Smith Tayla, Hawke Lisa, Chaim Gloria, Henderson Joanna
Centre for Addiction and Mental Health, Toronto, Ontario.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario.
J Can Acad Child Adolesc Psychiatry. 2017 Fall;26(3):214-223. Epub 2017 Oct 1.
Though previous research has identified the high burden of mental health and addiction (MHA) concerns among precariously housed youth, earlier studies have not examined differences in MHA concerns among housing insecure Canadian youth across sectors. This study examines this issue using the Global Appraisal of Individual Needs Short Screener (GAIN-SS) in a cross-sectoral sample of Canadian youth.
A total of 2605 youth ages 12 to 24 seeking services across sectors completed the GAIN-SS and a sociodemographic form. The analyses described demographic variables and sector of presentation, then evaluated internalizing, externalizing, substance use, and crime/violence concerns based on housing status.
While many precariously housed youth presented through the housing/outreach/support sector, 33.6% presented to other sectors. Housing groups endorsed comparably high levels of internalizing and externalizing problems. However, precariously housed youth reported higher rates of problematic substance use (OR = 1.54; 95% CI 1.25, 1.88; < 0.01) and crime/violence issues (OR = 1.95; 95% CI 1.54, 2.46; < 0.01). Precariously housed youth were 48% more likely to endorse concurrent disorders (OR = 1.48; 95% CI 1.21, 1.82; < 0.01), which was largely driven by the high rate of concurrent disorders among precariously housed females.
Since precariously housed youth with multiple clinical needs presented across sectors, attention must be given to screening for both housing stability and MHA and building stronger cross-sectoral partnerships. The findings should encourage systematic screening, MHA training and capacity building within housing sectors as well as integrated services across all youth-serving organizations.
尽管先前的研究已经确定了住房不稳定的青年中存在高心理健康和成瘾（MHA）问题负担，但早期研究并未考察加拿大住房不安全青年在不同部门之间MHA问题的差异。本研究使用个体需求全球评估简短筛查工具（GAIN-SS），在加拿大青年的跨部门样本中考察了这一问题。
共有2605名年龄在12至24岁之间、跨部门寻求服务的青年完成了GAIN-SS和一份社会人口学表格。分析描述了人口统计学变量和就诊部门，然后根据住房状况评估内化、外化、物质使用以及犯罪/暴力问题。
虽然许多住房不稳定的青年通过住房/外展/支持部门就诊，但33.6%的青年就诊于其他部门。住房群体认可的内化和外化问题水平相当高。然而，住房不稳定的青年报告的物质使用问题发生率更高（比值比=1.54；95%置信区间1.25，1.88；P<0.01）以及犯罪/暴力问题发生率更高（比值比=1.95；95%置信区间1.54，2.46；P<0.01）。住房不稳定的青年并发障碍的认可可能性高出48%（比值比=1.48；95%置信区间1.21，1.82；P<0.01），这在很大程度上是由住房不稳定的女性中并发障碍的高发生率驱动的。
由于有多种临床需求的住房不稳定青年在不同部门就诊，必须重视对住房稳定性和MHA进行筛查，并建立更强大的跨部门伙伴关系。这些发现应鼓励在住房部门进行系统筛查、MHA培训和能力建设，以及在所有为青年服务的组织中提供综合服务。
