Homelessness and Children's Use of Mental Health Services: A Population-Based Study

This study examined whether children who become homeless differ from other low-income children in their mental health service use before and after their first homeless episode, and to what extent homelessness is associated with an increased likelihood of mental health service use. Differences between children with and without new onset of sheltered homelessness in the use of mental health services emerged following homelessness and widened over time. Sheltered homelessness and foster care placement history were associated with increased odds of receiving inpatient and ambulatory mental health services. Findings underscore the importance of collaborations between homeless assistance, foster care, and mental healthcare in efforts to mitigate family homelessness and collateral needs among homeless children.     

Homelessness,housing instability,intimate partner violence,mental health,and functioning: A multi-year cohort study of IPV survivors and their children

Abstract

Homelessness and housing instability frequently accompany intimate partner violence and can negatively impact health and functioning. When children are exposed to homelessness or housing instability their ability to develop and function is compromised. The purpose of this study is to examine the differential impact of homelessness and unstable housing on health and functioning of women and their children over a 2-year period. Two hundred and seventy-seven mothers reporting intimate partner violence (stalking, physical, or sexual violence by an intimate partner) were asked about housing stability, abuse, risk for murder, mental health, employment/wages, and their child's functioning over a 2-year period. Outcomes of mothers reporting homelessness and unstable housing were compared to mothers reporting stable housing. Over one-third (36%) of the mothers reported at least one episode of unstable housing over the 2-year period and 11% reported homelessness. Measures of maternal mental health and child functioning were worse for both unstably housed and homeless women, compared to stably housed women, with a higher risk for sexual abuse and risk for murder for homeless women. New models of rapid rehousing are needed that address not only the housing problems of women who have experienced intimate partner violence but also the mental health and safety issues that the women and their children face.     

Baseline Characteristics of Dependent Youth Who Have Been Commercially Sexually Exploited: Findings From a Specialized Treatment Program

ABSTRACT

Commercial sexual exploitation of children has emerged as a critical issue within child welfare, but little is currently known about this population or effective treatment approaches to address their unique needs. Children in foster care and runaways are reported to be vulnerable to exploitation because they frequently have unmet needs for family relationships, and they have had inadequate supervision and histories of trauma of which traffickers take advantage. The current article presents data on the demographic characteristics, trauma history, mental and behavioral health needs, physical health needs, and strengths collected on a sample of 87 commercially sexually exploited youth. These youth were served in a specialized treatment program in Miami-Dade County, Florida, for exploited youth involved with the child welfare system. Findings revealed that the youth in this study have high rates of previous sexual abuse (86% of the youth) and other traumatic experiences prior to their exploitation. Youth also exhibited considerable mental and behavioral health needs. Given that few programs emphasize the unique needs of children who have been sexually exploited, recommendations are offered for providing a continuum of specialized housing and treatment services to meet the needs of sexually exploited youth, based on the authors’ experiences working with this population.     

A new look at the health and homeless experience of a cohort of five-year olds

Homelessness is increasing and health workers and others need to be ever vigilant about the risk that this has on children's health. What is that risk and what are children's experiences of homelessness? A retrospective case note study was carried out to compare the health of a group of five-year olds who had experienced homelessness and compare them with matched ‘non-homeless’ controls. A home interview questionnaire was used to give a profile of the children's housing experience and the health issues faced during their time in temporary accommodation. Fifty-three cases when compared with 41 controls showed a statistically greater prevalence of child protection issues and an increased number of health needs identified at the school nurse health appraisal. The housing profile identified that the case children moved homes many times (37 per cent more than five times), were homeless much longer than the officially registered period (67 per cent more than 12 months) and 61 per cent were made homeless through domestic violence. The study reinforces the need for us to acknowledge important environmental stress and to continue to advocate for this group of disadvantaged children.     

