1
|
Choudhury S, Choi SL, Lee Y, Manser SS. Examining the Role of Self-Harm in the Relationship between Emergency Department Service Utilization and Trauma-Induced Homelessness among Homeless Individuals in Texas. HEALTH & SOCIAL WORK 2024; 49:87-94. [PMID: 38478764 DOI: 10.1093/hsw/hlae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/17/2023] [Accepted: 09/08/2023] [Indexed: 04/30/2024]
Abstract
Homelessness is a complex public health problem in the United States. Current or ongoing history of trauma among individuals adds to the complexity and challenges of homelessness. Our study assessed the moderating role of self-harm in the association between emergency department (ED) service utilization and trauma-induced homelessness (TIH) among adults in Texas. Homeless adults (N = 282) who completed their baseline Vulnerability Index Service Prioritization Decision Assistance Prescreen Tool survey between February 2021 and February 2022 at a Local Mental Health Authority in Texas were selected. The outcome variable, TIH, was assessed by current period of homelessness due to experiencing trauma or abuse. The main independent variable was ED utilization, while self-harm in the past year was assessed as the moderating variable. A multivariate logistic regression with a moderation analysis was conducted while adjusting for the covariates. Individuals who utilized ED services and engaged in self-harm and risky behaviors had greater odds of experiencing current period of TIH. Male respondents were less likely to experience TIH. Finally, engaging in self-harm significantly moderated the association between ED service use and TIH. This study may help inform efforts to develop tailored interventions and promote resilience-based approaches to improve health outcomes among individuals experiencing homelessness due to TIH.
Collapse
Affiliation(s)
- Sumaita Choudhury
- MPH, is a doctoral candidate and research associate, Texas Institute for Excellence in Mental Health, Steve Hicks School of Social Work, University of Texas at Austin, 1823 Red River Street, Austin, TX 78712, USA
| | - Sharon Lee Choi
- PhD, is a research associate, Texas Institute for Excellence in Mental Health, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - Yehyang Lee
- MS, is a graduate research assistant, Texas Institute for Excellence in Mental Health, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - Stacey Stevens Manser
- PhD, is a research scientist and associate director, Texas Institute for Excellence in Mental Health, Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
2
|
Brown S, Barman-Adhikari A, Garcia K, Chassman S, Hsu HT, Petering R, Santa Maria D, Narendorf S, Shelton J, Bender K, Ferguson K. Substance use typologies among young people experiencing homelessness in seven cities across the United States: A latent class analysis. Addict Behav 2024; 150:107929. [PMID: 38056194 DOI: 10.1016/j.addbeh.2023.107929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Substance use and other health-risk risk factors, including mental health, trauma, and sexual-risk behaviors, often co-occur among youth experiencing homelessness (YEH). The present study aimed to identify subgroups of YEH based on polysubstance use and the linkages to sociodemographic and health-risk characteristics. METHODS From June 2016 to July 2017, 1,426 YEH (aged 18-26 years) were recruited from seven cities (Houston, Los Angeles, Denver, Phoenix, New York City, St. Louis, San Jose). Participants provided information via a self-administered electronic survey on substance use, mental health, trauma, sexual risk behaviors, and sociodemographic characteristics. The majority of YEH identified as Black (37.3%), cisgender (92.8%), and heterosexual (69.2%). On average, YEH were 20.9 years (SD = 2.1). This study employed latent class analysis (LCA) to identify subgroups of YEH according to their substance use. Multinomial logistic regression analyses were conducted to identify sociodemographic and health-risk characteristics associated with class-membership. RESULTS Four latent classes of YEH substance use were identified: (1) high polysubstance use; (2) moderate stimulant and high marijuana, alcohol, and prescription drug use; (3) high marijuana, alcohol, and prescription drug use; (4) low/moderate marijuana and alcohol use. Multinomial logistic regression models indicated that geographic location, gender, race/ethnicity, mental health, trauma history, and sexual risk behaviors were significant correlates of substance use class membership among YEH. CONCLUSIONS These findings offer important implications for the prevention and treatment of substance use among YEH. Screening protocols should consider co-occurring risk factors such as traumatic experiences, sexual risk behaviors, and mental health history as indicators of polysubstance use.
