Open access

Mental Health, Suicidal Behaviour, and Primary Healthcare among Homeless Youth

Publication: Canadian Journal of Community Mental Health
14 May 2021

Abstract

Youth homelessness is a complex psychosocial problem. It refers to the experience of young people who live without their parents or legal guardians and who do not have the means or the capacity to reside in a stable, secure, and permanent place. This exploratory study sought to examine the mental health and suicidal behaviour of 76 homeless Québec adolescents as part of a reflection on the mission of primary healthcare. Note that these adolescents are mostly in the first segment of the homelessness continuum and have voluntarily left their homes because of personal and family difficulties. These 43 girls and 33 boys aged 12 to 19 living temporarily in shelters completed a semi-structured interview and self-administered questionnaires regarding stressful events, psychosocial stress, and mental health. Of these, 38 reported suicidal behaviour, including attempted suicide in 19 cases. The results show that these young people exemplify a high degree of suffering and multiple problems. Evidence indicates that lost relationships and academic problems rooted in attention deficit/hyperactivity disorder are linked to suicidal behaviour. Finally, non-productive coping strategies centred on somatization and little reassurance of worth provided by the social support network are associated with suicidal behaviour. Caregivers in temporary shelters should look out for these factors and refer vulnerable youth to primarycare mental health professionals.

Résumé

L’itinérance chez les jeunes est un problème psychosocial complexe. Il renvoie à l’expérience que connaissent des jeunes qui vivent sans leurs parents ou gardiens et qui n’ont pas les moyens ni la capacité de résider dans un lieu stable, sécuritaire et permanent. Cette recherche exploratoire vise à étudier la santé mentale et les conduites suicidaires de 76 adolescents itinérants temporaires québécois dans le cadre d’une réflexion sur la prise en charge en soins de santé primaires. Notons que ces adolescents s’inscrivent majoritairement au premier segment du continuum de l’itinérance et qu’ils ont quitté volontairement leur domicile pour des difficultés personnelles et familiales. Ces jeunes (43 filles et 33 garçons) âgés de 12 à 19 ans, hébergés temporairement dans un refuge, ont été rencontrés afin de participer à une entrevue semi-structurée avec passation de questionnaires autoadministrés portant sur les événements stressants et le stress psychosocial ainsi que leur santé mentale. Parmi eux, 38 présentaient des conduites suicidaires, dont 19 avaient fait une tentative de suicide. Les résultats montrent que ces jeunes présentent une souffrance élevée avec des problèmes multiples. Les données indiquent que les ruptures affectives et les problèmes scolaires enracinés dans un trouble d’attention/hyperactivité sont liés aux conduites suicidaires. Enfin, les stratégies non productives de somatisation et le peu de soutien quant à la réassurance en sa valeur sont associés aux conduites suicidaires. Les intervenants des refuges temporaires sont invités à bien repérer ces éléments afin de les référer à des professionnels en soins primaires de santé mentale.

Formats available

You can view the full content in the following formats:

