Correlates of Suicidality and Mental Health Among Runaway/Homeless YOUTH

Purpose/Aim: To examine mental health diagnoses and suicidality among a sample of runaway, homeless, and street youth in the Denver Metro area of Colorado, to determine the scope of needed mental health services.

Background/Rationale: Mental illness among runaway, homeless, and street youth is common, and can have a devastating impact on other areas of their lives. Social service workers and health care providers can benefit from a better understanding of common mental health diagnoses, and frequency of suicide ideation among this population in order to develop tailored interventions for screening and treatment of mental health issues.   

Methods: 191 Denver metro area runaway/homeless youth living in shelters and visiting a drop-in center participated in an iPad-delivered survey and mobile modem in the summer of 2013.  The questionnaire borrowed from standard youth health scales and covered ED use, reasons for ED visit, access to other sources of medical care, mental health diagnoses, the PHQ-9 questionnaire, and extensive demographic information. PHQ-9 scores were calculated and categorized from minimal to severe depression. Mental health diagnoses were examined to find the most commonly reported diagnoses. 

Results/Outcomes:  PHQ-9 score: = 7.35 (sd= 7.22) for all youth. Youth reported depressive symptoms on a scale from minimal to severe were: minimal, 42.9%; mild, 19.9%; moderate, 13.6%; moderately severe, 10.0%; and severe, 13.6%. The most commonly reported mental health diagnoses were: anxiety (n= 59), bipolar disorder (n= 51), and major depressive disorder (n= 46). Youth also reported having post-traumatic stress disorder (n= 34), schizophrenia (n= 19), ADD/ADHD (n= 8), multiple-personality disorder (n= 4), and axis II diagnoses such as anti-social personality disorder and borderline personality disorder (n= 4).   20.9% (n= 38) of survey respondents reported having suicidal ideation within the last month. 

Conclusions: Screening for depression and suicidal ideation should be done for each youth upon entering shelter services since over 1/5^th of the young people reported recent feelings of suicidal ideation, and well over half the youth report mild signs of depression based on the PHQ-9. Survey delivery via IPad and remote modem is an efficient method of data collection at shelters and drop-in centers.  Shelters and clinics serving this population should establish and continually maintain policy and procedure describing what to do in the event of a behavioral health crisis, particularly as they relate to schizophrenia, manic episodes, and depression.  Point-in-time interventions should be considered to bring behavioral health care to youth in a timely way.