Adrian B. Bonner

Risk Factors for Homelessness: Evidence From a Population-Based Study

OBJECTIVEnThis study examined factors associated with lifetime experience of homelessness among young adults.nnnMETHODSnData were analyzed for 14,888 young adults (mean+/-SD age 21.97+/-1.77; 7,037 men and 7,851 women) who participated in the National Longitudinal Study of Adolescent Health (Add Health), a U.S. nationally representative, population-based sample. Data were collected from young adults through computer-assisted interviews six years after they had enrolled in the study as adolescents. Variables that have been associated with lifetime homelessness in at least one service sample were mapped to Add Health survey items. Data were analyzed by logistic regression.nnnRESULTSnA total of 682 respondents (4.6%) were classified as ever being homeless. Several factors related to childhood experiences of poor family functioning, socioeconomic disadvantage, and separation from parents or caregivers were independently associated with ever being homeless. Other significant independent factors included current socioeconomic difficulty, mental health problems, and addiction problems. Indicators of involvement in crime and addiction problems with gambling and alcohol were not independently associated with homelessness.nnnCONCLUSIONSnThe findings underscore the relationship between specific indicators of adversity in childhood and risk of homelessness and point to the importance of early intervention efforts. Consistent with the extant research literature, mental health problems also appear to be associated with homelessness, highlighting the potentially complex service needs of this population.

A Longitudinal Population-Based Study of Factors in Adolescence Predicting Homelessness in Young Adulthood

PURPOSEnAlmost everything known about risk factors for homelessness is based on cross-sectional studies of non-random samples. Furthermore, most studies have focused on a small number of risk factors and have not evaluated their relative importance. Our aim was to examine which factors, in a population-based sample of adolescents, independently predict homelessness in young adults.nnnMETHODSnParticipants (n = 10,433) in the US National Longitudinal Study of Adolescent Health (Add Health) were initially selected through systematic random sampling of US high schools. Interviews were conducted at home in 1994-1995 when the participants were 11-18 years of age and again in 2001 when participants were 18-28 years of age. We examined the relationships between a range of risk factors reported in adolescence (mood-related problems, substance involvement, delinquency, personality, quality of family relations, neighborhood quality, school adjustment, religious affiliation, perpetration of violence, and experiences of victimization) and experiences of homelessness reported in young adulthood, using regression analysis.nnnRESULTSnEach risk factor predicted homelessness. However, only family relationship quality (odds ratio [OR] = .79, 95% confidence interval [CI] = .69-.90), school adjustment problems (OR = 1.57, 95% CI = 1.35-1.82), and experiences of victimization (OR = 1.27, 95% CI = 1.11-1.45) were found to independently predict homelessness.nnnCONCLUSIONSnAmong a range of well-established risk factors, a troubled family background, school adjustment problems and experiences of victimization were found to be the strongest predictors of homelessness in a general population of young people. Our findings suggest possibilities for the early identification of young persons at risk for homelessness through schools, agencies offering family-based support, and clinical services.

Factor structure and use of the hospital anxiety and depression scale in the homeless and socially marginalized.

Abstract The homeless have been identified as a group at risk of significant anxiety and depression and screening is therefore highly desirable to identify those needing psychological and psychiatric support. However, the psychometric properties of routine screening instruments have yet to be established in this group. This study sought to determine the psychometric properties of the widely used Hospital Anxiety and Depression Scale in this group. Using a cross-sectional design, 314 clients presenting at homelessness units (shelters) supported by The Salvation Army were administered the HADS. Confirmatory factor analysis revealed three-factor models offered the best fit to the data (best-fit model CFI = .98, RMSEA = .06, WRMR = .87). This investigation confirms contemporary research findings that the HADS comprises an underlying tri-dimensional factor structure. However, the internal consistency of the HADS anxiety (alpha = .81) and depression (alpha = .90) sub-scales was excellent. The findings of the current study suggest that the HADS is a suitable screening tool in this group.

The UK Responsibility Deal and its implications for effective alcohol policy in the UK and internationally.

Commentary on McCarthy et al. (2012): Understanding how alcohol affects decisions to drive while intoxicated—the need to deconstruct impulsivity Fillmore, Mark T.

Suicide and homelessness

Suicide behaviour rates vary significantly between countries due to a range of cultural, behavioural and health‐related factors. Gender and age‐related factors also appear to be impor tant key determinants of vulnerability to suicide ideation and suicide completion. The homeless population is par ticularly at risk, due to multiple complex issues that relate to social exclusion, alcohol, drug, mental health and nutritional issues. Studying homeless people is problematic due to access, the transitory nature of their contact with statutary services, problems of self‐repor t and recall in people ‐ some of whom have mental health and cognitive issues. There is an increasing interest from practitioners and academic researchers in spiritual factors that appear to modulate the responses of an individual to the internal and external threats that underlie the motivation to end his or her life. Effective approaches to suicide prevention and crisis management require a good understanding of the interplay between this complex set of biological, psychological and social domains. These will be explored in the final section of this review. This paper, therefore, aims to provide a non‐systematic review of the existing literature published in academic journals and relvant ‘grey literature’ and focuses on themes in the literature that will hopefully inform both policy and practice.

Alcohol: Nutrition and Health Inequalities

Alcohol-use disorders are common in all developed countries and are more prevalent in men than women, with lower but still substantial rates in developing countries [1, 2]. Although rates of these disorders are lower in the Mediterranean countries (e.g. Greece, Italy and Israel) and higher in northern and eastern Europe (e.g. Russia and Scandinavia), they are responsible for a large proportion of the health-care burden in almost all populations [1, 2].