References

Abdel-Baki A., Aubin D., Morisseau-Guillot R., Lal S., Dupont M. E., Bauco P., Shah J. L., Joober R., Boksa P., Malla A., and Iyer S. N. 2019 Improving mental health services for homeless youth in downtown Montreal, Canada: Partnership between a local network and ACCESS Esprits ouverts (Open Minds), a National Services Transformation Research Initiative Early Intervention Psychiatry 13 Suppl 1 S20 -S28
Auerswald C. L., Lin J. S., and Parriott A. 2016 Six-year mortality in a street-recruited cohort of homeless youth in San Francisco, California PeerJ 4 e1909
Baron P., Joubert N., and Mercier P. 1991 Situations stressantes et symptomatologie dépressive chez les adolescents [Stressful situations and depression symptomatology among adolescents] Revue européenne de psychologie appliquée 41 173 -179
Cameron K. N., Racine Y., Offord D. R., and Cairney J. 2004 Youth at risk of homelessness in an affluent Toronto suburb Canadian Journal of Public Health 95 5 352 -356
Caron J. 1996 L’Échelle de provisions sociales : une validation québécoise [Quebec validation of the Social Provisions Scale] Santé mentale au Québec 21 2 158 -180
Cohen, J. (1988). Issues in power analysis. In J. Cohen (Ed). Statistical power analysis for the behavioral sciences (pp. 531–537). Lawrence, Erlbaum, Associations Publishers.
Cutrona C. E. and Russell D. W. 1987 The provisions of social relationships and adaptation to stress Advances in Personal Relationships 1 1 37 -67
Eynan R., Langley J., Tolomiczenko G., Rhodes A. E., Links P., Wasylenki D., and Goering P. 2002 The association between homelessness and suicidal ideation and behaviors: Results of a cross-sectional survey Suicide and Life-Threatening Behavior 32 4 418 -427
Falardeau, M. (2002). Huit clés pour la prévention du suicide chez les jeunes [Eight keys to youth suicide prevention]. Pressse de l’Université de Montréal.
Faul F., Erdfelder E., Lang A.-G., and Buchner A. 2007 G* Power 3 : A flexible statistical power analysis program for the social, behavioral, and biomedical sciences Behavior Research Methods 39 2 175191
Farrow J. A., Deisher R. W., Brown R., Kulig J. W., and Kipke M. D. 1992 Health and health needs of homeless and runaway youth: A position paper of the Society for Adolescent Medicine Journal of Adolescent Health 13 8 717 -726
Fournier, L. (2001). Enquête auprès de la clientèle des ressources pour personnes itinérantes des régions de Montréal- Centre et de Québec, 1998–1999 [Survey of users of homeless resources in the Quebec City area and downtown Montreal, 1998–1999]. Institut de la statistique du Québec.
Frydenberg, E., & Lewis, R. (1993). The Adolescent Coping Scale: Administrator’s manual. Australian Council for Educational Research.
Funk M., Benradia I., and Roelandt J. 2014 Santé mentale et soins de santé primaires : une perspective globale [Mental health and primary healthcare: A global perspective] L’information psychiatrique 90 5 331 -339
Gaetz, S., Dej, E., Richter, T., & Redman, M. (2016). The state of homelessness in Canada 2016. Canadian Observatory on Homelessness Press.
Garas P. and Balazs J. 2020 Long-term suicide risk of children and adolescents with attention deficit and hyperactivity disorder: A systematic review Frontiers in Psychiatry 11 1 -19
Gattis M. N. and Larson A. 2016 Perceived racial, sexual identity, and homeless status-related discrimination among Black adolescents and young adults experiencing homelessness: Relations with depressive symptoms and suicidality American Journal of Orthopsychiatry 86 1 79 -90
Gonzalez J. M. R., Jetelina K. K., Roberts M., Clutter M. O., Sanders C., Baidhya S., and Tsai R. 2018 The relationship between homelessness and behavior problems among youth in North Texas: A brief report American Journal of Criminal Justice 43 3 591 -602
Gouvernement du Québec (2014). Politique nationale de lutte à l’itinérance. Ensemble pour éviter la rue et en sortie [Quebec’s national policy to fight homelessness: Together to avoid and get off the street]. Direction des communications du ministère de la Santé et des Services sociaux.
Greenblatt M. and Robertson M. J. 1993 Life-style, adaptative strategies, and sexual behaviors of homeless adolescents Hospital and Community Psychiatry 44 1177 -1180
Greene J. M. and Ringwalt C. L. 1996 Youth and familial substance use’s association with suicide attempts among runaway and homeless youth Substance Use & Misuse 31 8 1041 -1058
Grunbaum J. A., Kann L., Kinchen S. A., Williams B., Ross J. G., Lowry R., and Kolbe L. 2002 Youth risk behavior surveillance—United States, 2001. Morbidity and mortality report Centers for Disease Control and Prevention 51 4 1 -62
Hadland S. E., Marshall B. D. L., Kerr T., Qi J., Montaner J. S., and Wood E. 2012 Suicide and history of childhood trauma among street youth Journal of Affective Disorders 136 3 377 -380
Hadland S. E., Wood E., Dong H., Marshall B. D. L., Kerr T., Montaner J. S., and DeBeck K. 2015 Suicide attempts and childhood maltreatment among street youth: A prospective cohort study Pediatrics 136 3 440 -449
Karabanow, J. (2004). Being young and homeless: Understanding how youth enter and exit street life. Peter Lang Publishing Inc.
