title: Relations between mental health diagnoses, mental health treatment, and substance use in homeless youth.
abstract: Youth experiencing homelessness have elevated rates of mental illness and substance use compared to the general population. However, the extent to which underlying mental health issues may contribute to substance use as a way to manage symptoms and whether mental health treatment may reduce risk for substance use is unclear. This paper investigated these relations in a community sample of homeless youth.
  
  
  
  Youth ages 13-24 (N=416) were interviewed as part of a community count and survey of homeless youth in Houston, Texas. A path analysis examined relations among lifetime diagnoses of ADHD, bipolar disorder, and depression; past-month marijuana, alcohol, and synthetic marijuana use, and hypothesized mediators of past-year mental health treatment and perceived unmet need for treatment.
  
  
  
  Rates of prior mental disorder diagnoses were high, with extensive comorbidity across the three diagnoses (n=114, 27.3% had all three diagnoses). Relations varied by diagnoses and substances. ADHD was positively related to current marijuana use (β=0.55 (0.16), p<0.001), a relation that mental health treatment did not mediate. Depression was positively related to synthetic marijuana use through unmet need (β=0.25 (0.09), p=0.004) and to alcohol use through unmet need (β=0.20 (0.10), p=0.04) CONCLUSIONS: This study provides new information about relations between prior mental health diagnoses and substance use in homeless youth. Findings support the need to consider prior mental disorder diagnoses in relation to current substance use and to assess for whether youth perceive they have unmet needs for mental health treatment.
authors.affiliation: University of Houston, Graduate College of Social Work, 3511 Cullen Blvd, 110 HA Social Work Building, Houston, TX 77204-4013, United States. Electronic address: sanarendorf@uh.edu.
authors.forename: Sarah Carter
authors.initials: SC
authors.lastname: Narendorf
authors.affiliation: University of Houston, Department of Health and Human Performance, 3875 Holman Street, 104 Susanna Garrison Gym, Houston, TX 77204-6015, United States.
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Cross
authors.affiliation: University of Texas, School of Nursing, 6901 Bertner Avenue, SON 724, Houston, TX 77030, United States.
authors.forename: Diane
authors.initials: D
authors.lastname: Santa Maria
authors.affiliation: University of Houston, Graduate College of Social Work, 3511 Cullen Blvd, 110 HA Social Work Building, Houston, TX 77204-4013, United States.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Swank
authors.affiliation: University of Houston, Graduate College of Social Work, 3511 Cullen Blvd, 110 HA Social Work Building, Houston, TX 77204-4013, United States.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Bordnick
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D018453:Homeless Youth / Q000523:psychology*; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology*; D008385:Marijuana Smoking / Q000453:epidemiology*; D001523:Mental Disorders / Q000453:epidemiology*; D011613:Psychotherapy; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013781:Texas / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol; Homeless; Marijuana; Mental disorder; Synthetic marijuana; Young adult