Changes in the association between social housing tenure and child outcomes across cohorts: comparing the millennium and British cohort studies

ABSTRACT

In recent decades, social housing in the UK has increasingly become the preserve of the poorest in society. This paper is the first to investigate how the child outcome penalties associated with social housing tenure have changed over time across UK cohorts. I compare the differences in the cognitive, mental health, and physical health outcomes of children in social housing with children in non-social housing and evaluate whether these tenure differences have changed between the 1970 British Cohort Study (BCS) and the 2000 Millennium Cohort Study (MCS). I find that in both cohorts, children in social housing exhibit worse outcomes across all three dimensions (cognitive, mental health, and physical health) than children in non-social housing. For cognitive and physical health outcomes, however, the tenure difference has narrowed between the two cohorts, while for mental health outcomes, the tenure difference has widened. These results suggest that children have experienced a relative worsening in their mental health outcomes across cohorts, but also a relative improvement in both their cognitive and physical health outcomes. The findings suggest that policies aimed at reducing tenure inequalities in child outcomes should focus on mental health development in the early years.     

Homelessness as One Component of Housing Instability and Its Impact on the Development of Children in Poverty

The number offamilies with children living in poverty and experiencing housing instability and homelessness has increased dramatically over the last two decades. Current public policy decisions will lead to further increases. Understanding the impact of this instability on the emotional, behavioral, and cognitive development of children is imperative. Few studies cn'tically examine the effects ofinstability on both domiciled and homeless children. This research examined the effects of homelessness and housing instability on 133 children 8 to 12 years of age living in poverty. Results indicate that whether a child is currently homeless is not as significant as overall stability which may have a long ranging effect on a child's future development.     

The role of eviction in veterans’ homelessness recidivism*

Eviction is one of the leading causes of homelessness in the U.S.A. Though permanent supportive housing (PSH) helps participants maintain housing, some still leave due to eviction. This study aimed to determine whether eviction is an important predictor of recidivism and time to return to homelessness for participants exiting PSH. The characteristics and post-exit service use of 2802 Veteran PSH participants were analyzed based on exit reason. A Cox proportional hazards survival analysis modeled risk factors for returning to homelessness within 360 days of exit. Compared with other exiters, evicted Veterans remained in the program for less time, were less likely to be receiving service-connected compensation, and used more services – particularly mental health and substance use services – following their exit, and those who returned to homelessness did so more quickly. Identifying participants who might benefit from more intensive services, project-based housing, or income supports may prevent evictions and subsequent returns to homelessness.     

残疾儿童心理健康内涵及结构初探

心理健康是儿童生活和健康成长的保障,相较于普通儿童,在某些方面具有障碍或缺陷的残疾儿童更容易出现情绪和行为问题,其心理健康状况堪忧,迫切需要得到更多的关注和有效的干预.本文基于心理健康的概念和标准,结合残疾儿童的身心发展特点,厘清了残疾儿童心理健康的内涵,其实质是努力达成残疾儿童与外界环境的适度平衡和内心的和谐,即良好的社会适应.在此基础上,从社会适应心理机能的活动领域和特质内容两个维度入手,初步构建出残疾儿童心理健康的五领域(自我意识、人际交往、学习适应、生活适应、社会支持)与三内容(认知、情绪情感、意志行为)相交叉的二维结构模型,为进一步开展残疾儿童心理健康教育的实践工作奠定理论基础.     

Rural homelessness: its effect on healthcare access,healthcare outcomes,mobility, and perspectives of novel technologies

Rural homelessness is an undeniable public health issue that is understudied in the research literature. The purpose of this study was to determine the sociodemographics, physical and mental health status, barriers to access to care, and perspectives on potential technological advances of homeless individuals. A structured 45–90?min interview was utilized to gather demographic, physical health, mental health, mobility, and technology use data from a sample of 75 homeless individuals within three shelters in three micropolitan Nebraska cities. Individuals in this region were more likely to be white, unmarried, and mobile who have various physical and mental health disorders. Adherence to treatment of mental health disorders ranged from 43–60 percent. This population had increased employment, access to healthcare services, and use of technology than predicted. Leaders from all over the country can use these data to help improve state and local efforts to better cater to this vulnerable population's needs.     

