Prevalence Of Homelessness Research Articles

Homeless patients requiring haemodialysis: incidence, caseload characteristics, and implications for care

Background Homelessness is a recognized risk factor for the development of kidney failure. However, the risk of requiring renal replacement therapy (RRT) in homeless populations remains unknown. Furthermore, access to and provision of RRT for homeless populations have not been described. Methods We performed a retrospective study of all patients who newly commenced in-centre haemodialysis at St. James’s Hospital, Dublin, from January 2021 to December 2023. Housing status was captured using registered addresses and a review of social workers’ assessments. Homelessness was defined according to the European Typology on Homelessness and Housing Exclusion Criteria. Using publicly available census and homelessness data, we estimated the risk of commencing haemodialysis among homeless and non-homeless populations in the catchment area. Results The overall prevalence of homelessness among adults in the catchment area was approximately 2000/270,000 (0.74%). Of the 74 patients who commenced haemodialysis over the 3-year period, 13 (17.6%) were homeless. There was a significant difference in the incidence of commencing haemodialysis between non-homeless and homeless individuals in the catchment area (p<0.001, chi-square test). Among patients who commenced haemodialysis, the mean age was 53 years in homeless patients and 62 years in non-homeless patients (p<0.05, one-way ANOVA). 3/13 homeless patients (23%) had received nephrology healthcare at least 3 months prior to haemodialysis, compared with 39/61 non-homeless patients (64%) (p <0.05, chi-square). Of the three homeless patients who had received three months of nephrology healthcare prior to haemodialysis, all three patients commenced haemodialysis via an arteriovenous fistula. Mental health comorbidities were more frequent among homeless patients than among non-homeless patients (23% versus 8%) (not statistically significant), as were substance use disorders (38% versus 7%) (p<0.05, chi-squared test). Conclusion The incidence of kidney failure requiring haemodialysis was higher in homeless adults than in their non-homeless peers. Homeless patients were younger and started haemodialysis more urgently. There is an unmet need for nephrology healthcare for the homeless population.

Prevalence of homelessness in Russia: an assessment based on a retrospective survey

This paper assesses the prevalence of street and hidden homelessness in Russia. Based on the representative survey “Person, Family, Society – 2023” (N = 9508 people) it was revealed that 4.6% of the adult population had experienced street homelessness, while 13.5% had faced hidden homelessness. 4.8% of respondents reported about suffering from homelessness for more than 1 year, including 2.5% with experience of more than 3 years of homelessness. Street homelessness problem is primarily for males, however the prevalence of hidden homelessness is high among women too. Factors such as male gender, low median income, and smoking increase the likelihood of homelessness in the past 10 years, while marriage, higher education, and children under the age of 18 in the household decrease this likelihood. Federal district of residence and type of settlement are not correlated with the experience of homelessness. Frequent alcohol consumption significantly increases the likelihood of street homelessness. Those who have experienced homelessness have unstable housing conditions with the expectation of ones future deterioration. They are more likely to live in communal apartments, hostels, and rented housing. The experience of homelessness is associated with lack of housing owned by the person. The experience of homelessness is closely related to feelings of loneliness and conflicts in the family. Homelessness is correlated with life dissatisfaction. Compared to several countries (Australia, Canada, European countries), Russia has a higher life-time prevalence of homelessness and longer average duration of homelessness. All this emphasizes the importance of housing market policies development and social protection of people vulnerable to homelessness.

Holding the Guardrails on Involuntary Commitment.

In response to the increasing number of mentally ill people experiencing homelessness, some policy-makers have called for the expanded use of involuntary commitment, even for individuals who are not engaging in behaviors that are immediately life-threatening. Yet there is no evidence that involuntary commitment offers long-term benefits, and significant reasons to believe that expanding the practice will cause harm. In addition, these proposals ignore research showing that most people with mental illness have the capacity to make medical decisions for themselves. Rather than expanding the use of involuntary commitment, policy-makers should support approaches proven to decrease the prevalence of homelessness, such as supportive housing. In addition, states should reevaluate their commitment standards for persons who pose no risk of harm to others. One promising approach is Northern Ireland's Mental Health Capacity Act of 2016, which establishes a uniform standard for imposing nonconsensual health care interventions, without any distinction between mental illnesses and other conditions in which capacity might be compromised.

Transgender Women Experiencing Homelessness - National HIV Behavioral Surveillance Among Transgender Women, Seven Urban Areas, United States, 2019-2020.

