Executive functions, creativity, and mental health in homeless young people: implications for housing outcome

Background: Homeless young people represent one of the most vulnerable groups in society, yet little is known about cognition, and especially executive functioning, in this group. Executive functions (EFs), higher-order cognitive processes important for adaptation, have been identified as likely key contributors to the capacity to exit homelessness. However, most homeless young people have experienced multiple adversities, with potential implications for EF development. To address gaps in current knowledge, this thesis aimed to profile executive functions among homeless young people and compare the profile to housed young people. Associations between EFs and mental health, and relationships between EFs and short-term housing outcomes were also explored. Methods: Sixty-nine homeless young people (16-19 years) from a homelessness charity, and 37 age-matched housed young people from a college/sixth form participated. Computerised EF tasks spanned the domains of working memory, set shifting/flexibility, planning, impulsivity/risky decision making, selective attention/inhibition, creative thinking, and verbal fluency. Results: Homeless young people demonstrated worse performance than housed youth on several EF tasks, particularly working memory and impulsivity/risky decision making. No differences were found between the groups in creativity. Rates of anxiety were higher in the homeless group, but not depression. Working memory predicted progression into more independent accommodation, such that those with longer working memory spans were twice as likely to have progressed rather than maintained after six months. Anxiety and depression did not seem to moderate this effect. A minority of young people had negative housing outcomes and were profiled separately. Conclusion: Findings from this thesis suggest that EFs should not continue to be overlooked by researchers and services, as they can impact on a homeless young person’s ability to move towards independence. Emerging adulthood, as a sensitive period for EF development, is likely to represent an opportune time for intervention to improve the likelihood of positive housing outcomes in homeless young people