Homeless Youths and Young Adults in Los Angeles: Prevalence of Mental Health Problems and the Relationship Between Mental Health and Substance Abuse Disorders

Abstract

Although understanding of the subsistence patterns, service utilization, and HIV-risk behaviors of homeless youths and young adults in increasing, relatively little is known about the epidemiology of mental health problems in this group or the relationships between mental health problems and substance use. This study measured symptoms of depression, low self-esteem, ADHD, suicidality, self-injurious behavior (SIB), and drug and alcohol use disorder in a sample of homeless youth and young adults living in Hollywood, CA. Results indicated extremely high prevalences of mental health problems as compared with corresponding rates of mental health problems found among housed youths in previous studies. Prevalence of mental health problems differed by age and ethnicity. African Americans were at lower risk of suicidal thoughts and SIB than were those of other ethnicities. Older respondents and females were at increased risk of depressive symptoms, and younger respondents were at increased risk of SIB. Previous history of sexual abuse and/or assault was associated with increased risk of suicidality and SIB. Risk factors for drug abuse disorders included ethnicity other than African American, homelessness for 1 year or more, suicidality, SIB, depressive symptoms, and low self-esteem. Risk factors for alcohol abuse disorder included male gender, white ethnicity, homelessness for 1 year or more, suicidality, and SIB. Extremely high rates of mental health problems and substance abuse disorders in this sample suggest the need for street-based and nontraditional mental health services targeted toward these youths and young adults.

A Dimensional Model of Psychopathology Among Homeless Adolescents: Suicidality, Internalizing, and Externalizing Disorders

“…This is an appropriate sample as research has shown that both suicidality and psychological disorders are more common among homeless adolescents than among community-dwelling youths (Kamieniecki 2001;Whitbeck et al 2004a). For homeless adolescents, lifetime suicide attempt rates have ranged from 18% (Yates et al 1988) to 53% (Smart and Ogborne 1994), and lifetime suicidal ideation rates have been as high as 28% (Booth and Zhang 1996) to 62% (Unger et al 1997). Also, the lifetime rate of one (or more) psychiatric disorders ranges from 78% (Sleegers et al 1998) to 90% (Feitel et al 1992).…”

Interventions With Street Youth: A Commentary on the Practice-Based Research Literature

“…Street youth are a diverse group, consisting of individuals with unique backgrounds and characteristics, including culture, age, sexual orientation, and family situations (Karabanow, 2003;Kurtz, Jarvis, & Kurtz, 1991;Robertson & Toro, 1991;Unger, Kipke, Simon, Montgomery, & Johnson, 1997;Zide & Cherry, 1992). Common among many street youth are backgrounds associated with physical and sexual abuse, neglect, and exposure to delinquent activities such as substance use, prostitution, and petty crime (Cauce et al, 2000;Karabanow, 2003;Kurtz et al, 1991;McCarthy & Hagan, 1992;Tyler & Cauce, 2002).…”

“…Common among many street youth are backgrounds associated with physical and sexual abuse, neglect, and exposure to delinquent activities such as substance use, prostitution, and petty crime (Cauce et al, 2000;Karabanow, 2003;Kurtz et al, 1991;McCarthy & Hagan, 1992;Tyler & Cauce, 2002). Such backgrounds may contribute to street youth's exhibiting high rates of depression (Unger et al, 1997), drug and alcohol abuse (Booth, Zhang, & Zwiatkowski, 1999;Yates, MacKenzie, Pennbridge, & Cohen, 1988), and sexual, emotional, and behavioral problems (Cauce et al, 2000).…”

A Risk‐Amplification Model of Victimization and Depressive Symptoms Among Runaway and Homeless Adolescents

“…Finally, victimization on the streets was predicted to be strongly associated with depressed affect (Arrow G). Victimization has been linked to increased risk for depressive symptoms in a variety of contexts (Browne & Finkelhor, 1986;Carmen, Ricker, & Mills, 1984;Gelles & Harrop, 1989) including populations of homeless youth (Unger et al, 1997).…”