The number of homeless individuals in the U.S. has continued to increase, with men comprising the majority of this population. These men are at substantial risk for neuropsychological impairment due to several factors, such as substance misuse, severe mental illness, untreated medical conditions (e.g., diabetes, liver disease, HIV/AIDS), poor nutrition, and the increased likelihood of suffering a traumatic brain injury. Impairments in attention, memory, executive functioning, and other neuropsychological domains can result in poor daily functioning and difficulty engaging in psychological, medical, or educational services. Thus, knowledge of the neuropsychological functioning of homeless men is critical for those who work with this population. Yet data in this area are limited. This study aimed to describe the functioning of men residing in an urban homeless shelter across the domains of attention/concentration, memory, executive functions, language, sensory-motor abilities, general intelligence, and reading ability. Particular areas of impairment included attention, visual memory, cognitive flexibility, balance/coordination, and fine motor control. Correlational analyses found that educational background and ethnicity were linked to test performance, and the results of cluster analysis found two distinct subgroups based on neuropsychological functioning: an "average" group and a "low average/impaired" group. Caveats in interpreting test scores, particularly in the domain of language, are discussed, along with possible explanations for differences between African American and non-African American participants. Based on the findings of this study, it is recommended that clinicians and other service providers working with men residing in homeless shelters consider the possibility of neuropsychological impairment when developing treatment plans. Specific recommendations for each subgroup are discussed. Future research in this area might also explore the utility of offering skill-enhancing interventions within homeless shelters, such as workshops to improve organizational and planning skills. Further, the development of adequate norms for neuropsychological tests that are to be used with homeless individuals is recommended, given the possibility of low educational attainments and below average reading skills in this population.
