Psychopathology among young homeless people: longitudinal mental health outcomes for different subgroups.

BACKGROUND Homeless young people are recognized as a very vulnerable group in terms of mental health; however, few studies in the UK have examined this. Furthermore, homeless young people represent a heterogeneous group in terms of their mental health and greater characterization could improve intervention work. OBJECTIVES The aims of this study were to examine prevalence and subtypes of psychopathology among a British sample of young homeless people and to investigate potential associations between identified typologies and a priori specified current and past experiences. In addition, the study intended to explore physical health, mental health, and housing outcomes for the different mental health subgroups. DESIGN A prospective longitudinal design was used. METHODS Structured interviews including a mental health assessment were conducted with 90 young homeless people aged 16-23 years. Follow-up interviews were conducted approximately 10 and 20 months later. Cluster analysis at baseline was used to identify groups based on lifetime mental health problems. RESULTS The current and lifetime incidence of mental health problems was high (88% and 93%, respectively). Three subgroups of homeless young people were identified: (1) minimal mental health issues; (2) mood, substance, and conduct disorder; and (3) post-traumatic stress disorder, mood, and anxiety issues. These groups differed with respect to follow-up indicators of change and stability of mental health status, service use, and suicide risk, but not housing outcome. Other characteristics (gender ratio, past experiences) also distinguished the subgroups. CONCLUSIONS Typologies of young homeless people based on psychopathology reveal differences in lifetime and future experiences including mental health at follow-up. Identified groups could be used to tailor interventions towards differing needs. PRACTITIONER POINTS Low mood, anxiety, post-traumatic stress disorder, and psychosis are common mental health issues among young homeless people in the UK. Subgroups of young homeless people with differing needs can be identified, and these groups can be used to predict outcomes. Tailoring support provision towards specific needs has the potential to improve mental health and other outcomes for vulnerable young homeless people. Young homeless people often do not access the support to which they are entitled. Services need to be adapted to improve access for this group.