Study reveals stress factor in homelessness

16 May 2006

A field study by a Sydney University postgraduate student could transform the care provided for homeless people living on the streets, in shelters and refuges.

Kathryn Taylor, who is close to completing a Doctor of Clinical Psychology/ Master of Science degree, carried out lengthy interviews with Sydney's homeless, looking out for cases of post traumatic stress disorder (PTSD).

Clinical psychology student, Kathryn Taylor, hit the streets to interview Sydney's homeless.
Clinical psychology student, Kathryn Taylor, hit the streets to interview Sydney's homeless.

Given that PTSD affects fewer than one in 60 people in Australia and is a treatable condition, Kathryn's findings were striking: two in every five of the people she interviewed were suffering from PTSD, while more than three out of four had suffered from PTSD at some time in their life.

"While the causal link between PTSD and homelessness would be difficult to confirm, the data does paint a picture of people who are traumatised, develop PTSD and are homeless," she explained.

PTSD is a psychiatric anxiety disorder that develops from a traumatic event. A trauma, in the clinical sense, is when someone experiences, witnesses or is confronted with a death, a serious injury or a grave physical threat, and when they respond to that event with intense fear.

When people who have suffered a trauma subsequently show three clusters of symptoms - intrusion, hyper arousal and avoidance - they may be diagnosed with PSTD.

"They may experience intrusive memories and flashbacks of the trauma; are easily startled and have difficulty in falling asleep; and avoid anything that reminds them of the traumatic event," explained Kathryn.

The most common traumas among the homeless people she interviewed were violence and rape, or witnessing others being attacked.

Census data indicates that there are around 100,000 homeless people in Australia, but, according to Kathryn, the figure is probably an under-estimate. "One of the problems with homeless studies is having access to the population," she said.

Her project is the first of its kind in Australia, and is unique in its research approach. Most studies into homelessness rely on information gathered from shelters; but Kathryn took to the streets for her interviews.

She approached people sleeping in parks, met missing persons, and accompanied volunteers from Mission Beat and St Vincent de Paul. "There is a lot more psychopathology in rough sleepers," she said.

Many of the stories were disturbing. "I interviewed a man who was so traumatised that his hair turned white overnight. He had just learnt that his son had axed someone to death," she said.

She interviewed 70 people aged between 18 and 73 living on the street, or in drop-in centres and hostels. "More than 98 per cent reported experiencing at least one trauma in their lifetime. In 70.5 per cent of cases, PTSD preceded or coincided with the onset of homelessness," she explained.

"This hard evidence recognising the high incidence of PTSD has enormous implications for service provisions for homeless people," said Kathryn. "There are effective treatments for the disorder but the homeless are not getting access to them," she explained.

An accepted part of the treatment for PTSD is exposure therapy, where people are encouraged to talk about the traumatic experience in a safe environment.

"There needs to be a holistic approach to helping homeless people, and mental health care needs to take a larger role," said Kathryn. "People need a secure place to live, help with day-to-day living, and psychiatric support."

Contact: Kate Rossmanith

Phone: 02 9351 3168