Exploring Mental Health Challenges and Risk Factors in the South India Homeless Population: A Descriptive Cross-Sectional Study

Background: Homelessness is a growing public health concern, particularly in developing countries, where individuals face severe physical and psychological challenges. Mental health among the homeless is often neglected due to stigma, limited access to care, and competing survival needs. Objectives: To assess the prevalence of psychiatric morbidity and identify associated risk factors among the homeless population in urban slums. Materials and Methods: A community-based cross-sectional study was conducted from March to June 2023 in the urban slums of Nellore, Andhra Pradesh. A total of 192 homeless individuals aged over 18 years were enrolled after obtaining informed consent. Data were collected using a semi-structured questionnaire, including socio-demographic details and standardised psychiatric tools: the Mini International Neuropsychiatric Interview (M.I.N.I), International Classification of Diseases (ICD-10), Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A). Data were analysed using SPSS version 22.0. Results: The mean age of participants was 36.4 ± 12 years, with 58.9% being male. Most were illiterate (43.2%) and unemployed (39.6%). Tobacco and alcohol use were reported by 73% and 48.5%, respectively. The overall prevalence of psychiatric morbidity was 46.4%, with depression (24.5%) and post-traumatic stress disorder (16.7%) being the most common. Psychiatric morbidity was significantly associated with unemployment, substance use, and living alone. Conclusion: The high prevalence of psychiatric disorders among the homeless underscores the urgent need for integrated mental health services and social support systems tailored to this vulnerable population.