Experiences of Informal Caregivers of Older Adults Transitioned From Nursing Homes to the Community Through the Money Follows the Person Demonstration

This study examined experiences of 156 informal caregivers of older adults who transitioned to the community through the Connecticut Money Follows the Person (MFP) Rebalancing Demonstration after prolonged nursing home stays. Caregiver burden, positive aspects of caregiving, depressive symptoms, anxiety, and comparative subjective stress were examined in relation to caregiver demographics and care receiver characteristics with a cross-sectional survey. Caregivers reported low burden, depressive symptoms, and anxiety, and fairly high levels of positive aspects of caregiving and satisfaction with community services. Most caregivers were less stressed compared to the time the care recipient was in, or before they entered, a nursing home. Live-in caregivers experienced more positive aspects of caregiving, but adult children reported higher burden than other caregivers. Unmet service needs also increased caregiver burden. Programs like MFP are a viable option with broadly positive outcomes from a caregiver’s perspective. Enthusiasm for increasing access to community care is growing for older adults who otherwise would reside in nursing homes for extended periods. Identifying unmet service needs and needs for targeted functional support could further enhance caregiver experiences and contribute to the successful transition of older adults to the community.     

An investigation of predictors of mental health in single men and women experiencing homelessness in three Canadian cities

Homelessness is related to poorer mental health, yet, there is limited understanding of the predictors of mental health of men and women experiencing homelessness. To support service providers in identifying individuals who might be at particular risk of poor mental health, this study investigated the predictors of mental health in 501 single men and women experiencing homelessness in Vancouver, Toronto, and Ottawa, Canada. Data were obtained via in-person, structured interviews. In order to identify whether predictors differ by gender, multiple linear regressions were conducted separately for men and women. Mental health status was measured by the Mental Component Summary score of the 12-item Short-Form Health Survey. Better mental health for men and women was associated with the presence of fewer chronic health conditions and a higher level of social support. An older age, not having experienced a recent physical attack, and absence of a mental health diagnosis were related to better mental health for women. The absence of unmet mental health needs within the past 12 months was associated with better mental health for men. The study highlights differences in factors associated with mental health for men and women. Service providers should be aware of the association of these factors with mental health to guide assessment and service planning.     

The Youngest Victims of Violence: Examining the Mental Health Needs of Young Children Who Are Involved in the Child Welfare and Juvenile Justice Systems

Children placed in the state’s custody due to neglect, abuse or maltreatment are one of America’s most vulnerable populations. Seventy-five percent of child victims of maltreatment are under the age of 12. Not only is their suffering a problem, these children are also at increased risk for delinquent behavior later in life. While research has documented the potential long-term consequences of child abuse and neglect, the mental health needs of young children involved in the foster care and juvenile justice systems have been largely overlooked. This study examined the social, emotional and behavioral difficulties of 670 children, age 3–11, who were involved in the child welfare and juvenile justice systems. Children in this study were living in residential treatment facilities, group homes, foster care homes or were receiving intensive home-based services. To assess the children’s mental health needs caregivers completed the parent form of the Strengths and Difficulties Questionnaire (Goodman, Journal of Child Psychology and Psychiatry 38:581–586, 1997). The findings indicated a high prevalence of mental health problems, with 81 % of the children in the sample having a total difficulties score in the borderline or abnormal range and 90 % of the children having borderline or abnormal scores on at least one of the subscales (conduct, emotional, peer or attention problems). When characteristics such as gender, race and age were considered significant differences were found among boys and girls, Caucasian and minority children, and age groups. The findings highlight the importance of mental health assessment and interventions that are gender and culturally sensitive and developmentally appropriate.     

Child Aware Practice in Adult Social Services: A Scoping Review

The development of “child aware” practice is about the capacity and capability of adult health and social service providers to identify and respond to the needs of children. A scoping review of the literature considered five adult adversities associated with family stress and reduced parenting capacity: mental illness, alcohol and substance abuse, homelessness, intellectual disability, and domestic violence. Although there are specific needs for children pertaining to particular adversities, there was substantial commonality of potential effects. These included emotional and psychological difficulties, physical and mental health problems, academic difficulties, language delays, peer difficulties, stigma, trauma reactions, loss and grief, instability, and social exclusion. How children react to difficulties in their family depends upon various protective factors, a child's frame of reference, and other dynamics within the family that can offset risks. The findings aim to inform policy, program development, and practice in adult social services, enhancing their responsiveness to children.     

