Relationships Between Caregiver Violence Exposure, Caregiver Depression, and Youth Behavioral Health Among Homeless Families
Homelessness affects a large and increasing number of families in the U.S., and trauma and other threats to mental health are quite common among homeless families. It is also important to better understand the relationship between adolescent mental health (related to both internalizing and externalizing symptoms) and caregiver mental health and trauma exposure, in order to better serve the needs of vulnerable families. The objective of this study is to explore the relationships between caregiver exposure to violence, caregiver depression, and adolescent depression and behavioral problems among homeless families.
A NIDA-funded effectiveness study (R01 DA018574) of the HOPE Family Program was recently completed. This program was an intervention with 247 homeless adolescents (aged 11-14 years) and their caregivers who were staying in 10 different New York City family homeless shelters. The intervention was comprised of eight multi-family group sessions, covering topics including family communication, puberty, sexuality, HIV, substance used, family rules, stress management, social supports, and hope. The effectiveness study tested the hypothesis that the HOPE Family Program would result in improvements related to youth risk-taking behavior, mental health status, and parent/family-level protective processes, as compared to the comparison group (health education).This study, meanwhile, is based on the secondary analysis of baseline data collected from 209 adolescents and their caregivers who were assigned to both the HOPE Family Program group and the comparison group. The youth whose data were used in this study were identified as the first children in their families to be registered for the program; the data for any additional children in each family were not examined. Baseline data collected included both demographic data and a set of standardized assessments related to areas including exposure to violence and other stressful circumstances (City Stress Inventory), depression and other mental health concerns (Brief Symptom Inventory, Children’s Depression Inventory, Strengths and Difficulties Questionnaire). Data were analyzed through Structural Equation Modeling, using AMOS.
Among this sample of homeless families, caregiver violence exposure has statistically significant relationships with both adolescent behavioral problems and adolescent depression symptoms, as mediated by caregiver depression.
Conclusions and Implications:
These findings indicate that adolescent behavioral health is associated with caregiver mental health, which, in turn, is associated with caregiver trauma exposure. This highlights the importance taking into account adult mental health while treating adolescent externalizing and internalizing behaviors, and ensuring that caregivers, too, have access to adequate treatment and supports. Furthermore, this treatment should be trauma-informed, given the link between trauma and mental health.