Collapse
Affiliation(s)
- Samantha Brown
- School of Social Work, Colorado State University, 450 W Pitkin St, Fort Collins, CO 80521, USA.
| | - Anamika Barman-Adhikari
- Graduate School of Social Work, University of Denver, 2148 S. High St., Denver, CO 80208, USA.
| | - Kevin Garcia
- School of Social Work, Colorado State University, 450 W Pitkin St, Fort Collins, CO 80521, USA
| | - Stephanie Chassman
- Graduate School of Social Work, University of Denver, 2148 S. High St., Denver, CO 80208, USA.
| | - Hsun-Ta Hsu
- School of Social Work, University of Missouri, 729 Clark Hall, Columbia, MO 65211, USA
| | - Robin Petering
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 1150 South Olive Street, 1503-1, Los Angeles, CA 90015, USA
| | - Diane Santa Maria
- Department of Nursing Systems, Cizik School of Nursing, The University of Texas Health Science Center at Houston, 6901 Bertner Ave., Ste. 591, Houston, TX 77030, USA
| | - Sarah Narendorf
- Graduate College of Social Work, University of Houston, 3511 Cullen Blvd. #110HA, Houston, TX 77204-4013, USA
| | - Jama Shelton
- Silberman School of Social Work at Hunter College, 2180 Third Ave., New York, NY 10035, USA
| | - Kimberly Bender
- Graduate School of Social Work, University of Denver, 2148 S. High St., Denver, CO 80208, USA.
| | - Kristin Ferguson
- School of Social Work, Arizona State University, 411 N. Central Ave., #865, Phoenix, AZ 85004-0689, USA
| |
Collapse
|
3
|
Orsi-Hunt R, Clemens EV, Thibodeau H, Belcher C. Young Adults with Lived Foster Care Experience Who Later Experience Houselessness: an Exploratory Latent Class Analysis. INTERNATIONAL JOURNAL ON CHILD MALTREATMENT : RESEARCH, POLICY AND PRACTICE 2023:1-25. [PMID: 37360287 PMCID: PMC10130814 DOI: 10.1007/s42448-023-00160-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 06/28/2023]
Abstract
Young adults with lived experience in out-of-home care during childhood report later experiences of housing instability as common. Existing literature identifies a host of factors compounding an individual's risk of experiencing houselessness, but research has yet to explore constellations of characteristics which describe youth formerly in care who later become unhoused. This exploratory study leverages a public-private data linkage collaborative to integrate and de-identify child welfare data extracted from a Rocky Mountain state's administrative database and houselessness service utilization data from a regional provider in a large metro area of the state. Linkage and sampling yielded a final sample of 285 youth (ages 18 to 24) formerly in foster care who accessed houselessness services between December 2018 and March 2020 and who had signed required consents. A 22-measure latent class analysis identified three characteristic groups: intensive youth corrections involvement and emancipation from the child welfare system (32% of sample); family-based challenges, neglect, and more moderate youth corrections involvement (41% of sample); and youth behavior and substance use challenges along with family reunification before accessing houselessness services (26%). We found that young women and Black, Indigenous, and people of color were disproportionately represented in the sample compared to the state's population of youth in out-of-home care. Youth with long histories of child welfare placement were a majority of the sample. Implications are discussed. Data-sharing barriers must be addressed to facilitate further research aimed at understanding houselessness within this population.
Collapse
Affiliation(s)
- Rebecca Orsi-Hunt
- Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, University of Colorado School of Medicine, 13123 E. 16th Ave, Box 390, Aurora, CO 80045 USA
| | | | | | | |
Collapse
|
4
|
Moore H, De Pedro K. Lesbian, Gay, and Bisexual Students Experiencing Homelessness and Substance Use in the School Context: A Statewide Study. THE JOURNAL OF SCHOOL HEALTH 2023; 93:107-114. [PMID: 36661077 PMCID: PMC10087241 DOI: 10.1111/josh.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE This study explored differences between lesbian, gay, and bisexual (LGB)-housed and homeless students regarding substance use patterns on and off school grounds and the unique contribution of homelessness to substance use in school. METHODS Data were from the 2013-2015 California Healthy Kids Survey, a statewide survey of school protective factors and risk behaviors. A representative sample of 9th- and 11th-grade students (N = 20,337) was used. Comparisons between housed (n = 19,456) and homeless (doubled up: n = 715; acute homeless: n = 166) LGB students were conducted. We used chi-square tests to compare rates of lifetime, past-30-day, and in-school substance use and conducted multivariate logistic regression models for each substance use variables. RESULTS Chi-square test results indicated significant differences in rates of substance use among students experiencing homelessness (both categories) and housed LGB students. Lesbian, gay, and bisexual students experiencing homelessness were more likely to report substance use off and on school grounds. Results from logistic regression analyses indicated that LGB students who experience homelessness were significantly more likely to report recent and in-school substance use. For example, students experiencing acute homelessness were about 3 times as likely to report heavy episodic drinking (adjusted odds ratio [AOR] = 3.13; 95% confidence interval [CI] = 2.13, 4.26) and more than 5 times as likely to smoke marijuana in school (AOR = 5.38; 95% CI = 3.46, 8.36), compared to housed LGB students. CONCLUSIONS LGB students who experience homelessness are at higher risk than housed LGB students of substance use on and off school grounds. Findings highlight the need to provide support in the school context for this subpopulation.
