(WITHDRAWN) Youth Service Engagement Among Housed and Unhoused Young Adults: The Role of Emotional Regulation

Background: Many young adults with history of homelessness have experienced trauma that contributes to elevated rates of mental health issues, including increased difficulty with emotional regulation. Such difficulties in emotional regulation has the potential to negatively impact the development of relationships with service providers, and thus impede access to needed services. This study seeks to examine differences in emotional regulation among housed and unhoused young adults and which aspects of emotional regulation may be associated with youth service engagement.

Methods: Data come from a study of HIV risk among young adults who have experienced homelessness, funded by the National Institute of Mental Health. 265 currently or previously homeless young adults ages 18-29 were recruited from drop-in centers (unhoused) or supportive housing programs (housed) located in Los Angeles, CA between June 2017 and March 2019. Six separate Logistic Regression Models assessed the association of demographics, controlling for substance use, and sub-scales of the Difficulties in Emotional Regulation Scale (DERS-18), including awareness, clarity, goals, nonacceptance, impulse, and strategy, with service engagement outcomes (development of positive and supportive relationships and knowledge about accessing housing, shelters, drop-ins, and treatment). Chi-square and t-tests examined differences in DERS scores and service use items among currently homeless participants and those who now have housing.

Findings: Results indicate significant differences in the development of at least one positive relationship with youth service staff person between housed (84.9%) and unhoused (75%) young adults. Young adults who identify as gender non-conforming experienced, on average, 75% lower odds of knowing how to access housing and treatment (medical, mental health, or substance use). Increased lack of awareness of one’s feelings and emotions or inattention to one’s emotional response was also associated with decreased odds of knowing how to access housing, shelter, drop-in services, and treatment. Young adults who scored higher in impulse, indicating greater struggle to control behavior when upset, was associated with a decreased in the odds of having identified someone in the youth service system that can offer support when needed. Finally, a lack of emotional awareness, greater difficulty in impulse control, and a nonacceptance of emotional responses that often reflect a tendency toward negative secondary responses to negative emotions and/or denial of distress was associated with decreased odds of these young adults having developed at least one positive relationship with a youth service staff person.

Discussion: Present findings suggest that housed and unhoused young adults differ in their emotional regulation capacities and specific aspects of emotional regulation are associated with different stressors. These results have implications for homeless youth service providers and potentially others who work with at-risk young people. Supporting at-risk young adults in the development of these specific skills of emotional regulation may aid them in developing the relationships that are necessary to access needed services; as well as support in maximizing the impact of resources spent on youth services.