Trauma, substance use, and mental health symptoms in transitional age youth experiencing homelessness

• Published in: Public health Nursing 2020-05, Vol.37 (3), p.363-370
• Main Authors: Dawson‐Rose, Carol, Shehadeh, Deena, Hao, Jennifer, Barnard, Jasmine, Khoddam‐Khorasani, Ladan (Ladi), Leonard, Adam, Clark, Kristen, Kersey, Eva, Mousseau, Haley, Frank, Julie, Miller, Aaron, Carrico, Adam, Schustack, Amy, Cuca, Yvette P.
• Format: Article
• Language: English
• Subjects: Adolescent; adolescent health; Adverse childhood experiences; Alcohol abuse; Anxiety; Anxiety disorders; Child & adolescent psychiatry; Child abuse & neglect; Childhood factors; Children; Correlation analysis; Cross-Sectional Studies; Diagnostic systems; Drug abuse; Drug use; Epidemiology; Female; Health problems; HIV; HIV/AIDS; Homeless people; homeless persons; Homeless Youth - psychology; Homeless Youth - statistics & numerical data; Homelessness; Human immunodeficiency virus; Humans; Male; Mental depression; Mental disorders; Mental Disorders - epidemiology; Mental health; Narcotics; Opioids; Post traumatic stress disorder; Prevalence; Psychological stress; Psychological Trauma - epidemiology; Risk levels; San Francisco - epidemiology; Smoking; Stimulants; Substance abuse; Substance use; Substance use disorder; Substance-Related Disorders - epidemiology; Surveys and Questionnaires; Symptoms; Teenagers; Tests; Trauma; vulnerable populations; Young Adult; Young adults; Youth
• ISSN: 0737-1209; 1525-1446; 1525-1446
• DOI: 10.1111/phn.12727

Objective This descriptive study examined the prevalence and correlates of trauma, substance use, and mental health symptoms in homeless transitional age youth (TAY) in San Francisco. Design & Sample One hundred homeless TAY were recruited from a community‐based organization to complete a survey on trauma, mental health symptoms, and substance use. Measurements We used these measures: National Institute on Drug Abuse (NIDA)‐Modified Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) for frequency and risk level of substance use; the 10‐item Adverse Childhood Experiences (ACEs) for prevalence of trauma; the Post‐traumatic Stress Disorder Checklist for DSM‐5 for post‐traumatic stress disorder (PTSD) symptoms; Center for Epidemiologic Studies Depression Scale for depression symptoms; and Generalized Anxiety Disorder 7‐item for anxiety symptoms. Results Almost all (n = 98) participants experienced at least one ACE during childhood, and 77% experienced four or more. Most participants (80%) reached the diagnostic threshold for PTSD, 74% for depression, and 51% for moderate anxiety. Symptoms of PTSD, anxiety, and depression were all significantly correlated with use of opioids and stimulants. Conclusion Trauma, and co‐occurring substance use and mental health problems are prevalent among homeless TAY. Individual‐ and community‐level interventions are needed to address and improve the health of this population.