Ellen L. Bassuk

Characteristics of sheltered homeless families.

To describe the characteristics of homeless families, we interviewed 80 homeless mothers and 151 children living in 14 family shelters in Massachusetts (two-thirds of the shelters in the state). Ninety-four per cent of the families were headed by women, 91 per cent were on AFDC (aid to families with dependent children), with twice as many as the state average having been on AFDC for at least two years; most had long histories of residential instability. Although 60 per cent had completed high school, only a third had worked for longer than one month. One-third of the mothers reported having been abused during their childhood, and two-thirds had experienced a major family disruption. At the time of the interview, almost two-thirds either lacked or had minimal supportive relationships and one-fourth of these named their child as the major support. Eighteen mothers were involved with the Department of Social Services because of probable child abuse or neglect. Seventy-one per cent of the mothers had personality disorders. In contrast to many adult homeless individuals, however, deinstitutionalized persons or those suffering from psychoses were not overrepresented. About 50 percent of the homeless children were found to have developmental lags, anxiety, depression, and learning difficulties, and about half required further psychiatric evaluation. Two-thirds described housing and social welfare agencies as not helpful. Given the many serious problems of the mothers and the difficulties already manifested by their children, comprehensive psychosocial and economic interventions must be made to interrupt a cycle of extreme instability and family breakdown.

Homelessness in female-headed families : Childhood and adult risk and protective factors

OBJECTIVES To identify risk and protective factors for family homelessness, a case-control study of homeless and low-income, never-homeless families, all female-headed, was conducted. METHODS Homeless mothers (n = 220) were enrolled from family shelters in Worcester, Mass. Low-income housed mothers receiving welfare (n = 216) formed the comparison group. The women completed an interview covering socioeconomic, social support, victimization, mental health, substance use, and health domains. RESULTS Childhood predictors of family homelessness included foster care placement and respondents mothers use of drugs. Independent risk factors in adulthood included minority status, recent move to Worcester, recent eviction, interpersonal conflict, frequent alcohol or heroin use, and recent hospitalization for a mental health problem. Protective factors included being a primary tenant, receiving cash assistance or a housing subsidy, graduating from high school, and having a larger social network. CONCLUSIONS Factors that compromise an individuals economic and social resources are associated with greater risk of losing ones home.

Exposure to violence and low-income children's mental health: direct, moderated, and mediated relations.

The authors examined the association between exposure to violence and different indexes of mental health among 95 extremely poor children (age range = 8-17 years) and analyzed potential moderators and mediators. Findings indicated that 62% of youths had been exposed to at least 1 form of violence. Controlling for other explanatory factors, exposure to violence was significantly associated with internalizing symptoms (e.g., depression, anxiety) across all children, but the relation was stronger for girls compared with boys. Externalizing problem behaviors were also associated with exposure to violence, but subgroup differences were not detected. Regression analyses indicated that self-esteem and a measure of perceived chronic danger may partially mediate the link between violence exposure and mental health symptoms.

Homelessness and Its Relation to the Mental Health and Behavior of Low-Income School-Age Children.

This study examined the relationship between housing status and depression, anxiety, and problem behaviors among children age 6 and older who were members of low-income, single-parent, female-headed families. Participants were 80 homeless and 148 never homeless children living in Worcester, Massachusetts. Children in both groups had recently been exposed to various severe stressors. Mother-reported problem behaviors were above normative levels for both homeless and poor housed youths but self-reported depression and anxiety were not. Controlling for other explanatory variables, housing status was associated with internalizing problem behaviors but not with externalizing behaviors. Among homeless youths, internalizing behavior problems showed a positive but curvilinear relationship with number of weeks having lived in a shelter. Housing status was not associated with self-reported depression and anxiety. Findings are discussed in terms of their implications for programmatic interventions and in light of recent welfare reform.

Mental Disorders and Service Utilization Among Youths From Homeless and Low-Income Housed Families

OBJECTIVE To assess the mental health of homeless and poor housed youths, using the National Institute of Mental Health (NIMH) Diagnostic Interview Schedule for Children (DISC) Version 2.3, and to examine mental health service use. METHOD As part of a comprehensive study of homeless and housed families Worcester, MA, data were collected on 41 homeless and 53 poor housed (never homeless) youths aged 9 to 17 using both the parent and youth versions of the DISC. RESULTS On the basis of the parent version of the DISC, current (6-month) prevalence rates of DSM-III-R disruptive behavior, affective, and anxiety disorders were comparable in homeless and housed youths but higher than rates found among youths in the NIMH-sponsored Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, which used the same diagnostic measure. Approximately 32% of the combined sample of homeless and housed youths had a current mental disorder accompanied by impairment in functioning. Mental health service use in the preceding 6 months among youths who had one or more current disorders and associated impairment ranged from 20% to 35%. A subgroup of youths with one or more current disorders and poor global functioning had never received treatment. CONCLUSIONS This sample of homeless and housed youths was found to have high rates of current mental disorders. Use of mental health services by children with mental health needs was low, particularly for youths with poor overall functioning.

Shelter from the Storm: Trauma-Informed Care in Homelessness Services Settings~!2009-08-20~!2009-09-28~!2010-03-22~!

