Mental Illness and Youth-Onset Homelessness: A Retrospective Study among Adults Experiencing Homelessness.

Chisom N Iwundu,Michael S Businelle,Darla E Kendzor,Tzu-An Chen,Lorraine R Reitzel,Kirsteen Edereka-Great

doi:10.3390/ijerph17228295

Abstract

Financial challenges, social and material instability, familial problems, living conditions, structural issues, and mental health problems have been shown to contribute to youth homelessness. Based on the paucity of literature on mental illness as a reason for youth homelessness, the current study retrospectively evaluated the association between the timing of homelessness onset (youth versus adult) and mental illness as a reason for homelessness among homeless adults living in homeless shelters and/or receiving services from homeless-serving agencies. Homeless participants (N = 919; 67.3% men) were recruited within two independent studies from Dallas and Oklahoma. Covariate-adjusted logistic regressions were used to measure associations between homelessness onset and mental illness as a reason for current homelessness, history of specific mental illnesses, the historical presence of severe mental illness, and severe mental illness comorbidity. Overall, 29.5% of the sample reported youth-onset homelessness and 24.4% reported mental illness as the reason for current homelessness. Results indicated that mental illness as a reason for current homelessness (AOR = 1.62, 95% CI = 1.12–2.34), history of specific mental illnesses (Bipolar disorder–AOR = 1.75, 95% CI = 1.24–2.45, and Schizophrenia/schizoaffective disorder–AOR = 1.83, 95% CI = 1.22–2.74), history of severe mental illness (AOR = 1.48, 95% CI = 1.04–2.10), and severe mental illness comorbidities (AOR = 1.30, 95% CI: 1.11–1.52) were each associated with increased odds of youth-onset homelessness. A better understanding of these relationships could inform needs for early interventions and/or better prepare agencies that serve at-risk youth to address precursors to youth homelessness.

Highlights

Youths who experience homelessness bear a disproportionate burden of physical and mental health problems compared with their housed counterparts [1,2,3]
Our findings support that mental illness—in particular, severe mental illness and its comorbidities as driven by bipolar disorder and schizophrenia/schizoaffective disorder- was associated with youth-onset homelessness
Given that both bipolar and schizophrenia/schizoaffective disorder have been shown to typically emerge during youth (~22–24 years of age) [13,18,19,52], results linking a history of these disorders with the reason for current adult homelessness and youth-onset homelessness suggest that youths with mental illness may face compounding stressors and barriers in the access and delivery of mental health care which could result in youth-onset homelessness that perpetuates homelessness as an adult [5,33]

Summary

Introduction

Youths who experience homelessness bear a disproportionate burden of physical and mental health problems compared with their housed counterparts [1,2,3]. Homeless children and youth are described as individuals less than 25 years of age living in poverty and without a stable, reliable and adequate nighttime residence, and who may not have an alternative safe living environment [4,5]. Included in this group are accompanied and unaccompanied children Res. Public Health 2020, 17, 8295; doi:10.3390/ijerph17228295 www.mdpi.com/journal/ijerph

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