Skip to main content
Log in

Homeless Youths and Young Adults in Los Angeles: Prevalence of Mental Health Problems and the Relationship Between Mental Health and Substance Abuse Disorders

  • Published:
American Journal of Community Psychology

Abstract

Although understanding of the subsistence patterns, service utilization, and HIV-risk behaviors of homeless youths and young adults is increasing, relatively little is known about the epidemiology of mental health problems in this group or the relationships between mental health problems and substance use. This study measured symptoms of depression, low self-esteem, ADHD, suicidality, self-injurious behavior (SIB), and drug and alcohol use disorder in a sample of homeless youth and young adults living in Hollywood, CA. Results indicated extremely high prevalences of mental health problems, as compared with corresponding rates of mental health problems found among housed youths in previous studies. Prevalence of mental health problems differed by age and ethnicity. African Americans were at lower risk of suicidal thoughts and SIB than were those of other ethnicities. Older respondents and females were at increased risk of depressive symptoms, and younger respondents were at increased risk of SIB. Previous history of sexual abuse and/or assault was associated with increased risk of suicidality and SIB. Risk factors for drug abuse disorder included ethnicity other than African American, homelessness for 1 year or more, suicidality, SIB, depressive symptoms, and low self-esteem. Risk factors for alcohol abuse disorder included male gender, white ethnicity, homelessness for 1 year or more, suicidality, and SIB. Extremely high rates of mental health problems and substance abuse disorders in this sample suggest the need for street-based and nontraditional mental health services targeted toward these youths and young adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Andrews, J. A., & Lewinsohn, P. M. (1992). Suicidal attempts among older adolescents: Prevalence and co-occurrence with psychiatric disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 655–662.

    Google Scholar 

  • Belsley, D. A., Kuh, E., & Welsch, R. E. (1980). Regression diagnostics. New York: Wiley.

    Google Scholar 

  • Brier, N. (1989). The relationship between learning disability and delinquency: A review and reappraisal. Journal of Learning Disabilities, 22, 546–553.

    Google Scholar 

  • Burvill, P. W. (1995). Recent progress in the epidemiology of major depression. Epidemiologic Reviews, 17, 21–31.

    Google Scholar 

  • Collins, L. M., Sussman, S., Rauch, J. M., & Dent, C. W. (1987). Psychosocial predictors of young adult cigarette smoking: A sixteen-month, three-wave longitudinal study. Journal of Applied Social Psychology, 17, 554–573.

    Google Scholar 

  • Dadds, M. R., Braddock, D., Cuers, S., Elliott, A., & Kelly, A. (1993). Personal and family distress in homeless adolescents. Community Mental Health Journal, 29, 413–422.

    Google Scholar 

  • DiClemente, R. J., Ponton, & Hartley, (1991). Prevalence and correlates of cutting behavior: Risk for HIV transmission. Special section: Impact of HIV on child and adolescent psychiatry. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 735–739.

    Google Scholar 

  • Dwyer, J. H. (1983). Statistical models for the social and behavioral sciences. New York: Oxford University Press.

    Google Scholar 

  • Garland, A. F., & Zigler, E. (1993). Adolescent suicide prevention. American Psychologist, 48, 169–182.

    Google Scholar 

  • Garrison, C. Z., Addy, C. L., McKeown, R. E., & Cuffe, S. P. (1993). Nonsuicidal physically self-damaging acts in adolescents. Journal of Child and Family Studies, 2, 339–352.

    Google Scholar 

  • Gittelman-Klein, R. (1987). Prognosis of attention deficit disorder and its management in adolescence. Pediatrics in Review, 8, 216–222.

    Google Scholar 

  • Greenbaum, P. E., Prange, M. E., Friedman, R. M., & Silver, S. E. (1991). Substance abuse prevalence and comorbidity with other psychiatric disorders among adolescents with severe emotional disturbances. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 575–583.

