Abstract

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. One hundred homeless TAY were recruited from a community-based organization to complete a survey on trauma, mental health symptoms, and substance use. 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. 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. 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.

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