The 130th Annual Meeting of APHA

Abstract #40606

Carol S. North, MD, MPE¹, Deborah Megivern, PhD², David Pollio, PhD³, and Karin M. Eyrich, MSW, MPE². (1) School of Medicine, Washington University, Department of Psychiatry, 660 S Euclid, CB 8134, Renard Building, Room 2210, St. Louis, MO 63110, (314)747-2013, northc@psychiatry.wustl.edu, (2) George Warren Brown School of Social Work, Washington University, Campus Box 1196, St. Louis, MO 63130-4899, (3) School of Social Work, Washington University, One Brookings Dr., Box 1196, St. Louis, MO 63130-4899

Previous work has demonstrated the homeless population to be highly traumatized, their trauma histories often going back many years prior to first homelessness. Homelessness has also specifically been associated with victimization and substance abuse, both during the time of homelessness and on a lifetime basis. The role of recent trauma in service utilization patterns among the homeless population has not been examined. The current study explored this issue in a randomly selected sample of 397 homeless people in St. Louis, MO. The Diagnostic Interview Schedule and the Composite International Diagnostic Interview/Substance Abuse Module were used to obtain structured psychiatric diagnoses. Self-report of service use in the last 12 months was measured in four domains: addiction, mental health, homeless "exiting" services (e.g., residential, permanent housing), and homeless "survival" services (e.g., shelter, meals). Use/nonuse of each service domain was examined in relation to having experienced a traumatic event within the same time period. To control for events prior to the study's time frame, logistic regression models included remote trauma and 12-month psychiatric diagnoses. Recent trauma (approximately 20% in the sample) uniquely predicted addiction, mental health, and homeless maintenance services, even controlling for effects of remote trauma and recent diagnosis. These effects appeared to be independent of the predictive role of psychiatric diagnoses. Service providers need to be aware of the pervasiveness of recent trauma and its independent influence in service utilization choices.

Learning Objectives:

• Identify how recent trauma in homeless persons' lives affect their health, mental health, substance abuse, and homelessness service use.
• Articulate the differences between the impact of recent and remote trauma on service use.
• Incorporate this information into programmatic responses.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.