7 February 2012
Article from The prevention action
Article from The prevention action
Article from The prevention action
A new study reveals that the capacity for resilience among homeless youth is seriously low – lower than that among young people in psychiatric outpatient services, as well as those in the general population. The study authors argue for the importance of intervening as early as possible in young people’s “homelessness trajectories” in order to reduce the level of deterioration in their coping resources and health.
Many studies have shown that suicidality and mortality rates among homeless populations are high, but the Canadian duo behind this new study adopted a different stance. Researchers Kristin Cleverley and Sean Kidd asked why these rates are not higher, given the severity of the adversity these young people typically face, and looked to resilience as a potential mechanism protecting some youth in this context.
There is some debate among academics about resilience (see: Resilience and the holy grail), but for Cleverley and Kidd it represents “a set of personal qualities such as self-efficacy, engagement of the support of others, having an action-oriented approach, and adaptability, that allow one to thrive in the face of adversity.” Among homeless youth those qualities might include so-called “street smarts” (an extensive knowledge of methods of surviving in street contexts) and lowered sensitivity to the opinions and behaviors of others.
This study investigated resilience in a relatively small sample of 47 youths with no fixed abode, all between 15 and 21 years of age. The young people were recruited by front-line workers in agencies in Ontario, Canada that provide services to homeless and street-involved youth. The average age at which they had first become homeless was 14 years and almost half of them (45%) had been homeless for more than six months.
The young people participated in semi-structured interviews in which they were asked to describe their lives before and after becoming homeless (pre-street and street histories) as well as their experiences with health services. They also completed a questionnaire called the Connor-Davidson Resilience Scale. This involved selecting one of five responses (ranging from “not at all true” to “true nearly all of the time”) to statements such as “I am able to adapt to change,” “I have a strong sense of purpose” and “I am not easily discouraged by failure.”
The research team found that higher levels of resilience are linked to lower levels of psychological distress, as well as fewer instances of suicidal thoughts. However, the length of time a youth has been homeless was an important factor. Young people who had spent longer than six months on the street had worse levels of resilience and more serious psychological distress than those who had been homeless less than six months. This may suggest that the intensity of situational and psychological distress increases over time and eventually overwhelms a young person’s resources to cope, as the authors suggest.
However, as the authors note, their study design makes it impossible to determine whether longer homelessness causes worse mental health – or vice versa. It is also possible that young people who have worse mental health are less able to secure stable housing, and therefore end up being homeless for a longer time.
Cleverly and Kidd point out that “developing datasets with homeless populations is a pervasive problem due to the high degree of instability in their life circumstances.” Their study was originally designed to be longitudinal, which would have involved following-up each of the 47 youth over a longer period of time, but, due to significant participant drop-out, it was only possible to a conduct cross-sectional study and to look at a “snapshot” of participants’ lives. (See Prevention Action’s reference section for more on longitudinal and cross-sectional designs.)
This has very important implications for the conclusions that can be drawn from the findings, mostly because it is not possible to make definitive statements about causality. Instead, the researchers can say that the findings suggest that spending more time on the streets contributes to the deterioration of resilience and increases psychological distress and that, with greater levels of psychological distress, the chances of a youth engaging in suicidal thoughts increases.
The difficulties associated with researching homeless populations have implications for those designing policies and programs to support children and young people. Increasingly, funding priority is given to programs with rigorously demonstrated evidence of effectiveness, but for this population gathering evidence on ‘what works’ is so challenging that it may be all but impossible to create evidence-based programs. Ultimately, policy-makers could end up inadvertently disadvantaging youth in urgent need of support and services, on the basis that researchers find them hard to study.
References:
Cleverley, K., & Kidd, S. A. (2011). Resilience and suicidality among homeless youth. Journal of Adolescence, 34, 1049-1054.
Article from The prevention action
