Mental health, suicide attempts, and self-harm among homeless adolescents: Data from the 2009 Philadelphia Youth Risk Behavior Survey (SA)

Background: Limited data exists to detail the impact of homelessness on the mental health and self-harming behavior of homeless adolescents. This study evaluated the relationship between self-reported homelessness and suicide attempts, non-suicidal harm, and frequency of mentally unhealthy days among an ethnically diverse sample of urban high school students.

Methodology: Data from the 2009 Philadelphia Youth Risk Behavior Survey were analyzed. One percent of respondents (N= 443) reported being homeless at the time of the survey. Research questions examined past history (within 12 months) of suicide attempts and non-suicidal harm, and frequency (past 30 days) of mentally unhealthy days. Analysis included chi square tests and odds ratio calculations.

Results: Among homeless adolescents, 71% (n =314) attempted suicide, 68% (n = 301) engaged in non-suicidal harm within the past year, while 18% (n = 80) reported frequent mentally unhealthy days during the past 30 days. Adolescents who attempted suicide were 6.15 times (95% CI: 5.673, 6.668) more likely to report being homeless. Adolescents who engaged in non-suicidal self-harm were 4.279 times (95% CI: 3.994-4.585) more likely to report being homeless. Homeless adolescents were 11 times more likely to engage in self harm, and 19 times more likely to attempt suicide as compared to non-homeless adolescents. No significant differences were found for mentally unhealthy days.

Conclusion: Findings indicate that homelessness increased the risk of suicide attempts and non-suicidal self-harm as compared to non-homeless adolescents. Mental health screenings and services should target this vulnerable and underserved population experiencing homelessness and housing insecurity.