Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. In a recent survey, runaway and homeless youth reported significantly higher rates of depression, self-injury, suicidal ideation, and suicide attempts as compared to stably housed participants.

2. Of the mental health outcomes assessed, youth who reported a history of both unaccompanied homelessness and running away had the highest prevalence of each outcome, followed by those who had run away and then those who had experienced unaccompanied homelessness, with the lowest prevalence being among stably housed youth.

Evidence Rating Level: 2 (Good)

Study Rundown:

Homelessness and running away are experiences common to many pediatric patients, and both have previously been associated with significant adverse outcomes. Few studies have investigated how each of these unique challenges may impact the mental health of the youth who experience them. In this study, researchers reviewed data from the 2016 Minnesota Study Survey which included questions about students’ history of homelessness and running away as well as their history of discrete mental health outcomes, including depression, suicidal ideation or attempts, and self-injurious behavior. Researchers found that youth who reported a history of both running away and recent homelessness also reported the highest rates of each of the mental health outcomes assessed. Moreover, youth with just a history of running away consistently had the second highest rate of each domain assessed, and youth with a history of just homelessness having the third highest rate, all compared to the baseline of stably housed youth. Overall, the study demonstrates the distinct needs of each population and particularly highlights the uniquely increased risks of youth with a history of running away. Further research is required to determine best practices for screening for this at risk population.

In-Depth [survey]:

In this study, researchers utilized data from the 2016 Minnesota Student Survey (MSS), a statewide, school-based survey organized by the Departments of Education, Health, Human Services, and Public Safety. Researchers restricted their sample to students in the 9th and 11th grades who responded to questions about housing status and mental health. Respondents were subsequently divided by their history of having run away, been homeless, both, or neither in the last 12 months. The patient health questionnaire-2 (PHQ-2) was used to screen for depressive symptoms, and participants were also asked about self-injury and suicidal ideation in the last 12 months. A total of 68 785 respondents were ultimately included in the final analysis (73% white, 50.7% female) with 65 021 being stably housed, 372 reporting only unaccompanied homelessness, 2996 reporting only a history of running away, and 396 reporting a history of both. Of the various mental health outcomes assessed, youth reporting a history of both reported the highest rates of reported self-injury (OR 4.9, 95% CI 3.8-6.2), suicidal ideation (OR 3.7, 95% CI 2.9-4.7), suicide attempts (OR 7.1, 95% CI 5.5-9.2) and depressed mood (OR 2.4, 95% CI 1.9-3.0) as compared to stably housed youth. Runaway youth consistently reported the second highest rate of these above health outcomes, with homeless youth being third highest, as compared to stably housed youth.

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