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Adolescent Substance Use, Mental Health Challenges Elevated Among Homeless Population
Homeless adolescents in the US were found to be more likely to have used cocaine, methamphetamine, or heroin than nonhomeless adolescents, and were also more likely to have seriously considered or attempted suicide, according to a study led by researchers from the Smith Center for Outcomes Research at Beth Israel Deaconess Medical Center and Harvard Medical School.
Findings were published in JAMA.
“The US is facing a youth homelessness crisis, which will only be exacerbated by challenges presented by the COVID-19 pandemic, including parental deaths, housing evictions, and worsening poverty,” study author Rishi K. Wadhera, MD, MPP, MPhil, a Smith Center investigator, said in a news release. “We need to implement policies and interventions that improve broad health, social, and educational outcomes among homeless adolescents, and perhaps more importantly, prevent and end adolescent homelessness altogether.”
Homeless and nonhomeless high school students in 22 states were surveyed voluntarily and anonymously in 2019 to assess for 4 mental health outcomes and 11 substance use outcomes. Data from more than 4500 homeless adolescents and more than 105,000 nonhomeless adolescents revealed the following substance use trends:
- 32.2% of homeless adolescents reported lifetime cocaine use compared with 2.9% of nonhomeless adolescents
- 36% of homeless adolescents reported methamphetamine use (3% nonhomeless)
- 28% of homeless adolescents reported heroin use (1.3% nonhomeless)
- Similar discrepancies were observed for ecstasy use (32.9% vs 3.6%), injection drug use (28.1% vs 2.4%), and prescription opioid misuse (31.3% vs 12.9%)
Of those surveyed, 53% of homeless adolescents reported persistent sadness or hopelessness vs 37.2% of nonhomeless adolescents, 44.4% of homeless adolescents reported having seriously considered suicide (19.2% nonhomeless), and 28% of homeless adolescents reported having attempted suicide (8% nonhomeless).
“Policy strategies that increase investment in social protections and child welfare systems, and that enable health care clinicians and schools to identify and refer homeless adolescents to evidence-based interventions, may help address upstream determinants of homelessness and improve mental health and substance use outcomes,” the researchers wrote.
Among the study’s limitations, its authors noted that the survey had a response rate of 65%, as well as a lack of information on participants’ gender identity and whether they were part of a homeless family or alone.
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The mental health crisis impacting the youth of America will be further discussed at the Psych Congress Elevate meeting in Las Vegas, Nevada, June 3 to 5, 2022. Elevate will present an exclusive session previewing an upcoming PBS documentary series, “Hiding in Plain Sight: Youth Mental Health,” accompanied by a live panel discussion with filmmakers and participants. This session will take place live on Sunday, June 5, 2022, 2:50 PM to 3:50 PM PT.
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