From Unity Health Toronto

Adolescents experiencing homelessness in the United States have significantly worse mental health and substance use outcomes than their housed counterparts, according to new research that evaluated mental health and substance use among homeless and housed high school students surveyed voluntarily and anonymously in 2019.

The research, published in JAMA and co-led by researchers from MAP Centre for Urban Health Solutions at St. Michael’s Hospital, also found that teens of colour and teens who identify as LGBTQIA+ bear the disproportionate burden of homelessness in the United States.

More than one in 20 U.S. high school students experienced homelessness in 2016 and 2017, according to a 2018 report from the United States Department of Housing and Urban Development. While the circumstances surrounding these adolescents’ homelessness are undoubtedly stressful and traumatic, few reliable and large-scale assessments of the psychiatric burden among homeless teens are available.

“Our study is a call-to-action for schools, health systems, and policymakers to address the significant burden of mental health and substance use challenges faced by homeless adolescents,” said Michael Liu, MPhil, first author of the study, a research coordinator at St. Michael’s MAP Centre for Urban Health Solutions and a medical student at Harvard Medical School. “The burden of homelessness falls disproportionately on Black, Hispanic, and LGBTQIA+ individuals, which reflects enduring structural injustices such as racism, homophobia, and transphobia in the US. We need to do a better job of identifying these students and connecting them to evidence-based interventions such as stable housing and mental health support.”