including physical and

mental illnesses. Here homelessness is defined as a lack of cus-

tomary regular access to a conventional dwelling unit. It has been

shown in several studies that nearly half were either depressed or

had substance use disorders and half had traumatic brain injury.

Homelessness is a social issue and the role of the psychiatrist in

reaching these vulnerable individuals is a matter of critical impor-

tance. In the UK health services are geographically delineated

making it more difficult for ‘out of area’ individuals to get help.

The responsibility for looking after people who are homeless, have

mental illness or physical co-morbidity, lies with policymakers as

well. As clinicians we must advocate for vulnerable patients and

psychiatry care needs to be in a joined-up manner. Early interven-

tions and home treatments where and if available are suitable and

can be effective but are often linked with secure addresses. Policies

must take into account huge variations across cultures and societies

and the contributions that unemployment and poverty can play

in increasing homelessness. Whether psychiatric disorders lead to

homelessness and whether homelessness leads to mental illness is

a circular argument and this vicious downward spiral needs to be

broken by adequate care and policy support.

Disclosure of interest

The author has not supplied his declaration

of competing interest.

State of the art: social media and e-mental health


Social media and e-mental health

M. Krausz

Addiction, West Vancouver, Canada

Mental health services worldwide are only able to serve a minor-

ity of patients. Expert advice is in most cases not accessible even

in developed countries with a functioning mental health care sys-

tem. Threshold to care are high and the time between first critical

developments and symptoms and first professional interventions

is long, sometimes several years.

The evolving communication tools through social media and web-

based services may provide new and exciting opportunities to

change that. Especially young people have a different approach

to interact, learn and access services through the Internet. The

momentum there is as crucial as it is in education. Our mental

health care system in all its components will most likely very dif-

ferent than today. E mental health will be an integrated component

contributing to more capacity, higher quality of care and better


What is the key in developing new tools and what can today’s cli-

nicians and researchers do to be an active partner in this process?

What are themajor concerns and how shouldwe address themalso

as professional organization? This may be an opportunity of a life-

time for a paradigm shift. Its success relates to good integration and

implementation of these exciting tools to create a new continuum

of tools addressing a continuum of needs.

Disclosure of interest

The author has not supplied his declaration

of competing interest.