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      Mental health symptoms among homeless shelter residents during COVID-19 lockdown in Tshwane, South Africa

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          Abstract

          Background

          In order to contain the spread of COVID-19 in South Africa during the national state of emergency, the Gauteng Department of Social Development established temporary shelters and activated existing facilities to provide basic needs to street-homeless people in Tshwane, which facilitated primary health care service-delivery to this community.

          Aim

          This study aimed to determine and analyse the prevalence of mental health symptoms and demographic characteristics among street-homeless people living in Tshwane’s shelters during lockdown.

          Setting

          Homeless shelters set up in Tshwane during level 5 of the COVID-19 lockdown in South Africa.

          Methods

          A cross-sectional, analytical study was conducted using a Diagnostic and Statistical Manual of Mental Disorders (DSM-5)-based questionnaire that looked at 13 mental health symptom domains.

          Results

          Presence of moderate-to-severe symptoms were reported among the 295 participants as follows: substance use 202 (68%), anxiety 156 (53%), personality functioning 132 (44%), depression 85 (29%), sleep problems 77 (26%), somatic symptoms 69 (23%), anger 62 (21%), repetitive thoughts and behaviours 60 (20%), dissociation 55 (19%), mania 54 (18%), suicidal ideation 36 (12%), memory 33 (11%) and psychosis 23 (8%).

          Conclusion

          A high burden of mental health symptoms was identified. Community-oriented and person-centred health services with clear care-coordination pathways are required to understand and overcome the barriers street-homeless people face in accessing health and social services.

          Contribution

          This study determined the prevalence of mental health symptoms within the street-based population in Tshwane, which has not previously been studied.

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          Most cited references33

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          Lifetime prevalence of psychiatric disorders in South Africa.

          Data on the lifetime prevalence of psychiatric disorders in South Africa are of interest, not only for the purposes of developing evidence-based mental health policy, but also in view of South Africa's particular historical and demographic circumstances. A nationally representative household survey was conducted between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate diagnoses. The data-set analysed included 4351 adult South Africans of all ethnic groups. Lifetime prevalence of DSM-IV/CIDI disorders was determined for anxiety disorders (15.8%), mood disorders (9.8%), substance use disorders (13.4%) and any disorder (30.3%). Lifetime prevalence of substance use disorders differed significantly across ethnic groups. Median age at onset was earlier for substance use disorders (21 years) than for anxiety disorders (32 years) or mood disorders (37 years). In comparison with data from other countries, South Africa has a particularly high lifetime prevalence of substance use disorders. These disorders have an early age at onset, providing an important target for the planning of local mental health services.
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            Is Open Access

            Health of Transgender Adults in the U.S., 2014–2016

            Transgender people experience significant interpersonal and structural discrimination and stigma. However, little is known about the health of transgender people, and even less about the health of specific groups-including male-to-female, female-to-male, and gender-nonconforming transgender populations-despite the variation in social and biological characteristics across groups.
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              DSM-5 cross-cutting symptom measures: a step towards the future of psychiatric care?

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                Author and article information

                Journal
                Afr J Prim Health Care Fam Med
                Afr J Prim Health Care Fam Med
                PHCFM
                African Journal of Primary Health Care & Family Medicine
                AOSIS
                2071-2928
                2071-2936
                03 April 2023
                2023
                : 15
                : 1
                : 3730
                Affiliations
                [1 ]Department of Family Medicine, Faculty of Health Sciences, School of Medicine, University of Pretoria, Tshwane, South Africa
                [2 ]Department of Psychiatry, Steve Biko Academic Hospital, Faculty of Health Sciences, University of Pretoria, Tshwane, South Africa
                Author notes
                Corresponding author: Michelle Janse van Rensburg, michelle.jansevanrensburg@ 123456up.ac.za
                Author information
                https://orcid.org/0000-0002-5772-3002
                https://orcid.org/0000-0002-4815-1583
                https://orcid.org/0000-0002-2103-9858
                http://orcid.org/0000-0002-0371-1022
                Article
                PHCFM-15-3730
                10.4102/phcfm.v15i1.3730
                10157371
                37042538
                f72ec69b-08ea-4f9b-a498-9bd18388bca2
                © 2023. The Authors

                Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.

                History
                : 10 July 2022
                : 16 December 2022
                Categories
                Original Research

                mental health,homelessness,temporary shelters,covid-19 lockdown,substance use,opioid withdrawal

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