Suicide among the homeless: A 9-year case-series analysis

Background: Among the homeless there are high rates of mortality and a significant number of attempted and completed suicides. In Tel-Aviv, Israel, there is an ongoing municipal outreach program for the homeless. Objective: The aim of the present study was to describe the subgroup of homeless persons who had died by suicide. Method: Over a 9-year period the records of each homeless person who had died were assessed by two psychiatrists and a clinical criminologist. The project was undertaken in a large city and was feasible due to close cooperation between the municipal welfare department and mental health consultants. Results: Of the 1,192 homeless persons located and contacted, 156 persons had died (13.1%). Nine of the deaths were by completed suicide (5.8%). All were male. Mean age for the suicide subgroup was 34±8.7 years, significantly younger than those who died of other causes (p < .01). The majority had completed high school education. While the majority of deaths were drug or alcohol related, in only 1 of 9 deaths by suicide was there a history of drug abuse. Psychiatric comorbidity was recorded in 4 of the 9 persons. The majority of persons (6/9) had died of suicide by hanging. Conclusion: Suicide is not a negligible cause of death among the homeless population.