Psychology and Homelessness

Introduction

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(Oxford Dictionary)

There are many types of homelessness however all homelessness is characterized by extreme poverty coupled with a lack of stable housing.

Types of Homelessness

Homeless Families. There are families on the street, sometimes with just a mom, sometimes just a dad, sometimes with both parents. Usually these are families who have fallen on hard times, having lost a job or their housing. Families don’t usually stay on the street very long and can get off of the street with some help from a church or the government.
Homeless Youth. Youths that have left their families or foster care homes, sometimes due to living conditions there were unacceptable to them like abuse or perhaps because they wanted to live an alternative lifestyle that was unacceptable to their guardians.
Couch Surfer. These are people who have enough of a support network(friends, family or co workers) that they can get a couple nights rest sleeping in their couch until they are able to secure their place they can call home.
Car living. Another form of homelessness that is becoming increasingly popular. Usually charecterized by individuals living in their car with their belongings and not having stable housing.
Chronically Homeless. These individuals usually have addiction or mental health issues, live in camps around urban areas. Some of these unfortunate people have been homeless from a year to forty years, having become hardened by the constant rejection and pity they receive.

Dear Writer,

Below you will find a compilation of sources all dealing with the plight
of homelessness. We take you through mental health, family,
socioeconomic,ethnicties and minorities and addiction.
It is our hope that you will find a wide range of sources all
touching on the psychological aspects that affect the homeless
and also the variation within the homeless community.

Sincerely,
S., N., H., B. & K.

Mental Health

Psychological Phenomena and the Homeless - Mental Illness
Welcome to our report on the homeless and the psychological phenomena affecting this diverse group of people. I will begin this report by giving a summary of my research on how mental illness impacts the homeless, and why it is important to study mental illness when dealing with the homeless population. A very common trend that comes up extremely often when dealing with the homeless is the issue of trauma, specifically in regards to how past trauma can lead to the increased risk of becoming homeless as an adult. Mental Illness is important when dealing with the homeless because a large proportion of this population have indeed suffered from some form of trauma in their past, and many resort to substance abuse in an effort to find relief from their daily struggles. I have divided my research into qualitative and quantitative research as follows, and end with two case studies that demonstrate why working with the homeless can be so difficult, especially in regards to psychiatrists hoping to help and treat mental illness among the homeless population. I hope you will enjoy my findings and find the following information invaluable.

Qualitative Research

1. Kim, Mimi M. Roberts, Amelia. (2004). Exploring Trauma Among Homeless Men in Treatment for Substance Abuse: A Qualitative Approach. Journal of Social Work Practice in the Addictions. 4.2. 21-32.
This study demonstrates a link between trauma and the development of various mental illnesses and substance abuse within the homeless community. Using a sample group of 10 homeless men, qualitative interviews are conducted in order to get an in-depth look at the lives of these men. Direct quotations are used in order to demonstrate how these men reflect on substance abuse, depression, and trauma in relation to their lives, as well as briefly touching upon their treatment experiences. This makes the study unique as we are able to view these issues from the perspectives and words of those who are directly experiencing them. The qualitative approach also allows us to gather a more personal account of the experiences of these men as opposed to a quantitative approach. Of particular importance in this study is the significance that is given to vicarious or secondary trauma: as children these men often witnessed trauma that impacted them in a serious way. For example, one man recalls that as a child his mother and father often got into violent fights, and afterwards this scarred him in the sense that he became even more sensitive to any fights around himself, and in a way saw the reflection of his parents fighting in their image:

"My mom and dad fighting was traumatic. I watched them fight a
lot. Once my mom jumped out of the car while my dad was driving
and he almost ran over her. I was in the back seat. It really bothered
me. I felt like everywhere I went, I saw people fighting like
that… ." (PG 27)

The secondary trauma phenomena has been examined as it relates to clinicians who treat victims of trauma, but not so much as it relates to children, which this article attempts to bring into the spotlight. The article also states that none of these men sought treatment for their secondary trauma, and raises the question of how their lives might have differed had they sought out help earlier in their lives.
Another finding highlighted in this research is that substance abuse and mental illness came before many of these men became homeless. This implies that substance abuse and mental illness are a cause of homelessness as opposed to an effect.

