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Abstract
Background Child homelessness has been associated with elevated mental health problems during early adolescence, a period of onset for psychiatric problems. Prior literature has relied on cross-sectional studies, limiting the understanding of temporality and trajectories of psychopathology. We extend prior literature by examining associations between child homelessness and internalising and externalising symptom trajectories in early adolescence, with consideration of timing and persistence of homelessness.
Methods Using population-based longitudinal data from the Avon Longitudinal Study of Parents and Children, we used multilevel models to examine the effects of homelessness prior to age 9, the timing of homelessness (eg, early vs middle childhood) and cumulative exposure to homelessness on internalising and externalising trajectories across ages <0–9 years. We also tested for sex differences in these associations.
Results Of the 8391 participants, 5.5% reported exposure to homelessness at least once before age 9. Children who experienced homelessness had elevated internalising and externalising symptoms compared with their consistently housed peers, with excess risk evident among children who first experienced homelessness in middle childhood (relative to early childhood) and children who experienced recurrent homelessness. We did not observe changes in symptom trajectories over the course of 4 years. Men who experienced homelessness displayed a more pronounced risk of internalising symptoms relative to women and men who did not experience homelessness.
Conclusion Childhood homelessness is associated with persistently elevated internalising and externalising symptoms across early adolescence compared with their consistently housed peers. Interventions and policies to address family homelessness may lead to better mental health among adolescents.
- MENTAL HEALTH
- HOMELESS PERSONS
- ADOLESCENT
- CHILD HEALTH
Data availability statement
Data may be obtained from a third party and are not publicly available. Access to Avon Longitudinal Study of Parents and Children data is through a system of managed open access (http://www.bristol.ac.uk/alspac/researchers/access/).
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Data availability statement
Data may be obtained from a third party and are not publicly available. Access to Avon Longitudinal Study of Parents and Children data is through a system of managed open access (http://www.bristol.ac.uk/alspac/researchers/access/).
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Footnotes
Contributors HHK, RK, NS, AT and CD conceived and designed the study. HHK conducted the data analyses. HHK and RK wrote the first draft of the manuscript and also revised the final draft of the manuscript. NS and AT supervised the analysis and writing. All authors critically reviewed the manuscript and approved the final version. HHK is responsible for the overall content as guarantor.
Funding The UK Medical Research Council and Wellcome (grant ref: 217065/Z/19/Z) and the University of Bristol provided core support for Avon Longitudinal Study of Parents and Children(ALSPAC). A comprehensive list of grants funding is available on the ALSPAC website (http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). This publication is the work of the authors, who will serve as guarantors for the contents of this paper. Partial funding/support for this research was provided by the Harvard T.H. Chan School of Public Health Initiative on Health and Homelessness.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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