Saturday, 15 January 2005 - 4:00 PM

This presentation is part of: Substance Abuse among Homeless Persons

The Impact of Trauma on Substance Abusing Homeless Men

Background: Homelessness brings with it a complex series of psychosocial and socioeconomic problems. Living without a stable and/or safe residence and having limited financial and social resources increases the number and intensity of stressful events faced by homeless men. Many of these events are psychologically traumatic and if they persistent, they may lead to post-traumatic stress disorder (PTSD). These traumatic events and their clinical presentations often go unnoticed or ignored in typical treatment plans for homeless men. This presentation addresses some of the vexing questions concerning the pathways to homelessness and the specific role that trauma plays in becoming and staying homeless.

Methods: This 4-year study (consisting of a 2-year pilot study and a 2-year filed study) captured both quantitative and qualitative data using self-administered survey packets and one-on-one interviews. Data were captured from over 350 homeless men in a metropolitan area of North Carolina. The quantitative data was collected using several validated instruments that measured trauma, substance use severity, mental and physical health, health care utilization, social support, and homelessness. The qualitative data captured the context and histories of homeless men with a focus on traumatic experiences.

Findings: Homeless men have been highly traumatized as adults and children. These men report high levels of long-term substance use/misuse and chronic mental illness, particularly depression. Homeless men who experience multiple traumatic events, particularly having a life threatening illness and witnessing violence, had worse long term social, health, and economic outcomes. The number of traumatic events and mental illness were significant predictors of trauma. Homelessness did not affect trauma symptom severity. The qualitative analysis confirmed significant levels of substance abuse and co-occurring mental health disorders resulting from family instability and high levels of childhood physical abuse, witnessing violence, and physical assault.

Conclusion: These results are a clarion call for treatment models that firstly involve assessing the risks, causes, protective factors, and impacts of trauma on homelessness men, and secondly, include ways to coordinate services that address the long-term recovery of homeless men.

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