Transgender women experience high prevalence of homelessness, which can affect their likelihood of acquiring HIV infection and can lead to poor medical outcomes. CDC analyzed data from the National HIV Behavioral Surveillance Among Transgender Women to identify whether personal characteristics and social factors affecting transgender women were associated with duration of homelessness during the past 12 months. Longer duration and chronic homelessness might indicate greater unmet needs, which increases their likelihood for acquiring HIV infection. Ordinal logistic regression was conducted to calculate adjusted prevalence odds ratios and 95% CIs for transgender women from seven urban areas in the United States experiencing homelessness 30-365 nights, 1-29 nights, and zero nights during the past 12 months. Among 1,566 transgender women, 9% reported 1-29 nights homeless and 31% reported 30-365 nights homeless during the past 12 months. Among participants who reported physical intimate partner violence or forced sex, 50% and 47%, respectively, reported experiencing 30-365 nights homeless. Furthermore, 55% who had been evicted or denied housing because of their gender identity and 58% who had been incarcerated during the past year experienced 30-365 nights homeless. The odds of transgender women experiencing longer duration of homelessness was associated with being younger and having a disability; higher psychological distress scores were associated with longer duration of homelessness. Analysis of social determinants of health found transgender women experiencing longer homelessness to be less educated, living below the Federal poverty level, and having lower social support. Therefore, focusing on HIV prevention and interventions addressing housing instability to reduce the duration of homelessness among transgender women is important. Further, integrating housing services with behavioral health services and clinical care, specifically designed for transgender women, could reduce HIV acquisition risk and improve HIV infection outcomes.

Prevalence of homelessness among hospitalized patients: A point-in-time survey.

Although homelessness is associated with increased acute healthcare utilization and poorer health outcomes, the prevalence of homelessness and housing insecurity in hospitalized patients is poorly characterized. We conducted an in-person survey to determine the prevalence of housing insecurity and homelessness among hospitalized patients at two hospitals in metropolitan Denver in conjunction with the Housing and Urban Development point-in-timecount on January 24, 2022. Of the 271 surveyed patients, 79 (29.2%) reported experiencing either housing insecurity (17.3%) or homelessness (11.8%). Of those experiencing housing insecurity or homelessness, 69.6% reported chronic health conditions, 55.7% reported multiple hospitalizations in the preceding year, 38% reported mental health concerns and 39.2% reported substance use. The prevalence of homelessness among a hospitalized patient population was over 20-fold higher than community prevalence estimates. Housing insecurity also impacted a substantial proportion of hospitalized patients and was associated with high rates of co-morbid conditions.

Homelessness Among Sexual Minority Youth.

This study examines the prevalence and types of homelessness experienced by sexual minority and heterosexual youth. Then, we examine whether state-level nondiscrimination policies and/or public attitudes on sexual diversity are associated with reduced homelessness among sexual minority youth. Finally, we investigate the differences in health risk behaviors at the intersections of sexual minority and homelessness status. We conducted a secondary data analysis using a large population-based sample from 21 states collected in the 2017 and 2019 Youth Risk Behavior Surveys. Self-reported data were obtained from sexual minority (n = 28 405) and heterosexual (n = 136 232) youth through a survey administered in high schools. We assessed the prevalence of homelessness and the types of homelessness. Sexual minority-stratified bivariate and multivariable analyses assessed associations between homelessness, state-level policy and cultural environments, and health-risk behaviors. Sexual minority youth were significantly more likely (12%) to be homeless compared with heterosexual youth (4.1%). Greater acceptance of sexual diversity at the state-level was associated with reduced homelessness among both sexual minority and heterosexual youth. Finally, homeless sexual minority youth experienced a broad array of health risk behaviors in excess of both nonhomeless sexual minority youth and homeless heterosexual youth. Sexual minority high school students were more likely to experience homelessness than their heterosexual peers. Public attitudes and greater acceptance of sexual diversity were associated with lower levels of sexual minority homelessness. More research and public health programs are needed to prevent and address homelessness among sexual minority youth.

The homeless, seizures, and epilepsy: a review.