Quantitative Research

2. Beijer, Ulla. Andreasson, Sven. (Oct 2010). Gender, hospitalization and mental disorders among homeless people compared with the general population in Stockholm. European Journal of Public Health. 20.5. 511-516.
This article uses a more quantitative approach in order to arrive at statistics regarding the prevalence of mental illness among the homeless population. Using a large sample of 1704 homeless individuals (1364 males and 340 females) who were admitted to hospital for treatment in Stockholm, the article aims to highlight differences between the homeless population and the general population. The general population is represented through a control group consisting of 5000 individuals, 3750 men and 1250 women. By comparing the statistics between these two large groups, the article attempts to draw conclusions about how homelessness impacts the prevalence of mental illness.
This article is significant for several reasons: it uses a large sample size, draws comparisons between a homeless group and a control group (general population), and places greater emphasis on the differences that exist between males and females in regards to mental illness. Of these, the most significant aspect is its comparison of the homeless sample with the general population sample. Through comparing these two large groups, significant differences can be found in regards to mental illness. The gender and ages of the two groups are also matched in order to give accurate results. The findings further support the reports that homeless people have poorer mental health than the general population. It also highlights findings that homeless woman are more likely to suffer from mental illness than homeless men, particularly among young woman.

3. Sullivan, G. Burnam, A. Koegel, P. (Oct 2000). Pathways to homelessness among the mentally ill. Social Psychiatry and Psychiatric Epidemiology. 35.10. 444-450.
This article compares and contrasts three groups to examine the correlation between homelessness, mental illness, and external factors that influence mental illness within the homeless. The three groups are as follows: mentally ill homeless, non-mentally ill homeless, and mentally ill housed. It draws the conclusion that the mentally ill homeless have more in common with other homeless people than other mentally ill housed. This implies that homelessness is not a result of mental illness, but rather of being in a disadvantageous or impoverished family. However, the study does go on to make connections between the mentally ill homeless and what it calls a “double dose” of disadvantage: the poverty listed above, plus another added layer of family instability and violence. It comes to the conclusion that mental illness is not itself a risk factor for homelessness, although the onset of mental illness can play a role in initiating homelessness for people who are at risk of it.

4. Olfson, Mark. Mechanic, David. Hansell, Stephen. Boyer, Carol A. Walkup, James. (May 1999). Prediction of homelessness within three months of discharge among inpatients with schizophrenia. Psychiatric Services. 50.5. 667-673.
This article examines people who suffer from schizophrenia, and the factors that put them at risk for homelessness after being discharged from hospital. This research is useful for you because it focuses on a specific illness, schizophrenia, as opposed to the broader research from the other sources regarding mental illness and trauma in general. Through focusing on a specific mental illness, we can gain insight as to why this group is more at risk when compared to other forms of mental illness, as well as strategies we can take to help this group.
Table 2 in particular shows a clear trend between the scores that these patients are given when they take psychiatric tests in hospital, and the rate of homeless experiences after discharge. Those who scored higher on these tests experience an increased risk of homelessness, and this is consistent across every single test that is administered. This makes a clear argument that a person’s mental health plays some role in how likely a person is to slip into homelessness after being released.

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Table 3 also shows a clear trend in regards to history of DSM-III-R drug abuse or dependence, and an increased risk of homelessness. The trends presented in the research in this article show that the risk of homelessness for discharged schizophrenics “significantly increases if they have had a drug use disorder, elevated psychiatric symptoms, or poor global functioning at the time of discharge.”

