Homeless Children Spike Calls Attention to MH Needs, Systems Working Together
Mental Health Weekly; Vol 24 Num 45, 11/24/2014
The number of children now homeless in this country has reached an “historic high,” according to the authors of a new report who say it’s not surprising that the mental health consequences among the mothers of these children are profound.
The report, “America’s Youngest Outcasts: A Report Card on Child Homelessness,” released Nov. 20 by the National Center on Family Homelessness at American Institutes for Research, estimates that 2.5 million children suffer from homelessness. It documents the number of homeless children in every state, their well-being, their risk for child homelessness, and state-level planning and policy efforts.
Among the major causes of homelessness for children in the United States are the ways in which traumatic experiences, especially domestic violence, precede and prolong homelessness for families. Other causes include the nation’s high poverty rate, lack of affordable care housing across the nation, continuing impacts of the Great Recession, racial disparities and the challenges of single parenting.
The report authors based the calculation on the most recent U.S. Department of Education count of homeless children in U.S. public schools and on 2013 U.S. Census data. From 2012 to 2013, the number of children experiencing homelessness annually in the United States increased by 8 percent nationally, increased in 31 states and the District of Columbia, and increased by 10 percent or more in 13 states and D.C.
The Obama administration made a commitment to end homelessness in America, said Ellen L. Bassuk, M.D., associate professor of psychiatry at Harvard Medical School and lead author of the re- port. Instead, there have been huge decreases on some aspects of veteran homelessness, she said. “Many efforts to end homelessness have targeted allocating 20,000 housing subsidies for veterans,” said Bassuk, who is also affiliated with the Center for Social Innovation. “Very little attention has been targeted to families and kids.”
The demographics of the family have changed, she said. Instead of two-parent households, there are a lot of households headed by women alone, she said. The report found that about 90 percent of families along the Northeast corridor are headed by women alone, and this occurs in about 75 percent of female-headed households across the rest of the country, Bassuk said. “No cadre of support is available for these families,” she said.
Mental health factors
One of the things the study found was that the vast majority of significant traumatic events occur in children as well as adults, Bassuk said. One of the major roots is domestic violence, she added. About one-third of women entering a shelter are fleeing from an abusive partner, she said. “They’ve been victims of trauma [that have] very significant mental health consequences. A lot of them have PTSD and are clinically depressed,” Bassuk said.
Bassuk added, “This is a very traumatic population. They’re going to have difficulties. The literature shows that lots of kids have mental health issues. These kids are ignored; that’s part of the reason why we wanted to write this report.”
The report suggests that to respond to the extremely high prevalence of exposure to traumatic stress (including domestic violence) and its mental health consequences — especially major depression, PTSD and substance use — all agencies should provide trauma-informed care — a strengths-based organizational approach in which all services are provided through the lens of trauma.
Parents seeking mental health care are confronted by long waiting lists at community mental health centers, said Bassuk. “It’s hard for them to see a therapist and [some- times] shelters are not set up to pro- vide trauma-related services,” she said. On the other hand, some shelters can be very mental health– oriented and have built-in mental health and trauma services, she said, adding that some transitional facilities are targeting mental health needs.
This report shines “a spotlight” on the children, 51 percent of whom are under the age of 6, said Bassuk. “As they get older, they’re living with relatives, outplacement and foster care. Separation from their families can be very destructive,” she said.
“It’s a tough picture,” Bassuk said. “People haven’t paid a lot of attention to their mental health needs.” Solutions going forward should include screening mothers and children for mental health issues and increasing the number of subsidies for families, she said.
‘Wake-up call’
“This should be an embarrassing wake-up call to those who would rather cut domestic spending to safety net programs like mental health services and housing assistance, decrease the number of people with health insurance, or avoid the issue of increasing employment opportunities with a living wage,” noted Kevin Martone, executive director of the Technical Assistance Collaborative, a national nonprofit organization that assists with the housing and community support services needs of low-income people with disabilities and people who are homeless.
The challenge for policymakers is not to pit populations against each other such that some groups receive all of the focus at the expense of others, Martone told MHW. “In re- cent years, the chronically homeless, people with disabilities and veterans have deservingly received increased resources, but this has forced policy- makers to shift attention away from critical issues such as child homelessness,” he said.
What makes child homelessness particularly complex, said Martone, is that so many systems must come together to fix the problem — and that just doesn’t happen easily. “It is critical for education, pediatrics and other systems that engage children to be aware of children who are homeless or at risk of homelessness and the psychological, learning, health and other effects of homelessness so that interventions can be made,” Martone said.
Martone added, “Despite the fact that we’re coming out of a recession and the economy is in recovery, state and federal government must address the child homelessness and housing instability called out in this report.”
Cost-effective solutions such as rapid re-housing, homelessness prevention funding and Housing First programs are important strategies that can prevent or end homelessness and stave off long-term negative outcomes, he said. Another solution would be access to better and more affordable health care through the Affordable Care Act. “We know that many kids are insured, but we need their parents to be insured,” he said. “The bottom line is that until parents can access employment with living wages, affordable housing, transportation, health insurance and affordable health care, too many children will experience or be at risk of homelessness,” said Martone. “The good news is that children are resilient, and with cross-system interventions, their outlook can be positive,” said Martone.
For a copy of the report, “America’s Youngest Outcasts,” visit www.homelesschildrenamerica.org/media
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