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Article   |    
Influence of Substance Abuse and Mental Disorders on Emergency Room Use by Homeless Adults
Deborah K. Padgett; Elmer L. Struening
Psychiatric Services 1991; doi:
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This work was funded in part by grant 87206-88206 from the New York City Department of Mental Health, Mental Retardation, and Alcoholism Services and by the New York State Psychiatric Institute. The authors thank the staff of the New York City Human Resources Administration for their cooperation in the survey as well as the shelter directors, their staffi, and the residents who participated in the study.

School of Social Work, New York University, 3 Washington Square North, New York, New York 10003

New York State Psychiatric Institute and Columbia University School of Public Health

1991 by the American Psychiatric Association

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Substance abuse and mental disorders increase the health care needs of homeless persons, whose primary source of care is often the emergency room. In this study, associations between substance abuse and mental health problems and use of emergency rooms were examined using data from a 1987 survey of 1,152 homeless adults in New York City shelters. Two-thirds (N=767) of the sample reported using an emergency room at least once in their lives, and 27.2 percent (N=313) reported use within the previous six months. Traumatic injury was the most frequently cited reason for the last emergency room visit. Respondents who reported psychotic ideation during the previous year or severe depressive symptoms during the previous week were much more likely to have used an emergency room within the previous six months. The preliminary findings suggest that substance abuse and mental disorders play a significant role in emergency room use by homeless adults.

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