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PubMed2007

A systematic review of cognition in homeless children and adolescents.

Objectives The cognitive function of homeless children and adolescents may be overlooked, albeit understandably, when societal interventions focus on their immediate housing needs. Nevertheless, homelessness might be hypothesized to carry many risks for the developing mind and brain. We wanted to discover whether this hypothesis had been tested previously. Design A systematic review to examine whether cognitive impairments were reported in homeless children and adolescents. Setting Objective, systematic review of standard databases, examined by key word searches. Participants Children and adolescents. Main outcome measures Formal assessments of cognition. Results We found that in spite of there being many homeless children in the world, fewer than 2000 have been assessed cognitively and reported in the literature. Yet when compared with those who are domiciled, these children tend to have lower intellectual functioning and decreased academic achievement. Furthermore, adolescents evince cognitive impairments in the contexts of drug, physical, and sexual abuse. Conclusions We suggest that cognitive and mental health screening be incorporated into those intervention programs deployed to facilitate societal reintegration of homeless children and adolescents.

Adolescent↗
PubMed2004

Experiences of being homeless or at risk of being homeless among Canadian youths.

A qualitative study was undertaken with four groups--immigrants, youths, Aboriginal people, and landlords--in order to explore, compare, and contrast diversity issues among the homeless population and those at risk of homelessness in a larger Canadian city (Calgary, Alberta) with a smaller city (Lethbridge, Alberta), to better understand their and to needs make recommendations for improvement in service delivery and policy formation. This paper focuses on the findings from our sample of youths who shared information on a range of factors that contributed to their being homeless or at risk of being homeless. The youths in this study also shared their positive as well as negative experiences with educators, peers, family members, and social service providers. Canada's homeless include growing numbers of young people, families, women, and members of various ethnic communities, including Aboriginal people and immigrants. Today it is no longer possible to articulate a single silhouette of the homeless, but rather a diversity of profiles is needed. It was in the light of this reality that a study, "Diversity Among the Homeless and Those At Risk," was carried out. It was undertaken with four groups--immigrants, youths, Aboriginal people, and landlords.

Adolescent↗
PubMed2002

Comparison of homeless veterans with other homeless men in a large clinical outreach program.

This paper compares homeless veterans with homeless nonveterans from different eras in an effort to better understand the connection between military service and urban homelessness. Two research questions are addressed based on interviews with over 4,000 homeless men who enrolled in a national outreach program for persons suffering from serious mental illness: First, is there anything unique in the social and personal characteristics of homeless veterans in the 1990s that would help to explain their relatively high prevalence in the homeless population, especially among those who were 19 or younger when the draft ended in 1973? Second, aside from age, are the homeless veterans of the era of the All-Volunteer Force different from homeless veterans who served during the era of the military draft? The results replicate many findings from research in the 1980s showing that even homeless veterans with psychiatric disorders tend to have more personal resources compared to homeless men who did not serve in the Armed Forces. Although veterans from the era of the All-Volunteer Force are different from veterans from the era of the draft, the introduction of the All-Volunteer Force per se does not appear to have changed the composition of the adult male homeless population.

Adult↗
PubMed2006

Comparison of context-based interaction patterns of mothers who are homeless with their preschool children.

PURPOSE: The primary purpose of this exploratory study was to examine the influence of context on interaction patterns used by mothers who are homeless with their preschool children during book-reading and game-playing activities. The impact of mothers' previously determined language functioning on their contextual use of facilitating language utterances was also examined. METHOD: Using a prospective, nonrandomized, comparison group design, mothers read a book and played a game with their preschool children. Facilitating language utterances produced by the mothers in 16 mother-child dyads during each activity were analyzed. RESULTS: Regardless of their language functioning, no significant contextual differences in percentage use of facilitating language utterances were found across mothers. Overall maternal use of facilitating utterances was less than 50%. Across both contexts, mothers used few different types of facilitating language utterances. CONCLUSIONS: This exploratory study provides initial evidence of overall consistency of facilitating language utterance use by mothers who are homeless during interactions with their preschool children across contexts, regardless of maternal language functioning. This study provides an initial framework for future research investigating the interactions of families who are homeless and discusses possible language interventions for these at-risk families.

Adult↗
PubMedDate not supplied

The meaning of family routines in a homeless shelter.