This review aims to estimate the prevalence of seizures and epilepsy among homeless people in current literature as well as understand the main adversities that this group withstands. We conducted a search for "epilep*", "seizur*", and "homeles*" in titles and abstracts of articles in PubMed. Overall, 25 articles met the final inclusion criteria and warranted analyses. This study suggests that the prevalence of epilepsy in the homeless population is between 2 and 30%, whereas the prevalence of homelessness in people with epilepsy is between 2 and 4%. Every study included in this review corroborates the increased prevalence of seizures and epilepsy among the homeless, which puts them at risk for worse outcomes related to this condition and numerous associated comorbidities. Further evidence is needed to clarify the distinction of primary and secondary seizures in this group, which shows a high rate of confounding factors for seizures like substance abuse or withdrawal and head injury, and to decrease the burden of epilepsy and homelessness in an already resource-deficient community.

Social support as a resilience factor for parent-infant dyads experiencing homelessness.

Despite the considerable prevalence of homelessness among very young children in the United States, there is a notable lack of research on risk, resilience, and developmental well-being of infants who experience family homelessness. In the present study, we considered social support as a resilience factor for quality of parent-infant relationships and parent depression among a sample of 106 parents and their infants (ages birth to 12 months) residing in emergency shelters for families experiencing homelessness. We assessed social support, parent histories of adverse experiences during childhood and adulthood, and parent current depression symptoms via structured interview measures, and we assessed quality of the parent-infant relationship with an observational approach. Results showed different patterns for the roles of adversity the parents had experienced during childhood compared to adversity experienced more recently, as adults. Childhood adversity predicted parent-infant responsiveness, with a positive association that was moderated by level of perceived social support. Parents with more childhood adversity showed more responsiveness with their infants only when they had access to high levels of social support. Adulthood adversity predicted higher scores for parent depression, while social support predicted lower parent depression scores. This work contributes to the very limited literature on the functioning of families with infants in shelters. Our discussion includes implications for research, policy, and prevention and intervention efforts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

State-level homelessness and drug overdose mortality: Evidence from US panel data

BackgroundAlthough homelessness is a well-documented risk factor for drug overdose at the individual level, less is known about state-level homelessness and overdose mortality in the United States (US). MethodsThis study used 2007–2020 panel data for all US states and the District of Columbia, from the following sources: US Department of Housing and Urban Development (homelessness data); Centers for Disease Control and Prevention (drug overdose death counts, population estimates, and opioid prescribing rates); Bureau of Labor Statistics (unemployment rates); and the National Forensic Laboratory Information System (drug seizure data). Two-way (state and year) fixed effects models regressed log-transformed drug overdose mortality rates on homelessness prevalence, in nested models adding demographic composition and unemployment measures, as well as drug supply measures. Models were weighted by state population size, and standard errors (SEs) were clustered at the state level. ResultsHomelessness prevalence was significantly and positively associated with rates of drug overdose mortality after adjusting for nationwide trends, time-invariant differences between states, demographic composition, and unemployment rates (b[SE]=0.98[0.36], p=0.009). The positive association between homelessness prevalence and overdose mortality was attenuated at higher levels of fentanyl availability (fentanyl involvement in drug seizures; interaction term b[SE]=−0.02[0.01], p=0.001). ConclusionThe positive association between state-level homelessness and drug overdose mortality suggests that policies and programs to prevent and reduce homelessness represent fundamental elements of a comprehensive response to the US overdose crisis.

Health and care utilization among youth with a history of parental incarceration and homelessness.

Despite widespread recognition of the health and social risks posed by parental incarceration (PI) and homelessness, these challenges are rarely considered in unison. We sought to (a) assess the experiences of homelessness among youth with and without a history of PI and (b) compare the health and healthcare utilization among youth with a combined history of PI and homelessness. Examining data from eighth-, ninth-, and 11th-grade public school participants in the 2019 Minnesota Student Survey (N = 110,904), we calculated univariate and multivariate analyses to characterize the health status and care utilization of youth who have experienced PI, past-year homelessness, or both. We observed higher prevalence of homelessness among youth with a history of PI compared to those without. The group with dual PI-homelessness experience had a higher proportion of youth that were younger, male, and non-White; and living in poverty or urban areas compared to youth with PI history only. Even after accounting for demographic factors, the dual PI-homelessness group evidenced higher expected odds for several physical health conditions (e.g., asthma, diabetes), and differences in care utilization indicators relative to individual PI and homelessness groups. Findings suggest that PI may be overrepresented among recently homeless youth and that youth with such dual experience possess distinct, and often elevated, health service needs. Health, education, housing, and other systems may need intersectoral strategies to better identify and support this at-risk subset of youth through clinical and policy approaches. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Teaching Homelessness: How American Community College Faculty Approach Housing Insecurity as a Curricular Topic