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Case Studies on the Homeless and Mental Illness

5. Felix, Alan D. Wine, Pamela R. (Jan 2001). From the couch to the street: Applications of psychoanalysis to work with individuals who are homeless and mentally ill. Journal of Applied Psychoanalytic Studies. 3.1. 17-32.
For my final source I have included a distinctly different approach than the other sources included so far. This article deals with two case studies that are presented through a psychoanalytic approach, making it unique in how it examines homelessness and the internal worlds of these troubled individuals. The cases are first presented from a report by the treating psychiatrist, and then followed up by a detailed analysis of the report by a psychoanalyst. This report can help you in your work as it presents two very detailed, personal accounts of homeless individuals and their struggles with addiction, mental illness, and attempts at recovery.

Luis. The first study involves a man named Luis, who suffers from the “triple disorder” that is commonly experienced by the mentally ill homeless: an Axis I psychotic disorder, substance abuse, and antisocial personality disorder. He often experiences violent outbursts and assaults his girlfriend; though at the same time shows a genuine concern for her and their kids. The psychiatrist has a significantly hard time in treating this patient as he often never attended scheduled appointments, and would turn up at the clinic at very unexpected times, often looking for immediate help. The study presents the very unique challenges that psychiatrists face when attempting to help the mentally ill homeless. Unfortunately this particular study has a rather sad ending as Luis ends up in prison, in which the psychiatrist remarks it’s “the closest to home he could realize.”

Erna. The second study involves a woman named Erna, who experienced a very troubling childhood due to the effects of substance-abusing parents, as well as sexual assaults by her father. She went on to have four children of her own, all of whom were eventually lost to foster care. She desperately wants to get her life back on track so that she could one day re-unite with her children and be a better mother to them than her mother was to her. Dr. Wine, the treating psychiatrist, goes on to guide her towards recovery and ultimately this case results in a much happier ending than the one with Luis. The psychodynamic approach is also really interesting, particularly in regards to Erna’s idealized vision of a Mother in contrast with her own mother from her childhood. This study also highlights the importance of the patient’s history in their treatment, in that “the process of history taking and formulation of a life narrative is often therapeutic for the patient, initiating the engagement process”. (PG 29)
In conclusion, these case studies show that the application of psychoanalytic theory can be useful in attempting to understand the inner world of the homeless mentally ill, as well as aid the process of treating them. The homeless mentally ill are considered one of the most difficult groups of people for psychiatrists to treat, and these studies provide detailed accounts of psychoanalytic work involving two people within this population. It highlights the importance of the alliance between the patient and the provider in aiding them to confront their deepest troubles, and as the article puts it, “it is from within the safety of this alliance that one forms the first foundation for “home””. (PG 31)

Family

Psychological Phenomena and the Homeless-Family

Source: 1 Steinbock, M. R. (1995). Homeless female-headed families: Relationships at risk. Marriage & Family Review, 20(1-2), 143-143. http://search.proquest.com.ezproxy.library.yorku.ca/docview/199509888?accountid=15182
This article showcases the many adversities that single parent and their children encounter as a result being homeless. It shows us that not only parents are affected by poverty but their children are adversely affected as well. Mothers may often lose their children as a result of being homeless. Having their children taken away can cause further damage to mental health as they lose their roles as nurturers and teachers to their children. Some of the children that are placed in foster homes away from their biological parents may often face psychological disturbances and developmental delays. Steinbock also mentioned that poverty is not the only cause of homelessness but domestic violence can also be a main contributor as well. This study also shows ways in which the government is trying to prevent families for becoming homeless, and is constantly looking ways to assist families after they homeless. Steinbock concluded by saying that stabilization of the family in the family home is very important.

