Homeless and jobless drug users turn to Mount Carmel for help, researchers say

Most drug users admitted to Mount Carmel Hospital are seeking help for social problems such as homelessness and unemployment rather than psychotic illness, according to a new study.

The study, published in the latest edition of the Malta Medical Journal, highlights gaps in the country’s social services system.

It found that for most patients with substance use disorders, hospital admission was seen as a “last resort” and represented “an immediate access to social services”.

Researchers Emma Camilleri, Caroline Vassallo and Kristian Sant analysed data over a 13-week period between October 2021 and January 2022.

Using urine tests carried out upon admission, they identified substance abusers and examined their clinical notes and discharge letters to determine the reasons for admission.

The study found that 58.8% of drug users were admitted due to social issues that included lack of social support, financial instability, unemployment and homelessness.

Around a third – 34.3% – were admitted with co-existing mental health conditions such as depression, anxiety and post-traumatic stress disorders. A quarter of all admissions involving comorbid mental health illness were due to substance-induced psychosis.

A third group, just under 7%, were admitted to stabilise before entering a rehabilitation programme. The researchers suggested the findings pointed to a gap in the social system for people who use drugs.

Access to social services is often 'a lengthy process'

“Access to social services in Malta is often a lengthy process which individuals may not be well versed in or may not be appropriately guided to do so. Such services are often not catered for individuals who make use of substances,” the study noted.

It also shed light on the fact that people diagnosed with substance abuse frequently discharged themselves against medical advice, and present for re-admission soon after.

“Individuals diagnosed with substance use disorder in the pre-contemplative phase of change are often chaotic in their use, seeking admission for a couple of days before re-establishing their substance use within the community,” the study said.

Others had to wait for weeks, if not months, to enter rehabilitation, contributing to frustration and requests for early discharge.

Of the 20 patients readmitted during the time of study, 13 were readmitted due to social reasons after struggling to cope outside the hospital.

“Substance users who seek admission to deal with social issues such as unemployment or financial issues are often faced with a lengthy process to deal with these problems, which also in turn leads to seeking early discharge,” the study said.