London, and Visiting Psychiatrist, Great Chapel Street Medical Centre,

It is well recognised that there is an increased psychiatric morbidity, in particular psychosis, personality disorder and substance abuse, among the single homeless (Lodge Patch et al, 1971). The reasons for this are complex. There is evidence that these people are mentally ill before becoming home less and that their illness may be a cause of their homelessness. In a study of newly presenting patients at the DHSS Reception Centre in Camberwell, London, Tidmarsh & Wood found that 87 % of those with mental illness had been staying recently with their families just before their first hospital admission, suggesting that mental illness may have led to homelessness in these patients (Tidmarsh & Wood, 1972).Although direct evidence is scant in the UK, it is felt that the closure of long-stay psychiatric hospitals could lead to some of their in-patients becoming homeless. The single homeless are vulnerable to frequent physical and psychiatric ill-health (Scott et al, 1966). Their lifestyle makes it difficult for them to integrate or be integrated into the usual pathways of health care. Many of these patients, despite their need for medical and psychiatric treatment, are withdrawn and introspective, failing to come to the attention of social service and medical teams. The study We describe a drop-in psychiatric clinic at Grea