Mental health problems in young people with experiences of homelessness and the relationship with health service use: a follow-up study

Background Homeless young people represent one of the most vulnerable and underserved populations. Objective To assess the prevalence of psychiatric disorder and comorbidity among a UK sample, and examine the longitudinal relationship between psychiatric conditions and different types of health service use. Methods 90 young people with experiences of homelessness were interviewed using a full psychiatric assessment. Participants were followed up 8–12 months later and completed an interview that included information about recent health service use (mental health, emergency room, general practitioner, hospital for physical problems, drug or alcohol services). Findings The prevalence of psychiatric disorder (88% current; 93% lifetime) and psychiatric comorbidity (73%) was high and that of mental health service use low in comparison (31%). Mood disorders, psychosis and suicide risk were significantly associated with mental health service use (OR 5.21, 95% CI 1.64 to 16.58; OR 10.0, CI 1.58 to 94.58; OR 6.25, CI 1.82 to 21.43, respectively). Emergency department use was predicted by mood disorders (OR 5.19, CI 1.68 to 16.0), psychosis (OR 7.33, CI 1.24 to 43.29), anxiety disorder (OR 2.88, CI 1.04 to 7.97), high-suicide risk (OR 3.42, CI 1.86 to 13.67) and comorbidity (OR 1.41, CI 1.05 to 1.90). Discussion and clinical implications The prevalence of psychiatric disorders in homeless young people was high and considerably higher than that reported for this age group in the general population. There is a need for improved uptake of services delivering longer term treatment of psychiatric problems among vulnerable groups of socially excluded young people