Collapse
Affiliation(s)
- Hadass Moore
- The Paul Baerwald School of Social Work and Social WelfareHebrew University of JerusalemJerusalemIsrael
| | - Kris De Pedro
- Attallah College of Educational StudiesChapman UniversityOrangeCA
| |
Collapse
|
5
|
de la Fuente-Roldán IN, Corchado-Castillo AI, Dorado-Barbé A. Mental Health and Homelessness in the Community of Madrid (Spain): The Impact of Discrimination and Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2034. [PMID: 36767398 PMCID: PMC9915538 DOI: 10.3390/ijerph20032034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to analyze the impact of experiences of violence and discrimination on mental health among people in situations of homelessness (PSH). For this purpose, a quantitative, descriptive, and correlational investigation was conducted by conducting a survey with 603 PSH living in the Community of Madrid (Spain). The results show high levels of mental health impairment, as well as approximately half of the participants having experienced discrimination and violence in the course of their homelessness. Perceived experiences of discrimination are associated with higher levels of mental health impairment (OR = 0.458; p = < 0.001; 95% IC 0.31-0.68). This deterioration is also related to a negative self-assessment of the general state of health among participants (OR = 0.262; p = < 0.001; 95% IC 0.12-0.57). However, impaired mental health is not associated with experiences of violence. The findings also indicate that there are intersections in terms of being female, young, and foreign that result in greater psychological impairment and a higher risk of experiencing violence and discrimination. This study provides an insight into the PSH experiences in relation to mental health, violence, and discrimination and the need to implement actions aimed at improving their psychosocial wellbeing from the perspective of respect for citizens' rights.
Collapse
Affiliation(s)
- Iria Noa de la Fuente-Roldán
- Department of Social Work and Social Services (Faculty of Social Work), Complutense University of Madrid, 28223 Madrid, Spain
- Institute for Research in Development and Cooperation (IUDC-UCM), Complutense University of Madrid, 28015 Madrid, Spain
| | - Ana Isabel Corchado-Castillo
- Department of Social Work and Social Services (Faculty of Social Work), Complutense University of Madrid, 28223 Madrid, Spain
| | - Ana Dorado-Barbé
- Department of Social Work and Social Services (Faculty of Social Work), Complutense University of Madrid, 28223 Madrid, Spain
| |
Collapse
|
6
|
Heerde JA, Bailey JA, Patton GC, Toumbourou JW. A population-based study of homelessness, antisocial behaviour and violence victimisation among young adults in Victoria, Australia. THE AUSTRALIAN JOURNAL OF SOCIAL ISSUES 2022; 57:762-782. [PMID: 36530738 PMCID: PMC9748854 DOI: 10.1002/ajs4.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 06/17/2023]
Abstract
Homeless young adults are at increased risk for contact with the police and are overrepresented in the justice system. This study explored associations between homelessness, antisocial behaviour and violence victimisation using longitudinal panel data gathered through young adulthood. Data were drawn from a state representative population-based sample of young adults from Victoria, Australia participating in the International Youth Development Study (IYDS; n = 2884, 54% female). Participants were surveyed at age 21 years, with follow-up at ages 23 and 25 years. We examined changes in the prevalence of homelessness and tested hypothesised directional relationships between young adult homelessness, antisocial behaviour and violence victimisation using longitudinal cross-lagged panel models. Multiple-group modelling was used to test whether these relationships were moderated by gender. The prevalence of young adult homelessness was highest at age 21 (6.5%), declining at ages 23 (3.9%) and 25 years (2.5%). Results showed that young adult homelessness, antisocial behaviour and victimisation were related cross-sectionally, but not longitudinally. Gender did not significantly moderate these associations. Findings suggest that the state of homelessness is associated with temporary vulnerability to potentially harmful and problematic situations involving antisocial behaviour and victimisation. These situations are likely to heighten risk for contact with the police and direct physical and psychological harm.
