The mental health of old homeless men.

The recent focus on the young homeless mentally ill has diverted attention from other subgroups of the homeless, particularly the aging, who compose one fourth of the homeless population. A total of 86 street-dwelling and 195 non-street-dwelling (177 flophouse-, 18 apartment-dwelling) men aged 50 and older on the Bowery in New York City were studied. Although 23% evidenced psychosis or had prior psychiatric hospitalization (PPH group), depression was more prevalent with one third of all men categorized as clinically depressed. Only 5% evidenced gross organic mental disease. Several groups were identified for intervention because of their increased susceptibility to depression: alcoholics, relatively younger men, those with organic mental symptoms, street men. With respect to the PPH men, they did not appear to be distinct from the other homeless men on various social and health indices, although they differed substantially from age-matched community men. Thus these men must be viewed as homeless first, and in addition, as having the handicap of mental illness. Contrary to the popular stereotype, there was no evidence of widespread isolation among the PPH men, and despite their disturbances, most showed an adequate capacity for survival.