Source: 2 Rossi, P. H. (1990). The old homeless and the new homelessness in historical perspective. American Psychologist, 45(8), 954-959. doi:10.1037/0003-066X.45.8.954
This article compares old homeless and new homelessness. The “old homeless” of the 1950s were mainly old men living in cheap hotels on skid rows. The new homeless were much younger, suffering from greater poverty, and with access to poorer sleeping quarters. In addition, homeless women and families appeared in significant numbers. One major difference between the old homeless and the new is that nearly all of the old homeless managed, somehow, to find nightly shelter indoors, whereas large number of the new homeless sleep in the streets or in public places, such as building lobbies and train stations. What seem s to be constant in the two generation is that poverty is the main cause of homelessness however the new generation homeless is a lot poorer than the old generation. Another cause of old generation was also alcoholism , but the new generation the cause seems to be depression, family pressures and loneliness which at some point can be linked to mental illness.

Source 3 Lehman, K. A."We are not home yet": Formerly homeless families define their needs and the impact of homelessness.Dissertation Abstracts International: Section B: The Sciences and Engineering, , 3282. http://search.proquest.com.ezproxy.library.yorku.ca/docview/619559208?accountid=15182
This is a qualitative study of nine families that was once homeless. In this study the Families talked about how being homeless has impact their lives. Their needs fell within three main categories; Personal, Family and Community/ System. Personal needs: not being able to find and job, as a result there was no income to feed and support the family. Not being able to visit the doctor which resulted in mental health issues, physical health also deteriorated, then turning to alcohol for comfort or any other available drugs one of the biggest fight was to remain clean or sober for their family. Family: not being able to give assistance or support to the family, or send the children to school also affected the mental status of parents, it puts a big strain on the mental health , knowing that you are responsible for your family and is unable to do so also bring about shame within the community. The constant judgment from friends and family even you very own family. Community; If you are lucky sometime you are able to find community housing but sometimes the location of these housing put you in area where the job are even harder to come by. There is more violence in the housing community as most everyone is experiencing the frustration you are experiencing. Sometime the hardest thing to come to terms to where you are at that moment. Being homeless takes a psychological impact on everyone; Family have to adapt to a harder lifestyle, cope with system that is not there to protect them and they may end up losing all their friends and sometimes family due to being homeless. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Socioeconomic

In this section of the wiki page there will be information on the socio economic causes of homelessness, with focus on poverty, lack of affordable housing, chronic unemployment with the minimum wage dilema and the reduction in financial support. There will be information presented on how these factors directly and indirectly affect homelessness, and how a great portion of the homeless community is homelessness because of the prevalence of these factors in society.

De Venanzi. (2008). The institutional dynamics of homelessness: The United States of America and Japan compared. The International Journal of Sociology and Social Policy. 28.3/4. 129-145
Though this article doesn’t talk specifically on poverty, affordable housing, chronic unemployment, and reduction in welfare support, the author does claim that the origins of homelessness are in these four important factors. He also states briefly that homelessness is a result of reforms in welfare and taxation, changes in urban planning and housing policy, unemployment, and of trends such as gentrification. The remainder of this article the author focuses specifically on his research on the inner practices of various normative institutions namely, morality, family and prison. Also the author tries to uncover the ways the above institutions operate in producing acute states of social and moral disempowerment and how they affect the facilities of subordinate to competently fend for themselves in a wider society.

Poverty

Definition: Lacking sufficient money to live at a standard considered comfortable or normal in society (Oxford University Press Online Dictionary)

Nooe, R.M, Patterson, D.A. (March 2011). The ecology of homelessness. Journal of Human Behavior in the Social Environment. 20 (2). 105-152
In this article Mooe and Patterson describe the ecology of homelessness. They present a ecological model of research and practice literature. The biopsychosocial risks that lead to homelessness are reviewed followed by an assessment of the social and individual consequences resulting from period of homelessness. Mooe and Patterson explain that poverty is overriding and intertwined in homelessness. They elucidate that people suffering from poverty are not able to meet essential needs such as housing and food nor can they obtain other needed services. They cite: “… poverty represents vulnerability, a lower likelihood of being ableto cope when the pressure gets too great. It thus resembles serious mental illness, physical handicap, chemical dependency, or any other vulnerability that reduces one’s resilience and the resilience of one’s family and friends. (Burt, 1992)”

