Emotional health among youth experiencing family homelessness

Abstract

BACKGROUND AND OBJECTIVES: Youth who are homeless with adult family members comprise 37% of the US homeless population, yet mental health among this group has not yet been well described. We aimed to compare the risk of suicidality, and factors that may protect against it, between family-homeless and nonhomeless youth. METHODS: We used cross-sectional data, representing 62 034 eighth-to 12th-graders, to estimate the adjusted odds ratio (aOR) of emotional distress, self-injury, suicidal ideation, and attempted suicide in the past 12 months for youth who experienced family homelessness in the past 12 months compared with housed youth, controlling for covariates. We then tested whether developmental assets moderated these outcomes. RESULTS: Four percent (n = 4594) of youth (mean age 14.9 years) were homeless with an adult family member. Among these, 29.1% (n = 1317; aOR: 2.52, 95% confidence interval [CI] 2.34-2.69) reported self-injury, 21% (n = 940; aOR: 2.30, 95% CI: 2.14-2.48) reported suicidal ideation, and 9.3% (n = 416; aOR: 3.24, 95% CI: 2.91-3.60) reported suicide attempts. Developmental assets decreased the odds of these outcomes for all youth but were less protective for homeless youth. CONCLUSIONS: Youth experiencing recent family homelessness are at higher risk of suicidality than their nonhomeless peers, suggesting homelessness itself as a marker of risk. Factors that protect emotional health are less impactful among youth experiencing recent family homelessness. Thus, interventions among homeless youth may need to address social determinants of health such as stable housing and adversity in addition to developmental assets.