Community college students are more likely than their peers in four-year colleges to experience homelessness or housing instability. At the same time, homelessness is a curricular topic, particularly in social science courses. Given the prevalence of homelessness and housing instability in the community college student population, likely worsened by the COVID-19 pandemic and subsequent and ongoing economic crisis, this project sought to discover how community college faculty approach homelessness and housing instability as a curricular topic, including their theoretical and praxis perspectives, and the integration of students’ lived experience into their instruction. Fourteen faculty from a variety of disciplines participated in interviews, revealing that homelessness is most often used a way for students to explore foundational theories in sociology. Participants problematized their teaching around homelessness, particularly their service-learning activities, and described the importance of care and safety when discussing housing with students they recognized could have lived experience with homelessness. Future research should explore students’ experiences in classes where homelessness is a curricular topic, and how more critical theoretical approaches may be beneficial.

Homelessness and the association with future substance use and STI/HIV risk behaviors among urban gay, bisexual, and other men who have sex with men (MSM): a longitudinal analysis

ABSTRACT Introduction: Homelessness is associated with an increased risk of syphilis, HIV, and other STIs and disproportionately impacts sexual and gender minorities. Method: Data for this analysis came from a longitudinal cohort study of 285 urban gay, bisexual, and other men who have sex with men (MSM). The study aimed to (1) describe the prevalence of homelessness over time (2) identify characteristics associated with homelessness, and (3) measure associations between recent homelessness and substance use and STI/HIV risk behaviors three months later. Participants were recruited from clinical and non-clinical settings and attended a baseline visit and study visits every three months for up to 18-months. Data was collected between July 2018 and September 2020. Descriptive analyses and mixed-effects logistic regression models were utilized. Results: One-third of participants (94) reported experiencing homelessness throughout the study. Homelessness was significantly and independently associated with increased risk for future drug/alcohol use before/during sex (aOR: 3.8, 95% CI: 1.7, 8.6), methamphetamine use (aOR: 6.3 95% CI: 2.6, 15.2), injection drug use (adjusted odds ratio (aOR): 3.7, 95% CI: 1.0, 13.1), and sex exchange (aOR: 12.7; 95% CI: 5.5, 29.4). Conclusion: Interventions to reduce homelessness are necessary to lower risk of substance use and STI/HIV risk behaviors.

Identifying Predictors of Homelessness Among Adults in a Large Integrated Health System in Northern California.

Introduction Homelessness contributes to worsening health and increased health care costs. There is little published research that leverages rich electronic health record (EHR) data to predict future homelessness risk and inform interventions to address it. The authors' objective was to develop a model for predicting future homelessness using individual EHR and geographic data covariates. Methods This retrospective cohort study included 2,543,504 adult members (≥ 18 years old) from Kaiser Permanente Northern California and evaluated which covariates predicted a composite outcome of homelessness status (hospital discharge documentation of a homeless patient, medical diagnosis of homelessness, approved medical financial assistance application for homelessness, and/or "homeless/shelter" in address name). The predictors were measured in 2018-2019 and included prior diagnoses and demographic and geographic data. The outcome was measured in 2020. The cohort was split (70:30) into a derivation and validation set, and logistic regression was used to model the outcome. Results Homelessness prevalence was 0.35% in the overall sample. The final logistic regression model included 26 prior diagnoses, demographic, and geographic-level predictors. The regression model using the validation set had moderate sensitivity (80.4%) and specificity (83.2%) for predicting future cases of homelessness and achieved excellent classification properties (area under the curve of 0.891 [95% confidence interval = 0.884-0.897]). Discussion This prediction model can be used as an initial triage step to enhance screening and referral tools for identifying and addressing homelessness, which can improve health and reduce health care costs. Conclusions EHR data can be used to predict chance of homelessness at a population health level.

Easy to use and validated predictive models to identify beneficiaries experiencing homelessness in Medicaid administrative data.