It is reasonable to assume that individuals and families who are homeless have been exposed to trauma. Research has shown that individuals who are homeless are likely to have experienced some form of previous trauma; homelessness itself can be viewed as a traumatic experience; and being homeless increases the risk of further victimization and retraumatization. Historically, homeless service settings have provided care to traumatized people without directly acknowledging or addressing the impact of trauma. As the field advances, providers in homeless service settings are beginning to realize the opportunity that they have to not only respond to the immediate crisis of homelessness, but to also contribute to the longer-term healing of these individuals. Trauma-Informed Care (TIC) offers a framework for providing services to traumatized individuals within a variety of service settings, including homelessness service settings. Although many providers have an emerging awareness of the potential importance of TIC in homeless services, the meaning of TIC remains murky, and the mechanisms for systems change using this framework are poorly defined. This paper explores the evidence base for TIC within homelessness service settings, including a review of quantitative and qualitative studies and other supporting literature. The authors clarify the definition of Trauma-Informed Care, discuss what is known about TIC based on an extensive literature review, review case examples of programs implementing TIC, and discuss implications for practice, programming, policy, and research.

Predictors of Academic Achievement among Homeless and Low-Income Housed Children.

Abstract Based on a study of sheltered homeless and low-income housed families, predictors of academic achievement among 174 English-speaking children age 6 and older were examined, focusing on housing status, mobility, and race/ethnicity. Days absent from school was hypothesized as the mediating link between homelessness and academic achievement. In multivariate analyses, a composite measure of academic achievement was independently predicted by childs gender (girls scoring higher than boys), race/ethnic status (non-Latino Whites scoring higher than children of color), age, and school mobility. Housing status was not associated with academic achievement. Results indicated that homeless and housed children had comparable rates of absenteeism and other school-related problems, which may explain why homeless and housed children were similar in terms of achievement. Although children of color were equivalent to non-Latino White children in terms of nonverbal intellectual ability, their lower academic achievement scores suggest that they are not reaching their academic potential.

Intimate Partner Violence in Extremely Poor Women: Longitudinal Patterns and Risk Markers

Despite high revalence rates of intimate partner violence in the lives of extremely poor women with dependent children, few studies have investigated the patterns of violence that occur over time, and the characteristics of women that serve as risk markers for partner violence. This paper describes patterns of domestic violence longitudinally and uses multivariate analyses to delineate childhood and adult risk markers for recent intimate partner violence in this population of women. Analyses draw upon a sample of 436 homeless and extremely poor housed mothers receiving welfare, in a mid-sized city in Massachusetts with a large Hispanic population of Puerto Rican descent and relatively fewer Blacks. We found that among women with complete longitudinal data (N=280), almost two-thirds experienced intimate partner violence at some point during their adult life by the end of study follow-up, and that the abuse before and after the baseline interview was episodic and limited over time. To examine the role of individual womens factors, while controlling for partner characteristics, we used baseline data on women who had been partnered during the past year (N=336). Among childhood predictors, we found that sexual molestation contributed most significantly to adult intimate partner violence that occurred during the past year prior to the baseline interview. Adult risk markers included inadequate emotional support from non-professionals, poor self-esteem, and a partner with substance abuse problems. Having a partner with poor work history was another independent predictor of recent abuse. Ethnicity did not significantly predict whether women were abused or not during the past year, contrary to other findings reported in the literature.

Out on the street: a public health and policy agenda for lesbian, gay, bisexual, and transgender youth who are homeless.

A disproportionate number of lesbian, gay, bisexual, and transgender (LGBT) youth experience homelessness each year in the United States. LGBT youth who are homeless have particularly high rates of mental health and substance use problems, suicidal acts, violent victimization, and a range of HIV risk behaviors. Given the intense needs of LGBT youth experiencing homelessness, it is imperative to understand their unique experiences and develop responsive practices and policies. The range and severity of health risks vary across subgroups of all homeless LGBT youth, and because the population is nonhomogeneous, their particular needs must be identified and addressed. Thus, the purpose of this article is to review the causes of homelessness among LGBT youth, discuss the mental health and victimization risks faced by this population, address differences among homeless LGBT subgoups, and recommend effective interventions and best practices. The authors conclude by discussing promising future research and public policy directions.

Multiply homeless families: The insidious impact of violence

Abstract Little is known about the dynamics of homelessness among families that have been homeless more than once. Using longitudinal data from the Worcester Family Research Project, this article describes the duration of family homelessness, compares the characteristics of mothers who had been homeless only once with those who had been homeless multiple times, and identifies factors that contribute to repeated episodes of family homelessness. Certain factors such as interpersonal violence, especially during childhood, were highly associated with residential instability. At baseline, multiply homeless mothers had higher rates of childhood sexual abuse and stranger violence than their first‐time homeless counterparts. Sexual molestation during childhood was also an important predictor of recidivism. When the sample was followed prospectively, first‐time homeless mothers who experienced partner violence after being rehoused were more than three times as likely to experience a second homeless episode. Although homelessness is primarily a structural problem, national housing policy for poor people must be combined with supportive programs.