Trauma, substance use, and mental health symptoms in transitional age youth experiencing homelessness

Carol Dawson-Rose, Deena Shehadeh, Jennifer Hao, Jasmine Barnard, Ladan Khoddam-Khorasani, Adam Leonard, Kristen Clark, Eva Kersey, Haley Mousseau, Julie Frank, Aaron Miller, Adam Carrico, Amy Schustack, Yvette P. Cuca

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: This descriptive study examined the prevalence and correlates of trauma, substance use, and mental health symptoms in homeless transitional age youth (TAY) in San Francisco. Design & Sample: One hundred homeless TAY were recruited from a community-based organization to complete a survey on trauma, mental health symptoms, and substance use. Measurements: We used these measures: National Institute on Drug Abuse (NIDA)-Modified Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) for frequency and risk level of substance use; the 10-item Adverse Childhood Experiences (ACEs) for prevalence of trauma; the Post-traumatic Stress Disorder Checklist for DSM-5 for post-traumatic stress disorder (PTSD) symptoms; Center for Epidemiologic Studies Depression Scale for depression symptoms; and Generalized Anxiety Disorder 7-item for anxiety symptoms. Results: Almost all (n = 98) participants experienced at least one ACE during childhood, and 77% experienced four or more. Most participants (80%) reached the diagnostic threshold for PTSD, 74% for depression, and 51% for moderate anxiety. Symptoms of PTSD, anxiety, and depression were all significantly correlated with use of opioids and stimulants. Conclusion: Trauma, and co-occurring substance use and mental health problems are prevalent among homeless TAY. Individual- and community-level interventions are needed to address and improve the health of this population.

Original languageEnglish (US)
Pages (from-to)363-370
Number of pages8
JournalPublic Health Nursing
Issue number3
StatePublished - May 1 2020


  • adolescent health
  • homeless persons
  • substance abuse
  • trauma
  • vulnerable populations

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health


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