To develop easy to use and validated predictive models to identify beneficiaries experiencing homelessness from administrative data. We pooled enrollment and claims data from enrollees of the California Whole Person Care (WPC) Medicaid demonstration program that coordinated the care of a subset of Medicaid beneficiaries identified as high utilizers in 26 California counties (25 WPC Pilots). We also used public directories of social service and health care facilities. Using WPC Pilot-reported homelessness status, we trained seven supervised learning algorithms with different specifications to identify beneficiaries experiencing homelessness. The list of predictors included address- and claims-based indicators, demographics, health status, health care utilization, and county-level homelessness rate. We then assessed model performance using measures of balanced accuracy (BA), sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (area under the curve [AUC]). We included 93,656 WPC enrollees from 2017 to 2018, 37,441 of whom had a WPC Pilot-reported homelessness indicator. The random forest algorithm with all available indicators had the best performance (87% BA and 0.95 AUC), but a simpler Generalized Linear Model (GLM) also performed well (74% BA and 0.83 AUC). Reducing predictors to the top 20 and top five most important indicators in a GLM model yields only slightly lower performance (86% BA and 0.94 AUC for the top 20 and 86% BA and 0.91 AUC for the top five). Large samples can be used to accurately predict homelessness in Medicaid administrative data if a validated homelessness indicator for a small subset can be obtained. In the absence of a validated indicator, the likelihood of homelessness can be calculated using county rate of homelessness, address- and claim-based indicators, and beneficiary age using a prediction model presented here. These approaches are needed given the rising prevalence of homelessness and the focus of Medicaid and other payers on addressing homelessness and its outcomes.

Stressful Life Events and Risk of Homelessness After Active Duty: An Assessment of Risk and Resilience Among Servicemembers.

The transition from military to civilian life may present increased exposure to various stressful life events (SLEs) that can increase the risk of homelessness (eg, loss of employment, dissolution of romantic relationships). We assessed the extent to which exposure to SLEs occurring proximal to US Army soldier transitions out of active duty was associated with risk of homelessness. A total of 16 589 respondents who were no longer on active duty but participated while on active duty during 2011-2014 baseline surveys completed follow-up surveys during 2016-2018 and 2018-2019. The follow-up surveys assessed SLEs and homelessness occurring in the past 12 months. We used modified Poisson regression models to evaluate how much differential SLE exposure and effects explained the aggregate association of a risk index with homelessness among a sample of 6837 respondents, weighted to represent the full sample. More than half (n = 3510, 52.8%) of respondents reported experiencing any SLEs in the past 12 months. Most (60.5%) of the difference in prevalence of homelessness among respondents defined as being at high risk of homelessness (vs lower risk) was explained by differential exposure to, and/or effects of, these SLEs. Personal betrayal by a loved one and economic problems played the largest roles in adjusted risk differences (0.045 and 0.074, respectively). Homelessness might be reduced by gearing interventions toward soldiers at high risk of homelessness who are transitioning out of active duty to reduce exposure to and effects of modifiable SLEs on experiencing homelessness.

Gender Minority Youth Experiencing Homelessness and Corresponding Health Disparities

PurposePediatricians and youth service providers frequently interface with vulnerable populations, including gender minority youth (e.g., transgender, nonbinary, gender questioning, and other gender diverse individuals) and youth experiencing homelessness. The purposes of this study are to estimate the prevalence of homelessness and types of homelessness experienced among gender minority youth and their corresponding health outcomes. MethodsData for this study came from gender minority (n = 3,194) and cisgender (n = 93,337) high school students who answered questions on transgender status and homelessness status in the 2017 and 2019 Youth Risk Behavior Survey (YRBS). We compared the prevalence of homelessness between gender minority and cisgender youth and assessed where youth experiencing homelessness had slept in the prior month: shelters, nonparental homes, streets, hotel, or other locations. Finally, logistic regression models and marginal effects (ME) were used to examine health outcomes at the intersection of gender minority status and homelessness. Results22% of gender minority youth reported homelessness during the prior month. Cisgender youth were significantly less likely to report being homeless (3%). Transgender youth experiencing homelessness were significantly more likely to live on the streets than cisgender youth experiencing homelessness (ME = 0.20; 95% CI = 0.10–0.30; p < .001). Gender minority youth experiencing homelessness reported elevated health-risk behaviors in excess of nonhomeless gender minority youth and cisgender youth experiencing homelessness. DiscussionPublic health campaigns, housing interventions, and youth service providers should consider and create tailored programs to secure housing and to promote the health of gender minority youth experiencing homelessness.