Karabanow, J., & Naylor, T. (2013). Pathways towards stability: Young people’s transitions off of the streets. In S. Gaetz, B. O’Grady, K. Buccieri, J. Karabanow, & A. Marsolais (Eds.), Youth homelessness in Canada: Implications for policy and practice (pp. 53–74). Canadian Homelessness Research Network Press.
Kidd S. A. 2004 The walls were closing in, and we were trapped: A qualitative analysis of street youth suicide Youth & Society 36 1 30 -55
Kidd S. A. and Carroll M. R. 2007 Coping and suicidality among homeless youth Journal of Adolescence 30 2 283 -296
Kidd S. A., Gaetz S., and O’Grady B. 2017 The 2015 National Canadian Homeless Youth Survey: Mental health and addiction findings The Canadian Journal of Psychiatry 62 7 493 -500
Kidd S. A. and Shahar G. 2008 Resilience in homeless youth: The key role of self-esteem American Journal of Orthopsychiatry 78 2 163 -172
Kipke M. D., O’Connor S., Palmer R., and MacKenzie R. G. 1995 Street youth in Los Angeles. Profile of a group at high risk for human immunodeficiency virus infection Archives Pediatrics and Adolescent Medicine 149 5 513 -519
Labelle R., Breton J. J., Berthiaume C., Royer C., Raymond S., Cournoyer M., Balan B., Zaloum T., Bibaud A., Gauvin G., and Janelle A. 2015 Psychometric properties of three measures of protective factors for depression and suicidal behaviour among adolescents Canadian Journal of Psychiatry 60 2 Suppl 1 S16 -S26
Molnar B. E., Shade S. B., Kral A. H., Booth R. E., and Watters J. K. 1998 Suicidal behavior and sexual/physical abuse among street youth Child Abuse & Neglect 22 3 213 -222
Moskowitz A., Stein J. A., and Lightfoot M. 2013 The mediating roles of stress and maladaptive behaviors on self-harm and suicide attempts among runaway and homeless youth Journal of Youth and Adolescence 42 7 1015 -1027
National Alliance to End Homelessness. (2012). An emerging framework for ending unaccompanied youth homelessness. National Alliance to End Homelessness. Retrieved from http://www.endhomelessness.org/library/entry/an-emerging-framework-for-ending-unaccompanied-youth-homelessness
Newcomb M. D., Huba G. J., and Bentler P. M. 1981 A multidimensional assessment of stressful life events among adolescents: Derivation and correlates Journal of Health and Social Behavior 22 400 -415
Paradise M. and Cauce A. M. 2002 Home street home: The interpersonal dimensions of adolescent homeless Analyses of Social Issues and Public Policy 2 223 -238
Regroupement des Auberges du Coeur du Québec. (2018). Rapport statistiques annuel [Annual statistics report]. Unpublished document. Fondations des ACQ.
Rew L. 2001 Relationships of sexual abuse, connectedness, and loneliness to perceived well-being in homeless youth Journal for Specialists in Pediatric Nursing 7 2 51 -63
Rew L., Taylor‐Seehafer M., Thomas N. Y., and Yockey R. D. 2001 Correlates of resilience in homeless adolescents Journal of Nursing Scholarship 33 1 33 -40
Rhoades H., Rusow J. A., Bond D., Lanteigne A., Fulginiti A., and Goldbach J. T. 2018 Homelessness, mental health and suicidality among LGBTQ youth accessing crisis services Child Psychiatry Human Development 49 643 -651
Rotheram-Borus M. J. 1993 Suicidal behavior and risk factors among runaway youths The American Journal of Psychiatry 150 1 103 -107
Roy E., Haley N., Leclerc P., Sochanski B., Boudreau J. F., and Boivin J. F. 2004 Mortality in a cohort of street youth in Montreal JAMA: The Journal of the American Medical Association 292 5 569 -574
Septier M., Stordeur C., Zhang J., Delorme R., and Cortese S. 2019 Association between suicidal spectrum behaviors and attention-deficit/hyperactivity disorder: A systematic review and meta-analysis Neuroscience Biobehavioral Reviews 103 109 -118
Shaffer D., Fisher P., Lucas C. P., Dulcan M. K., and Schwab-Stone M. E. 2000 NIMH Diagnostic Interview Schedule for Children Version IV (NIMH, DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses Journal of the American Academy of Child & Adolescent Psychiatry 39 28 -38
Sibthorpe B., Drinkwater J., Gardner K., and Bammer G. 1995 Drug use, binge drinking and attempted suicide among homeless and potentially homeless youth Australasian Psychiatry 29 2 248 -256
Smith, A., Saewyc, E., Albert, M., MacKay, L., & Northcott, M. (2007). Against the odds: A profile of marginalized and street-involved youth in BC. The McCreary Centre Society.
Statistics Canada. (2009). National longitudinal survey of children and youth — Cycle 8 survey instruments 2008–2009 — Book 2, youth questionnaires. Statistics Canada.
Stiffman A. R. 1989 Suicide attempts in runaway youths Suicide and life-threatening behavior 19 2 147 -159
Votta E. and Manion I. 2004 Suicide, high-risk behaviors, and coping style in homeless adolescent males’ adjustment Journal of Adolescent Health 34 3 237 -243
World Health Organization and World Organization of Family Doctors. (2008). Integrating mental health into primary care: A global perspective. WHO Press.
Yoder K. A. 1999 Comparing suicide attempters, suicide ideators, and nonsuicidal homeless and runaway adolescents Suicide and Life-Threatening Behavior 29 1 25 -36
Yoder K. A., Hoyt D. R., and Whitbeck L. B. 1998 Suicidal behavior among homeless and runaway adolescents Journal of Youth and Adolescence 27 6 753 -771