Characteristics of homeless alcohol and drug abusers identified through an assertive outreach program

Differences between substance abusers and non-abusers, and among abmers of alcohol, drugs, or both substances, were investigated for 1166 persons identified as homeless or at risk of homelessness by an assertive outreach program in a moderate size city. The 603 self-reported substance abusers included disproportionate numbers of male, Black, unmarried, and currently homeless persons with a history or symptoms of mental illness, who expressed a primary need for assistance dealing with the social service system. Type of abuse was associated with demographic characteristics, length of homelessness, mental illness status, and primary expressed needs. An accurate picture of subgroup differences can aid design and delivery of services for the homeless.     

Public library support of families experiencing homelessness

While public libraries are often used by people experiencing homelessness, the value of libraries for homeless children and families has been understudied. This brief explores how public libraries can support families experiencing homelessness and how they can engage with other service providers and agencies as part of a collective impact model to support a wide array of families’ needs. Since homelessness is the result of many interconnected social and economic conditions, this paper also examines how awareness and a lack of knowledge of these factors can impact service delivery and expectations. Finally, a case study of how the Queens Library in New York City engages with family shelters to support children’s learning and exploration is included to provide best practice examples.     

Political and organizational barriers to satisfying low-income U. S. seniors' need for affordable rental housing with supportive services

A substantial share of the low-income older tenants who occupy U. S. government-subsidized rental housing has physical and cognitive limitations. These older tenants are often women living alone in their 70s and 80s, who need help obtaining community-based services, demand-responsive transportation, help with apartment housekeeping and maintenance, self-care assistance, and design modifications made to their dwellings. Other low-income and frail older persons who have large housing expense burdens or occupy physically deficient dwellings also need affordable rental housing with these supportive services. The unmet supportive service needs of these groups persist even as this country's major political and professional stakeholders are aware of their problems and have solutions. This paper examines five major political and organizational barriers that have restricted the availability of supportive services in affordable rental developments. It offers 12 policy recommendations.     

Homelessness and aging out of foster care: A national comparison of child welfare-involved adolescents

The present study represents the first large-scale, prospective comparison to test whether aging out of foster care contributes to homelessness risk in emerging adulthood. A nationally representative sample of adolescents investigated by the child welfare system in 2008 to 2009 from the second cohort of the National Survey of Child and Adolescent Well-being Study (NSCAW II) reported experiences of housing problems at 18- and 36-month follow-ups. Latent class analyses identified subtypes of housing problems, including literal homelessness, housing instability, and stable housing. Regressions predicted subgroup membership based on aging out experiences, receipt of foster care services, and youth and county characteristics. Youth who reunified after out-of-home placement in adolescence exhibited the lowest probability of literal homelessness, while youth who aged out experienced similar rates of literal homelessness as youth investigated by child welfare but never placed out of home. No differences existed between groups on prevalence of unstable housing. Exposure to independent living services and extended foster care did not relate with homelessness prevention. Findings emphasize the developmental importance of families in promoting housing stability in the transition to adulthood, while questioning child welfare current focus on preparing foster youth to live.     

Kinship care and issues in permanency planning

Kinship caregivers are a child-care resource for families experiencing stress or temporary parenting due to illness, incarceration, or death of a parent. This article examines whether and how felt caregiver burden influences the reported propensity of caregivers to want to adopt the children in their care. Kinship caregivers who were enrolled in KinNET completed the survey (N = 102) and the data were entered anonymously into SPSS for analysis. Their mean age was 57.51 years (SD = 10.13), 95% were female (SD = .19), and two-thirds were non-white (SD = .73). Using “likelihood of adopting the child in my care,” as the outcome variable in the linear regression analysis, caregiver’s age, monthly income, and total hours employed were significant predictors. Total pressures, family service needs, and physical problems scales were not statistically significant predictors. The adjusted R square was .439 and significant (.006). Understanding the factors that are predictive of adopting children in kinship care will help programs target services more effectively. Helping kinship caregivers and the children in their care is also important in promoting their health and social well-being.