Perceived Racial, Sexual Identity, and Homeless Status-Related Discrimination Among Black Youth Experiencing Homelessness

Purpose:  Black GLB youth experiencing homelessness possess multiple stigmatized identities. Perceptions of race and sexual-identity-based discrimination are positively associated with depressive symptoms and suicidality among Black GLB and racial/ethnic minority youth (Thoma & Huebner, 2013; Milburn et al., 2010). GLB youth who reported perceived discrimination based on sexual orientation were found to report significantly more depressive symptoms and suicidal ideation compared to their heterosexual counterparts (Almeida, Johnson, Corliss, Molnar, & Azrael, 2009). Perceived stigma due to homeless status was associated with sexual orientation and also related to negative psychological well-being among homeless youths (Kidd, 2007). Our study expands on previous research by testing predictors of compromised mental health in a targeted sample of Black homeless youth.

Methods: This study utilized a cross-sectional research design with structured face-to-face interviews of a convenience sample of 89 black homeless youths aged 16-24 years (M=20.06, SD=2.06). Data was collected between October 2012 and October 2013. We measured psychological well-being using:  (1) the Center for Epidemiologic Studies Depression Scale (CES-D) and (2) suicidality as measured by a three-item index constructed from items regarding suicidal thoughts, planning, and suicide attempts. Respondent characteristics included sexual identity, history of trauma, and homelessness severity. Homeless stigma was measured using a 13-item social stigma scale and racial and GLB discrimination were measured using 7- and 13-item scales from the Alcohol Use Disorder and Associated Disabilities Interview Schedule–IV (AUDADIS-IV). After completing bivariate tests, we defined a path model and tested for direct and indirect effects of respondent characteristics on psychological well-being, with experiences of stigma and discrimination entered into separate models as mediators. 

Results:  Results showed significant associations between respondent characteristics and psychological well-being. Reporting a sexual identity other than heterosexual (n=44), a history of trauma, and sleeping on the street were positively associated with depressive symptoms and suicidality. Endorsing experiences of homelessness stigma, racial discrimination, and GLB discrimination were independently positively associated with depressive symptoms, though only homelessness stigma was associated with suicidality after controlling for discrimination. Results of meditational analyses showed that while 30% of the association between sleeping on the street and depressive symptoms was explained by homelessness stigma, it explained 60% of the association with suicidality. Approximately 70% of the association between sexual identity and depressive symptoms was explained by experiencing GLB stigma, though discrimination did not mediate the pathway between sexual identity and suicidality. Although the experience of racial discrimination did not act as a mediator, it remained an independent predictor of depressive symptoms and suicidality after controlling for respondent characteristics.    

Implications: The impact of stigma related to being homeless may suggest that housing first as an intervention may reduce the negative impact that homelessness has on mental health. The most appropriate interventions would be systemic and aimed at reducing the experiences of discrimination of this population. Future research should take into account multiple minority status and how their health is impacted by stigma and discrimination related to multiple stigmatized identities.