Information & Authors

Information

Published In

cover image Canadian Journal of Community Mental Health
Canadian Journal of Community Mental Health
Volume 39Number 4December 2020
Pages: 25 - 38

History

Version of record online: 14 May 2021

Key Words

  1. homeless youth
  2. mental health
  3. suicidal behaviour
  4. primary health care

Mots-clés

  1. jeune sans-abri
  2. santé mentale
  3. suicidalité
  4. soins de santé primaire

Authors

Affiliations

Réal Labelle [email protected]
Centre de recherche de l'Institut universitaire en santé mentale de Montréal Université du Québec à Montréal
Claude Berthiaume
Service de recherche de l'Hôpital Rivière-des-Prairies Université de Montréal
Marc Daigle
Centre de recherche et d'intervention sur le suicide, enjeux éthiques et pratiques de fin de vie Université du Québec à Montréal
Jean-Jacques Breton
Service de recherche de l'Hôpital Rivière-des-Prairies Université de Montréal
Janie Houle
Centre de recherche de l'Institut universitaire en santé mentale de Montréal Université du Québec à Montréal

Metrics & Citations

Metrics

Other Metrics

Citations

Cite As

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

There are no citations for this item

View Options

View options

PDF

View PDF

Login options

Check if you access through your login credentials or your institution to get full access on this article.

Subscribe

Click on the button below to subscribe to Canadian Journal of Community Mental Health

Purchase options

Purchase this article to get full access to it.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

Media

Media

Other

Tables

Share Options

Share

Share the article link

Share on social media