Collapse
Affiliation(s)
- Jessica A. Heerde
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia
- Department of Social WorkThe University of MelbourneMelbourneVictoriaAustralia
- Centre for Adolescent HealthRoyal Children’s HospitalMelbourneVictoriaAustralia
- Murdoch Children’s Research InstituteMelbourneVictoriaAustralia
| | - Jennifer A. Bailey
- Social Development Research GroupSchool of Social WorkUniversity of WashingtonSeattleWashingtonUSA
| | - George C. Patton
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia
- Centre for Adolescent HealthRoyal Children’s HospitalMelbourneVictoriaAustralia
- Murdoch Children’s Research InstituteMelbourneVictoriaAustralia
| | - John W. Toumbourou
- Centre for Adolescent HealthRoyal Children’s HospitalMelbourneVictoriaAustralia
- Murdoch Children’s Research InstituteMelbourneVictoriaAustralia
- School of PsychologyCentre for Social and Early Emotional DevelopmentDeakin UniversityBurwoodVictoriaAustralia
| |
Collapse
|
7
|
Heerde JA, Bailey JA, Kelly AB, McMorris BJ, Patton GC, Toumbourou JW. Life-course predictors of homelessness from adolescence into adulthood: A population-based cohort study. J Adolesc 2021; 91:15-24. [PMID: 34271292 PMCID: PMC8423126 DOI: 10.1016/j.adolescence.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 06/20/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Internationally, the prevalence of young adult homelessness is concerning. Few data on life-course predictors from longitudinal studies exist, limiting our capacity to inform prevention strategies at the population-level. METHODS Data were drawn from a state representative population-based sample of young adults from Victoria, Australia participating in the International Youth Development Study (IYDS; N = 927, 54% female). Participants were recruited in state-representative secondary school samples at Grade 7 (age 13, 2002), with follow-up in Grades 9 (age 15) and 11 (age 17) and at ages 21, 23 and 25. Using longitudinal path modelling, we conducted a series of analyses testing life-course predictors of young adult homelessness across multiple socializing contexts, and the interrelationships among them. RESULTS The rate of young adult homelessness was 5.5%. Path modelling showed higher levels of family conflict at ages 13 and 15 uniquely predicted homelessness by age 25. This effect remained after accounting for other risk factors in peer-group (e.g., interactions with antisocial peers), school (e.g., low academic performance), and community contexts (e.g., low neighborhood attachment). Peer drug use and interaction with antisocial peers at age 15 mediated the association between family conflict at age 13 and homelessness by age 25. CONCLUSIONS Findings point to the vulnerability of early adolescents to family conflict. This vulnerability heightens risk for young adult homelessness. Findings strengthen the case for both primary prevention programs that build healthy relationships between family members from early on in adolescence and for investment in homelessness prevention at key developmental periods.
Collapse
Affiliation(s)
- Jessica A Heerde
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Honorary Research Fellow, The Murdoch Children's Research Institute, Australia.
| | - Jennifer A Bailey
- Social Development Research Group, School of Social Work, University of Washington, USA
| | - Adrian B Kelly
- School of Psychology and Counselling, Queensland University of Technology, Australia
| | | | - George C Patton
- Professorial Fellow in Adolescent Health Research, Department of Paediatrics, The University of Melbourne, Centre for Adolescent Health, Murdoch Children's Research Institute, Australia
| | - John W Toumbourou
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University; and Centre for Adolescent Health, Murdoch Children's Research Institute, Australia
| |
Collapse
|
8
|
Fronek P. Demoralization in the wake of the COVID-19 pandemic: Whereto the future for young Australians? QUALITATIVE SOCIAL WORK : QSW : RESEARCH AND PRACTICE 2021; 20:487-493. [PMID: 34253989 PMCID: PMC8261383 DOI: 10.1177/1473325020973332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
COVID-19 is changing lives. Less attention has been paid to the future of young people by governments since the onset of the pandemic. We suggest that young people are vulnerable to demoralization, a state of hopelessness and helplessness, during and post-COVID-19. This reflection drawn from journaling and ongoing reflexive conversation from December 2019 to April 2020 offers a critical perspective on the circumstances of young Australians that encompasses consideration of the structural factors that impact on health, life chances, equality and social justice as well as the personal aspects of reflection.
Collapse
Affiliation(s)
- Patricia Fronek
- Patricia Fronek, School of Human Services
and Social Work, Griffith University, Gold Coast Campus, Parklands Drive,
Southport, Qld 4222, Australia.
| |
Collapse
|