Counting homelessness: Working creatively to generate complex descriptive profiles of the health and demographics of people experiencing homelessness in Adelaide

AbstractAnalyses of the prevalence of homelessness suggest homelessness is increasing in Australia and other countries. Yet, difficulties exist in obtaining an accurate picture of homelessness due to a dearth of robust data and inconsistent definitions. This study aimed to build a comprehensive descriptive profile of homelessness and associated health needs in Adelaide. Five data sources were analysed and compared to produce descriptive sociodemographic and health statistics. Across data sources, people experiencing homelessness had a high prevalence of poor health outcomes and service utilisation. Consistent with the international literature, high rates of physical and mental health conditions were reported, including depression, anxiety and dental problems. While there was variability in demographic data, Aboriginal and Torres Strait Islander peoples were consistently over‐represented. Analysing data from multiple sources provided a richer understanding of who is experiencing homelessness and their health needs, highlights it is not always necessary to collect new data to overcome dataset limitations and illustrates how data comparison can improve the use of existing data. The paper concludes with reflections on the challenges and potential of the methodology. Overall, the study shows analysing data from multiple sources can provide rich information to service providers and government departments to inform more nuanced and effective services.

LIFE ON THE STREETS IS HORRIBLE: OLDER RURAL-URBAN MIGRANTS COPE WITH HOMELESSNESS IN ETHIOPIA

Abstract The prevalence of homelessness among older adults in Ethiopia is growing. While prior studies examined the push factors and challenges of homeless elders, little is known about how older people in Sub Saharan Africa cope with homelessness. This study explored the coping strategies of homeless older people in Kobo Town, Ethiopia. Purposive sampling was used to identify 10 homeless older people and four key informants. Study participants were homeless for a year or longer. Thematic analysis was used to analyze the data collected through in-depth interviews. To cope with the challenges faced on the street, homeless older people used various strategies including begging, holy water, drying leftover food, using river water for hygiene and sanitation, sleeping in church compounds, and creating their own social networks. Despite their efforts, the coping strategies used by elders were not sufficient. In the absence of family and government support, study participants relied heavily on begging to meet their survival needs. The findings call attention to the need for a national income support program and other supportive services for older adults. Homelessness is the product of a failing support system. Despite Ethiopia having a Plan of Action for Older Persons and Social Protection Policy for Vulnerable Groups, these policies have not been effectively implemented leaving older adults with no safety net. This study calls for the development of new policies to empower older people in Ethiopia and prevent them from turning to begging as their only recourse.

Experiences with Eviction, House Foreclosure, and Homelessness Among COVID-19 Infected Adults and Their Relation to Mental Health in a Large U.S. City.

This study examined experiences with eviction, house foreclosures, and homelessness in a large U.S. city sample of adults with Coronavirus Disease-2019 (COVID-19). A total of 3595 adults with COVID-19 participated in an assessment of health and well-being after completing contact tracing activities. The sample had a 5.7% lifetime prevalence of eviction, 3.7% lifetime prevalence of house foreclosure, and 8.2% lifetime prevalence of homelessness. Relative importance analyses revealed drug use was the most important variable associated with any lifetime eviction, lifetime house foreclosure, lifetime homelessness, and being currently at-risk of eviction or recently evicted. Loneliness was also relatively strongly associated with any lifetime eviction or homelessness, while socioeconomic characteristics were the most importance variables associated with late mortgage payments in the past month. Treatment for addiction problems may be important for in the aftermath of the COVID-19 pandemic and adults with histories of housing instability may be particularly at risk.

Patterns of homelessness and housing instability and the relationship with mental health disorders among young people transitioning from out-of-home care: Retrospective cohort study using linked administrative data.

ObjectivesThe study examined the relationship between mental health, homelessness and housing instability among young people aged 15–18 years old who transitioned from out-of-home in 2013 to 2014 in the state of Victoria, Australia with follow-up to 2018. We determined the various mental health disorders and other predictors that were associated with different levels of homelessness risk, including identifying the impact of dual diagnosis of mental health and substance use disorder on homelessness.MethodologyUsing retrospective de-identified linked administrative data from various government departments we identified various dimensions of homelessness which were mapped from the European Topology of Homelessness (ETHOS) framework and associated mental health variables which were determined from the WHO ICD-10 codes. We used ordered logistic regression and Poisson regression analysis to estimate the impact of homelessness and housing instability respectively.ResultsA total homelessness prevalence of 60% was determined in the care-leaving population. After adjustment, high risk of homelessness was associated with dual diagnosis of mental health and substance use disorder, intentional self-harm, anxiety, psychotic disorders, assault and maltreatment, history of involvement with the justice system, substance use prior to leaving care, residential and home-based OHC placement and a history of staying in public housing.ConclusionsThere is clearly a need for policy makers and service providers to work together to find effective housing pathways and integrated health services for this heterogeneous group of vulnerable young people with complex health and social needs. Future research should determine longitudinally the bidirectional relationship between mental health disorders and homelessness.