Statistics Canada(2004). Analysis of income in Canada. Catalogue. Ministry of industry. 75-203XIE.
This is a STAT Canada report published under the name of “Analysis of income in Canada”. This is a statistical report outlining the income of the populous of Canada in 2002 focusing on family income and low income. This is report is organized into chapters and focuses on a specific income concept. All figures in this report are sample survey estimates. As to the low income figures in Canada there is data on the decrease in the low income rate after the year of 2002 and the subsequent stop in drop of the that year. The report also relays data on the varied low income rate that is dependent on the family type and number of earners. Also there are subsequent charts/graphs and more figures on LI (low income) rates for female lone parent increases after five consecutive years, and the downward trend of children LI rate as the rate for Canadians grew. And lastly data is presented of Canadians crossing the LICO (low income crossover line) line and the concluding part in the report of when LI touched more than 1 in 5 people over a six year period.

Lack of Affordable Housing

Shin,M. & Gillespie, C. (1994)The roles of housing and poverty in the origins of homelessness. American Behavioral Scientist. 37:4. 505-521.Sage productions.
Shin and Gillespie state the supply of low income housing is also diminished by the gentrification of neighborhoods, the upgrading of low rent units into higher priced units, conversion to condominiums, and temporary removal of units from the market. The loss of low income units slowed by the mid 1980s.The decline in housing affordable to the poorest renters is a joint function of the loss of housing that is affordable in constant dollars and erosion of incomes among poor households, which led to a continually tightening standard of affordability. Housing affordability is regularity raised as a major policy concern.

Quigley, J.M. & Raphael, S.(2004) Is housing unaffordable? Why isn’t it more affordable? The Journal of EconomicPerspective,18:1, 191-214
The average household devotes roughly one-quarter of income to housing expenditures, while poor and near-poor households have commonly devote half of their income housing. These high proportions suggest that small percentage changes in housing prices and rents will have large impacts on non-housing consumption and household well-being. But economists are wary, even uncomfortable, with the rhetoric of “affordability” which jumbles together in a single term a number of disparate issues: the distribution of housing prices, the distribution of housing quality, the distribution of income, the ability of households to borrow, public policies affection housing markets, conditions affecting the supply of new or refurbished housing, and the choices people make about how much housing to consume relative to other goods. This mixture of issues raises difficulties in interpreting even basic facts about housing affordability.

Chronic Unemployment

Nooe, R.M, Patterson, D.A. (March 2011). The ecology of homelessness. Journal of Human Behavior In The Social Environment. 20 (2). 105-152
Nooe and Patterson also give a portion of their article to speak about employment and the lack thereof and the minimum wage dilemma that is recurring now. They state that unemployment is often identified as a major cause of homelessness; however, many homeless persons being report being employed or having occasional work. They say that the difficultly is that many jobs do not provide adequate wages and benefits for self sufficiency. Also presented is data from the United States Interagency Council on Homelessness that find that the median monthly income for persons were homeless was about 44% of the federal poverty level. This data also has correlations as to decline in the value of minimum wage with the parallel decreased availability, but increased competition for affordable housing has heightened the risk for homelessness. Many of the temporary jobs held by homeless persons do not provide sufficient wages and benefits such as health insurance to ensure self sufficiency. Also again the Interagency Council on Homelessness recognized that employment prospects are dim for those who lack appropriate skills or adequate. Furthermore, the duration of homelessness may decrease the prospects of employment. And state that it isn’t surprising that homelessness itself may further diminish ones chances of employment, as prolonged idleness may cause loss in work habits, responsibility, and commitment to employment.