    Google Scholar 

  • Greenblatt, M., & Robertson, M. J. (1993). Life-styles, adaptive strategies, and sexual behaviors of homeless adolescents. Hospital and Community Psychiatry, 44, 1177–1180.

    Google Scholar 

  • Hicks, R. D, Batzer, G. B., Batzer, W. B., & Imai, W. K. (1993). Psychiatric, developmental, and adolescent medicine issues in substance use and abuse. Adolescent Medicine: State of the Art Reviews, 4, 453–468.

    Google Scholar 

  • Jenkins, R. L., & Stahle, G. (1972). The runaway reaction. Journal of the American Academy of Child and Adolescent Psychiatry, 11, 294–313.

    Google Scholar 

  • Johnson, C. J., Montgomery, S. B., & Kipke, M. D. (1995). Utilization of services by homeless and runaway youth in Hollywood. Presented at the annual meeting of the American Public Health Association, San Diego, CA.

  • Kahn, M. W., Hannah, M., Kirkland, S., Lesnik, S., Clemens, C., & Chatel, D. (1992). Substance misuse, emotional disturbance, and dual diagnosis in a meal-line population of mixed ethnicity. International Journal of the Addictions, 27, 317–330.

    Google Scholar 

  • Khantzian, E. J. (1985). The self-medication hypothesis of addictive disorders: Focus on heroin and cocaine dependence. American Journal of Psychiatry, 142, 1259–1264.

    Google Scholar 

  • Kipke, M. D., Montgomery, S. B., Simon, T. R., & Iverson, E. F. (1997). Substance abuse disorders among runaway and homeless youth. Substance Use and Misuse, in press.

  • Kipke, M. D., O'Connor, S., Palmer, R., & MacKenzie, R. G. (1995). Street youth in Los Angeles: Profile of a group at high risk for Human Immunodeficiency Virus infection. Archives of Pediatric Adolescent Medicine, 149, 513–519.

    Google Scholar 

  • Kipke, M. D., Simon, T. R., Montgomery, S. B., Unger, J. B., & Iverson, E. F. (1997). Homeless youth and their exposure to and involvement in violence while living on the streets. Journal of Adolescent Health, in press.

  • Koegel, P., & Burnam, M. A. (1992). Problems in the assessment of mental illness among the homeless. In M. J. Robertson & M. Greenblatt (Eds.), Homelessness: A national perspective. New York: Plenum Press.

    Google Scholar 

  • Levinson, B. M., & Mezei, H. (1970). Self-concepts and ideal-self concepts of runaway youths: Counseling implications. Psychological Reports, 26, 871–874.

    Google Scholar 

  • McGee, R., Feehan, M., Williams, S., & Partridge, F. (1990). DSM-III disorders in a large sample of adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 611–619.

    Google Scholar 

  • McLaughlin, M., & Pepper, B. (1990). The young and the restless: Programming for the crisis-ridden young adult patient. In N. L. Cohen (Ed.), Psychiatry takes to the streets: Outreach and crisis intervention for the mentally ill. New York: Guilford.

    Google Scholar 

  • Melchior, L. A., Huba, G. J., Brown, V. B., & Reback, C. J. (1993). A short depression index for women. Educational and Psychological Measurement, 53, 1117–1125.

    Google Scholar 

  • Milin, R., Halikas, J. A., Meller, J. E., & Morse, C. (1991). Psychopathology among substance abusing juvenile offenders. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 569–574.

    Google Scholar 

  • Monitoring the Future. (1994, December 8). Drug use continues to climb among American teenagers, as attitudes about the dangers of drugs soften, U-M says. Press release.

  • National Institute of Mental Health. (1992). Diagnostic interview schedule for children. Washington, DC: Author.

    Google Scholar 

  • Peterson, A. C., Compas, B. E., Brooks-Gunn, J., Stemmler, M., Ey, S., & Grant, K. E. (1993). Depression in adolescence. American Psychologist, 48, 155–168.

