Encampment Sweeps, Mental Health, and Sleep Quality Among People Experiencing Homelessness in Los Angeles County

Background: Los Angeles County faces one of the most severe homelessness crises in the United States, with encampment sweeps significantly impacting people experiencing homelessness (PEH). Qualitative literature has highlighted the traumatic experience of encampment sweeps in causing heightened psychological distress among PEH, which may lead to poor sleep quality. Since 2024, California has implemented strict anti-camping laws, which could exacerbate the already heightened stress experienced by PEH.

Our study examined the relationships among the cumulated exposure to encampment sweeps, concerns about anti-camping law, psychological distress, and sleep quality using mediation analysis. We proposed two hypotheses: (1) accumulated experiences of sweeps would be positively associated with heightened concerns about camping laws, higher psychological distress, and lower sleep quality; and (2) the accumulated effect of encampment sweeps (X) will be associated with lower sleep quality (Y) through a sequential mediation process: first, via higher concerns regarding the camping law (M₁), which in turn elevates psychological distress (M₂), ultimately leading to poor sleep quality.

Methods: Cross-sectional data were derived from 917 respondents in the Periodic Assessment of Trajectories of Housing Study (PATHS), an ongoing cohort of unsheltered PEH in Los Angeles County. Responses for the total number of sweeps experienced were obtained to indicate accumulated sweeps experienced. Three items, “feel nervous or anxious,” “may force me to move,” and “affect me personally,” were used to measure concerns about camping ordinances. Psychological distress was measured using PHQ-4. The participant indicated their sleep quality within the past week using a Likert-type scale, ranging from “very poor” to “very good.”

Results: Correlation analyses concluded that accumulated sweeps were associated with heightened concerns about camping laws (r = 0.17, p < .001), elevated psychological distress (r = 0.11, p < .05), and lower sleep quality (r = -0.08, p < .05). The overall mediation model was statistically significant, F(3,768) = 47.60, p < 0.001, R² = 0.157. The mediation analysis showed a significant indirect effect from accumulated sweeps to sleep quality through concerns about anti-camping law and psychological distress (X -> M₁ -> M₂ -> Y), Effect = -0.016, 95% CI [-0.026; -0.009]. The indirect effect through concerns about anti-camping law was also significant (X -> M₁ -> Y), Effect = -0.017, 95% CI [-0.033; -0.003]. These findings indicated that repeated exposure to sweeps contributes to perpetual concerns regarding anti-camping policies and worsening mental health outcomes, leading to poor sleep quality among PEH.

Conclusion and Implications: Our study explored the adverse psychological effects of enforcement-driven policies, which lead to poor sleep quality among PEH. The results highlight the need for trauma-informed, housing-first interventions to mitigate mental distress and promote stability among PEH. Policymakers and administrators should embrace trauma-informed policies that emphasize voluntary relocation and comprehensive support services. Future research should prioritize longitudinal approaches and comparative evaluations of alternative programs to encampment sweeps, such as encampment resolution strategies and to inform equitable solutions to end homelessness.