Reduction in financial support

Berger, P.S. & Tremblay,Jr., K.R.(1999) Welfare Reform’s Impact onHomelessness. Journal of Social Distressand the Homeless. Human Sciences Press, Inc.
Welfare reform may decrease the number of homeless if persons gain jobs that allow financial independence and self-sufficiency. Human service providers and advocates for the homeless point to the necessity of sufficient resources to get persons into jobs paying a living wage and into adequate, affordablehousing. Concerned that welfare reform would have an undesirable impact on the availability of safe, decent, and affordable housing for the low-income households, NLIHC, the National Housing Law Project, the National Housing Conference and other housing-related groups formed a Housing and Welfare ReformTask Force to develop a statement and recommendations to “protect low income people,their communities, and their housing” and to “strengthen the likelihood that those on welfare will successfully make transition to work”. These organizations understood the importance of creating this task force for the benefit of those with low incomes to better prevent homelessness.

Ethnicities and Minorities

Hudson, A. , Nyamathi, A. , Slagle, A. , Greengold, B. , Griffin, D. K. , Khalilifard, F. et.al. (2009). The power of the drug, nature of support, and their impact on homeless youth. Journal of Addictive Diseases, 28 (4), 356-365.
The authors, researchers at UCLA did a qualitative study that was conducted with 24 homeless youth to gain an understanding of the youths’ perceptions about the power of drug use and the positive and negative aspects of family, friends, and peers in their struggle with drug and alcohol use. Of the 24 youth participating in the focus group sessions, 18 were men and 6 were woman. The sample was nearly evenly divided by age; 10 were between the ages of 17 and 20 years, whereas 14 were between the ages of 21 and 25 years. Upon their findings they found that some key reasons why youths’ homelessness exists and substance abuse occur is, because of family members’ drug use or family conflict. The commonly most used drug that participants used frequently was marijuana, and alcohol. Although this article doesn’t mentioned thoroughly how substance use and addiction causes homelessness it does shed light on factors that contribute to the substance usage.

Kipke, D. , Montgomery, Susanne B. , Simon, Thomas R. , & Iverson, Ellen F. (1997). "Substance abuse" disorders among runaway and homeless youth. Substance Use & Misuse, 32 (7-8), 969-986.
The authors above conduct an epidemiologic research to estimate the prevalence of alcohol and other “drug abuse” disorders among runaway and homeless youth, and documented this by variation of gender, age, ethnicity, age first left home, and length of time homeless. Participants living in the Hollywood area of Los Angeles, California ranged from ages 13- 23 years who are in either a public or private shelter, half-way house, on the street, in an abandoned building or even staying at a platonic friend’s house or apartment. From their findings African-American subjects were found to be significantly less likely than Caucasian subjects to report evidence of having either an “alcohol abuse” disorder or an illicit “drug abuse” disorder. In tables 1-3 within the article you will see the overall findings from the study conducted. In closing it is important for me to mention that this study has several limitations which should be considered when interpreting the results because the findings relied solely on the participants self-report that one could argue is unreliable. However this study does show many homeless and run away youth do turn to drugs not only for the sake of taking a drug but, for a means of cooping and meditation depending on each individual.

