Assessing and Treating Complex Mental Health Needs Among Homeless Youth in a Shelter-based Clinic

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2020 Feb 13

PMID 32046711

Citations 11

Authors

Dominika A Winiarski

Anne K Rufa

Dawn T Bounds

Angela C Glover

Kristin A Hill

Niranjan S Karnik

Affiliations

Soon will be listed here.

Abstract

Background: Rates of homelessness have been increasing in recent years, thereby necessitating a more direct approach to treating this complex social problem. Homeless youth have disproportionately high rates of untreated mental health problems and are therefore particularly vulnerable to the effects of homelessness during the transition period from adolescence to adulthood.

Methods: The study team developed a shelter-based clinic and collected clinical measures on youth who attended this clinic from October 2016 through June 2018.

Results: Youth attended an average number of three sessions, but there was a significant drop in follow-up after the first (intake) appointment. Depression, anger, and adjustment disorder emerged as the most common presenting mental health concerns identified by clinicians in the intake appointment, and trauma was identified as a significant complaint for those youth who returned for a second session.

Conclusion: Mental health care is needed in this population, but future studies should explore alternative approaches to retaining homeless youth in treatment and in designing targeted trauma-informed interventions.

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References

Chorpita B, Daleiden E, Weisz J . Identifying and selecting the common elements of evidence based interventions: a distillation and matching model. Ment Health Serv Res. 2005; 7(1):5-20. DOI: 10.1007/s11020-005-1962-6. View

Gelberg L, Gallagher T, Andersen R, Koegel P . Competing priorities as a barrier to medical care among homeless adults in Los Angeles. Am J Public Health. 1997; 87(2):217-20. PMC: 1380797. DOI: 10.2105/ajph.87.2.217. View

Kessler R, McLaughlin K, Green J, Gruber M, Sampson N, Zaslavsky A . Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. Br J Psychiatry. 2010; 197(5):378-85. PMC: 2966503. DOI: 10.1192/bjp.bp.110.080499. View

Asanin J, Wilson K . "I spent nine years looking for a doctor": exploring access to health care among immigrants in Mississauga, Ontario, Canada. Soc Sci Med. 2008; 66(6):1271-83. DOI: 10.1016/j.socscimed.2007.11.043. View

Leucht S, Engel R . The relative sensitivity of the Clinical Global Impressions Scale and the Brief Psychiatric Rating Scale in antipsychotic drug trials. Neuropsychopharmacology. 2005; 31(2):406-12. DOI: 10.1038/sj.npp.1300873. View

Chibanda D, Bowers T, Verhey R, Rusakaniko S, Abas M, Weiss H . The Friendship Bench programme: a cluster randomised controlled trial of a brief psychological intervention for common mental disorders delivered by lay health workers in Zimbabwe. Int J Ment Health Syst. 2016; 9:21. PMC: 4940904. DOI: 10.1186/s13033-015-0013-y. View

Lamb J, Bower P, Rogers A, Dowrick C, Gask L . Access to mental health in primary care: a qualitative meta-synthesis of evidence from the experience of people from 'hard to reach' groups. Health (London). 2011; 16(1):76-104. DOI: 10.1177/1363459311403945. View

Branson C, Clemmey P, Mukherjee P . Text message reminders to improve outpatient therapy attendance among adolescents: a pilot study. Psychol Serv. 2013; 10(3):298-303. DOI: 10.1037/a0026693. View

Peterson P, Baer J, Wells E, Ginzler J, Garrett S . Short-term effects of a brief motivational intervention to reduce alcohol and drug risk among homeless adolescents. Psychol Addict Behav. 2006; 20(3):254-64. DOI: 10.1037/0893-164X.20.3.254. View

10.

Slesnick N, Dashora P, Letcher A, Erdem G, Serovich J . A Review of Services and Interventions for Runaway and Homeless Youth: Moving Forward. Child Youth Serv Rev. 2010; 31(7):732-742. PMC: 2699020. DOI: 10.1016/j.childyouth.2009.01.006. View

11.

Solorio M, Milburn N, Andersen R, Trifskin S, Rodriguez M . Emotional distress and mental health service use among urban homeless adolescents. J Behav Health Serv Res. 2006; 33(4):381-93. DOI: 10.1007/s11414-006-9037-z. View

12.

Martijn C, Sharpe L . Pathways to youth homelessness. Soc Sci Med. 2005; 62(1):1-12. DOI: 10.1016/j.socscimed.2005.05.007. View

13.

Christiani A, Hudson A, Nyamathi A, Mutere M, Sweat J . Attitudes of homeless and drug-using youth regarding barriers and facilitators in delivery of quality and culturally sensitive health care. J Child Adolesc Psychiatr Nurs. 2008; 21(3):154-63. DOI: 10.1111/j.1744-6171.2008.00139.x. View

14.

Castro A, Gustafson E, Ford A, Edidin J, Smith D, Hunter S . Psychiatric disorders, high-risk behaviors, and chronicity of episodes among predominantly African American homeless Chicago youth. J Health Care Poor Underserved. 2014; 25(3):1201-16. PMC: 4251732. DOI: 10.1353/hpu.2014.0124. View

15.

Tyler K, Akinyemi S, Kort-Butler L . Correlates of service utilization among homeless youth. Child Youth Serv Rev. 2014; 34(7). PMC: 3564660. DOI: 10.1016/j.childyouth.2012.03.010. View

16.

Hudson A, Nyamathi A, Greengold B, Slagle A, Koniak-Griffin D, Khalilifard F . Health-seeking challenges among homeless youth. Nurs Res. 2010; 59(3):212-8. PMC: 2949422. DOI: 10.1097/NNR.0b013e3181d1a8a9. View

17.

Hudson A, Nyamathi A, Sweat J . Homeless youths' interpersonal perspectives of health care providers. Issues Ment Health Nurs. 2008; 29(12):1277-89. DOI: 10.1080/01612840802498235. View

18.

Guy R, Hocking J, Wand H, Stott S, Ali H, Kaldor J . How effective are short message service reminders at increasing clinic attendance? A meta-analysis and systematic review. Health Serv Res. 2011; 47(2):614-32. PMC: 3419880. DOI: 10.1111/j.1475-6773.2011.01342.x. View

19.

Murray L, Dorsey S, Haroz E, Lee C, Alsiary M, Haydary A . A Common Elements Treatment Approach for Adult Mental Health Problems in Low- and Middle-Income Countries. Cogn Behav Pract. 2015; 21(2):111-123. PMC: 4304666. DOI: 10.1016/j.cbpra.2013.06.005. View

20.

Ryan K, Kilmer R, Cauce A, Watanabe H, Hoyt D . Psychological consequences of child maltreatment in homeless adolescents: untangling the unique effects of maltreatment and family environment. Child Abuse Negl. 2000; 24(3):333-52. DOI: 10.1016/s0145-2134(99)00156-8. View