Depression in homeless mothers: Addressing an unrecognized public health issue.

Abstract

Homeless mothers experience disproportionately high rates of major depressive disorder compared with the general population. Stressed by their circumstances, these women struggle to protect their families. Children living with a depressed parent have poorer medical, mental health, and educational outcomes. Despite the adverse impact on children, depression among mothers experiencing homelessness remains unacknowledged, unrecognized, and untreated. This article reviews the evidence supporting preventive and therapeutic interventions with low-income and homeless mothers and children, and finds that few services have been adapted and evaluated for use in the homelessness service system. Based on the robust evidence describing positive outcomes in programs for low-income parents with depression, the authors propose guidelines for adapting and implementing services directly by programs serving homeless families. Once families are housed and urgent issues addressed, they recommend assessing all family members, routinely providing culturally competent parenting supports, trauma-informed services, and treatment for major depressive disorders. They also emphasize the critical importance of creating child-centered spaces and developmental services for the children. To ensure quality care, training must be available for the staff. Given the increasing numbers of homeless families and high rates of maternal depression and its negative impact on children, support for these programs should become a high public health priority.

Childhood Adversity and Development of Self Among Mothers Transitioning From Homelessness to Self-Sufficiency

“…Women's internalizing issues are common antecedents of homelessness, particularly when combined with low levels of education, unemployment, and poor health (Bassuk et al, 1998;Rog & Buckner, 2007). However, the adverse mental and emotional experiences of homeless women are often unrecognized, undiagnosed, and untreated (Bassuk, 2007;Bassuk & Beardslee, 2014). said that single mothers live impossible lives and found that more than 90% of homeless single mothers have experienced severe physical or sexual abuse (see also Vostanis, 2002).…”

“…Among homeless mothers, half report fewer than three people they could count on for support and close to 15% of these mothers indicate their children serve as their only support network (Letiecq, Anderson, & Koblinsky, 1998;Zima et al, 1996). The combination of economic adversity, residential instability, and poorer maternal mental health is linked with a host of adverse outcomes for children in homeless families (Bassuk & Beardslee, 2014).…”

The Role of Recovery Housing: Prioritizing Choice in Homeless Services

“…On a given night in 2014, approximately 20% of the homeless population had a serious mental illness (U.S. Department of Housing and Urban Development, 2015a), and several studies have found high rates of co-occurring disorders (Fazel et al, 2008;Fazel, Geddes, & Kushel, 2014;Torchalla et al, 2011;Bassuk, Buckner, Perloff, & Bassuk, 1998;North & Smith, 1992). Among homeless mothers, rates of posttraumatic stress disorder (PTSD) range from 22% to 33% (U.S. Department of Housing and Urban Development, 2015b, Bassuk et al, 1998;Hayes, Zonneville, & Bassuk, 2013), while lifetime rates of depression range from 45% to 85% (Bassuk et al, 1996;Bassuk et al, 1998;Weinreb, Buckner, Williams, & Nicholson, 2006;Bassuk & Beardslee, 2014). In one study of homeless families, 63% of mothers had a co-occurring substance use disorder and PTSD, and 85% had both a substance use disorder and depression (Hayes et al, 2013).…”

House to House, Shelter to Shelter

“…In addition, women living with IPV must grapple with sometimes overwhelming concerns: protecting their children, ensuring that basic survival needs such as food and shelter are met, and managing feelings of shame and isolation (Thompson et al, 2000). It is not surprising that homeless women who experience extreme poverty, violence, and limited support networks have high rates of depression (Bassuk & Beardslee, 2014).…”