Thompson, S. , Jun, J. , Bender, K. , Freguson, M. , & Pollio, E. (2010). Estrangement factors associated with addiction to alcohol and drugs among homeless youth in three U.S. cities. Evaluation and Program Planning, 33 (4), 418-427.
Substance abuse is highly prevalent among homeless young people. Estimates from empirical research indicate that 39–70% of homeless youth abuse drugs or alcohol (Chen, Thrane, Whitbeck, & Johnson, 2006; Martijn & Sharpe, 2006). In this study conducted researchers suggests that social estrangement and adolescent substance use are related. Adolescents who use high levels of alcohol later demonstrate difficulty in establishing adult social connections (Chassin, 2008). Substance abuse and dependency also appear to increase with length of homelessness or estrangement from traditional society (Johnson, Whitbeck, & Hoyt, 2005; Rew, Taylor-Seehafer, & Fitzgerald, 2001). In this article the authors mention the four domains of estrangement that are hypothesized to predict addiction among homeless youth. They are disaffiliation, human capital, identification with homeless culture, and psychological dysfunction. The homeless young people in this study (N = 146) ranged in age from 18 to 24 (mean = 20.2; S.D. +1.89) years. Participants were predominately Black/not Latino (n = 57; 39.0%) or White/not Latino (n = 44; 30.1%), with the remainder identifying themselves as Latino (n = 25; 17.1%) or other ethnicity (n = 20; 13.7%). Most respondents were male (n = 99; 67.8%), reported primarily living on the streets or in temporary shelters (n = 71; 48.6%) and had been homeless an average of 5.3 years (S.D. + 3.9). In tables 1- 4 found in the article you will see the various finding that were found among alcohol addicted and non-addicted homeless youth, drug addicted and non-addicted homeless youth, logistic regression to predict alcohol addiction by four domains of estrangement, and finally the logistic regression results—drug addiction by four domains of estrangement.

Nyamathi, A., Longshore, D., Keenan, C., Lesser, J. & Leake, B. D. (2001). Childhood predictors of daily substance use among homeless women of different ethnicities. American Behavioral Scientist, 45(1), 35-50.
Adeline Nyamathi, ANP, PhD, is the associate dean for international research and scholarly activities. In this study 1.331 structured surveys were given to homeless women in Los Angeles, who were daily substance users. This study is interesting because it finds the difference in predictors for alcohol and drug abuse. Childhood sexual, physical and emotional abuse and having a parent who abused drugs or alcohol predicted daily drug use in women compared with those that did not report those characteristics. This was similar for the women who were alcohol users, except these women did not report childhood sexual abuse, and interestingly women who had lived in a juvenile institution were more likely to report daily alcohol use. Also found was the role of normative ties, women in this study who had contact with family were less likely to be substance abusers or to have a history of substance abuse. A limitation to this study would be found in the women reporting childhood abuse, because this is self-reported women may have blocked out abuse or due to the shame not reported it at all.

Addiction

When examing the addiction in the homeless it is important to also remember there is a broad range within that group. Below you will find sources that look at gender differences, how men and women are different in their addiction, coping and past experiences. Although there are gender differences, there is variation within each gender, based on age, culture and ethnicity. Youth homeless are quite a large group that need to be looked at with their own set of issues that differ from adult homeless. One of the points to take away is that addiction in the homeless is cyclical, if addicted youth stay homeless and addicted they will inevitably become addicted homeless adults.

Gender Differences

Maurin, J. T., Russel, L. & Memmott, R. J. (1989). An exploration of gender differences among the homeless. Research in Nursing & Health, 12, 315-321.
Judith T. Maurin, PhD, RN, is a professor and associate dean for academic affairs in the College of Nursing, University of Utah. In this study Judith T. Maurin and associates interview 337 homeless in Utah (79% men, 21% women). There are a few main gender differences found; Women overall had more normative ties than men, they were more likely to be married, have children. Women who did not have children with them stated they expected to be reunited with their children (28.6% compared to 15% of men). Significantly 86.9% of men interviewed were alone compared with just 35.2% of women. Men also had been homeless longer than women, 46% of men had been homeless for over 6 months compared with 33% of women. Women were more likely to be in a state of psychological distress than men (65.7% compared to 39%), this could possible be explained by the fact that the majority of women had not been homeless for that long. As in a few other studies (Nyamathi, 2001; Stein, J. A. (1995) ) a correlation is made between normative ties and substance abuse, in this study men and women who were alone reported drinking the most out of all respondents. With all studies exploring gender differences it is important to remember that even within certain genders there is a broad range of diversity.

