Recorded presentation

Linda Weinreb, MD and Homeless Families Program Trauma Working Group. Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, 508-856-3225, weinrebl@ummhc.org

While being homeless in itself may be traumatic, women come to the experience of homelessness with significant histories of violence and victimization. Ninety-four percent of women in the SAMHSA-funded Homeless Families Program report lifetime exposure to trauma at baseline, with three-quarters reporting physical violence and over half reporting sexual violence perpetrated by a family member or someone known to them. Many indicate experiences of early trauma, e.g., family disruptions, with 17% having lived in foster care and 15% having resided in group homes. Over one-fourth of the homeless women across study sites report moderate to severe trauma symptoms (FOA), and the majority report mental health symptoms, i.e., elevated BSI Global Severity Index scores, and histories of substance abuse.

The inter-related issues of trauma, mental illness and substance abuse have implications for the care of homeless mothers and their families. While many of these women are in obvious need of treatment for psychiatric and substance use disorders, their histories of trauma may dispose them to be reluctant treatment participants. Mothers in this sample typically have one or two children under the age of 18 living with them, and over 30% of these children are under age 5. Many of these women, therefore, are facing the challenges of caring for young children while they are in significant current distress, and having had prior experiences of being parented poorly themselves. The implications for treatment of women and children, and the need for trauma-informed parenting education, support and skills training will be discussed.

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