OBJECTIVE: This exploratory investigation sought to understand what meaning parents, living in a homeless shelter, attribute to family routines and the nature of those routines. METHOD: In-depth interviews were conducted with 12 parents living in a homeless shelter. Thematic analysis was employed to develop descriptive codes and themes from transcribed data and field notes. RESULTS: Parents described family routines focused on three features: promoting intimacy, maintaining or developing a legacy, and connections with the community. These routines seemed to preserve family integrity while homeless and to provide hope for the family to continue into the future. CONCLUSIONS: Homeless parents, in this investigation, seemed to expend a substantial amount of energy to create or maintain family routines while living in a homeless shelter. Findings suggest that occupational therapy services may help support homeless parents as they exercise their role as the organizer of family routines.

Activities of Daily Living↗
PubMed2003

Health care utilization among homeless adolescents and young adults.

A probability sample of Californian homeless females was examined for health service utilization, comparing adolescents to older women. Adolescent homeless women reported higher outpatient visit use. Possessing public health insurance increased the odds of outpatient visits. Future research might use the outpatient setting to aid adolescents in exiting homelessness.

Adolescent↗
PubMed1991

A personal memoir of the state hospitals of the 1950s.

The author recalls his experiences as an attendant at a state mental hospital in the early 1950s, before the introduction of psychotropic drugs. State hospitals of that era served not only as treatment centers for mentally ill patients but also as de facto nursing homes, retirement homes, orphanages, and shelters for chronic physically ill persons, medically ill poor people and wards of the state, adults and juveniles convicted of crimes, behaviorally disturbed retarded people, and alcoholics. The author argues that the deinstitutionalization movement removed an important, if unrecognized, source of palliative care for dispossessed individuals and recommends redesigning the state hospital to provide compassionate housing and treatment by trained persons for homeless and chronic physically and mentally ill individuals. Four patients typical of the heterogenous population of state hospitals in the 1950s are described.

History, 20th Century↗
PubMed1992

Serious mental illness and disability in the adult household population: United States, 1989.

The major significance of the current report is that it provides estimates and characteristics for that portion of the civilian SMI population living in households. Survey results show that approximately 3.3 million adult Americans have mental disorders that seriously interfere with one or more aspects of daily life and that about 2.6 million of these persons are currently limited in one or more functional areas. These results suggest that the household component of the SMI population is comprised of between 2.6 and 3.3 million adults, depending upon the criteria employed for inclusion. Undoubtedly, both of these numbers are conservative because of the likelihood of underreporting in the survey. Placed in the context of the entire adult population, these findings suggest that the SMI population can be conservatively estimated to include 4 to 5 million adult Americans, or 2.1 to 2.6 øpercent of the adult population. In addition to the household population, it is estimated that 200,000 SMI persons are homeless on any given day (13). An additional 1 million to 1.1 million are residents of nursing homes (14), approximately 50,000 to 60,000 are patients of mental hospitals, and approximately 50,000 are inmates of State prisons (15). A major remaining need is to collect similar data on all SMI persons, whether their residence is a household, an institutional or noninstitutional group quarter, or some other setting, including streets and shelters. In order to formulate more effective national policy to address the needs of these disabled Americans, a need exists to examine the longitudinal relationship between course of disorder and functioning as they relate to service and program participation.

Adult↗
PubMed2005

Predictors of first mental health service utilization among homeless and runaway adolescents.

PURPOSE: To describe and explain variations in first mental health service utilization before and after running away from home for homeless adolescents. METHODS: Survey interviews were conducted with homeless and runaway youth in several Midwestern locations. The effects of family of origin factors and street experiences on the likelihood of seeing a mental health professional for the first time before running away and after running away for the first time were examined. Bivariate and multivariate logistic regression methods are used to analyze these data. Interactions are tested across race and gender sub-groups. RESULTS: Caretaker education, caretaker rejection, and family transitions increase the probability that an adolescent first sees a mental health professional before running away from home. Post-run intervention is more likely for females, younger runaways, shelter users, youths with social support networks, and youths abused by their caretakers. A gender gap in first service use exists for Whites but not for minority youth. Minority youth who experienced family abuse were less likely than abused Whites to report ever seeing a mental health professional. CONCLUSIONS: Analyses indicate homeless youth's utilization patterns are differentiated by family of origin factors, street experiences, timing of first utilization, and by race and gender interactions. Our findings suggest that youths whose first contact with mental health service use follows running away for the first time may experience higher levels of mental distress compared with other homeless runaways. The significant differences in first service use across race and gender subgroups should be further explored. The racial-ethnic gap in first mental health intervention for abused youths indicates this sub-group is not receiving services that are available to other homeless youths. Our findings suggest that homelessness does not homogenize racial/ethnic differences in first mental health service utilization.

Adolescent↗