    Google Scholar 

  • Robertson, M. J. (1992). Homeless and runaway youths: A review of the literature. In E. L. Bassuk (Ed.), Topics in social psychiatry. New York: Plenum Press.

    Google Scholar 

  • Robertson, M. J., & Winkleby, M. A. (1996). Mental health problems of homeless women and differences across subgroups. Annual Review of Public Health, 17, 311–336.

    Google Scholar 

  • Robins, Cottler, L. B., & Babor, T. (1990). Composite International Diagnostic Interview-Expanded Substance Abuse Module (CIDI-SAM). St. Louis, MO: Author.

    Google Scholar 

  • Rohde, P., Lewinsohn, P. M., & Seeley, J. R. (1996). Psychiatric comorbidity with problematic alcohol use in high school students. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 101–109.

    Google Scholar 

  • Romans, S. E., Martin, J. L., Anderson, J. C., Herbison, G. P., & Mullen, P. E. (1995). Sexual abuse in childhood and deliberate self-harm. American Journal of Psychiatry, 152, 1336–1342.

    Google Scholar 

  • Rosenberg, M. (1979). Conceiving the self. New York: Basic Books.

    Google Scholar 

  • Shaffer, D., & Caton, C. L. M. (1984). Runaway and homeless youth in New York City. New York: Ittleson Foundation.

    Google Scholar 

  • Shore, M. F., & Cohen, M. D. (1992). Homelessness and the chronically mentally ill. In M. J. Robertson & M. Greenblatt (Eds.), Homelessness: A national perspective. New York: Plenum Press.

    Google Scholar 

  • Simon, T. R., Kipke, M. D., Montgomery, S. B., Unger, J. B., & Iverson, E. F. (1996, November). Homeless youth in Hollywood: The lives left behind. Presented at the annual meeting of the American Public Health Association, New York.

  • Smart, R. G., & Adlaf, E. M. (1991). Substance use and problems among Toronto street youth. British Journal of the Addictions, 86, 999–1010.

    Google Scholar 

  • Smart, R. G., & Ogborne, A. C. (1994). Street youth in substance abuse treatment: Characteristics and treatment compliance. Adolescence, 29, 733–745.

    Google Scholar 

  • Smart, R. G., & Walsh, G. W. (1993). Predictors of depression in street youth. Adolescence, 28, 41–53.

    Google Scholar 

  • Stiffman, A. R. (1989). Suicide attempts in runaway youths. Suicide and Life-Threatening Behavior, 19, 147–159.

    Google Scholar 

  • Stowell, R. J. A., & Estroff, T. W. (1992). Psychiatric disorders in substance-abusing adolescent inpatients: A pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 1036–1040.

    Google Scholar 

  • Sullivan, W. O., & Engin, A. W. (1986). Adolescent depression: Its prevalence in high school students. Journal of School Psychology, 24, 103–109.

    Google Scholar 

  • Wilens, T. E., Biederman, J., Spencer, T. J., & Frances, R. J. (1994). Comorbidity of attention-deficit hyperactivity and psychoactive substance use disorders. Hospital and Community Psychiatry, 45, 421–435.

    Google Scholar 

  • Winters, K. C., & Henly, G. A. (1993). Adolescent Diagnostic Interview Schedule and manual. Los Angeles: Western Psychological Services.

    Google Scholar 

  • Zima, B. T., Wells, K. B., & Freemen, H. E. (1994). Emotional and behavioral problems and severe academic delays among sheltered homeless children in Los Angeles County. American Journal of Public Health, 84, 260–264.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Unger, J.B., Kipke, M.D., Simon, T.R. et al. Homeless Youths and Young Adults in Los Angeles: Prevalence of Mental Health Problems and the Relationship Between Mental Health and Substance Abuse Disorders. Am J Community Psychol 25, 371–394 (1997). https://doi.org/10.1023/A:1024680727864

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1024680727864

Navigation