Stein, J. A. & Gelberg, L. (1995). Homeless men and women: Differential associations among substance abuse, psychosocial factors, and severity of homelessness. Experimental and Clinical Psychopharmacology, 3(1), 75-86.
Judith A. Stein, Department of Psychology, University of California Los Angeles, leads this study surveying 531 homeless (386 men, 145 women). As with other studies this one also found the link between women, normative ties and less substance abuse. Greater substance use was reported by men, who in this study were more likely to have less normative ties and also more likely to have a mental illness and criminal involvement. Women as found in other studies were more likely to be living with a child which predicted less substance abuse and less time homeless. Overall between drug use and alcohol use and drug use and criminal involvement, women had stronger associations, while between drug use and victimization and drug use and mental illness men had stronger associations. A limitation to this study could be the use of self-report, and that the sample of women was much smaller than that of men.

Calsyn, R. J., Morse, G. (1990). Homeless men and women: Commonalities and a service gender gap. American Journal of Community Psychology, 18(4), 597-608.
Robert J. Calsyn, professor, Department of Psychology, University of Missouri-St. Louis, sampled 248 (122 women, 126 male) homeless in St. Louis for this study. This study found similar gender differences to others, women were more likely to have dependent children (68.9%), men were not (96.8%). Consistent with other research, women were found to utilize a larger social network than men, men had been homeless longer and were more likely to have a criminal record. Men also reported more of a problem with alcohol use than women in this study, this could be because the majority of women in this study had dependent children and social ties correlating to less substance use. Some findings in this study are consistent with other research cited here, although there could be limitations given that it is a relatively small sample in one city.

Youth

Gwadz, M. V., Nish, D., Leonard, N. R. & Strauss, S. M. (2007). Gender differences in traumatic events and rates of post-traumatic stress disorder among homeless youth. Journal of Adolescence, 30, 117-129.
Marya Viorst Gwadz, Center for Drug Use and HIV Research, Institute for AIDS Research, National Development and Research Institutes. This report used 85 homeless and at-risk youth from New York City sampled from drop in centers. It was found that the majority of youth experience recurring abuse and neglect during childhood, girls and young women are more likely to develop PTSD as a result of this, the difference may be explained due to females enduring sexual trauma. The majority of male and female homeless youth in this study (85.9%) experienced at least one traumatic event, trauma in street youth is much higher than in other populations of youth. All youth in this study were sampled from the same drop in center and the sample number itself is very small, limiting the scope of these findings and their applicability to the general street youth population.

Kidd, S. (2007). Youth homelessness and social stigma. Journal of Youth and Adolescence, 36, 291-299.
Sean A. Kidd, assistant professor, McMaster Department of Psychiatry and Behavioural Neurosciences, conducted surveys with 208 youth in Toronto and New York City. In this study a number of links between street youth and substance abuse are shown, family situations play a huge part as high rates of parental drug use are reported. The dangers of street life lead youth to turn to substances to cope with the life, also a high number of mental disorders are reported, depression, PTSD and suicidal behaviour. The youth in this sample were predominantly white (56%), and from two cities not that different. More diversity in the sample is needed from ethnicity and different parts of the country (Canada and United States).

Okazaki, S. (Producer, Director). (1999). Black tar heroin: the dark end of the street Documentary. San Fransisco, CA: Farallon Films. http://youtu.be/9Yt4Mmn7ofI
This documentary was filmed from 1995 to 1998 in San Fransisco, California, produced and directed by Steven Okazaki. It follows the lives of five addicted and at times homeless youth over three years. Showcasing their struggle through drug-related crimes such as prostitution, drug dealing and illness such as AIDS and overdoses. Steven Okazaki gives us an uncensored at times uncomfortable look into their lives. While this is in no way a proper research study, through interviews with the youths they talk in depth about their childhoods (addicted parents, trauma, sexual abuse), they speak candidly not only about their past but what has lead them to their current situation. This is a useful source to supplement the journal articles and provide first hand context to the plight of addicted homeless youth.

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