UCSF study examines link between childhood adversities, homelessness

Negative childhood experiences like abuse or neglect are largely associated with the mental health outcomes of older homeless adults.

That’s according to a new report by UC San Francisco released Wednesday that chronicled 350 homeless adults over the age of 50 living in Oakland between July 2013 and June 2014.

While it’s difficult to completely attribute homelessness to adverse childhood experiences, the study revealed that the frequency of such experiences as a child directly related to depressive symptoms later in life and a person’s history of suicide attempts and psychiatric hospitalizations.

“We can’t provide causality, but [what we saw was] an amazingly strong association between the number of early childhood adversities and your current mental health outcomes,” said Dr. Margot Kushel, a professor of medicine and senior author on the study that was published in the American Journal of Geriatric Psychiatry.

The study asked participants about seven categories of negative childhood events: neglect, verbal abuse, physical abuse, sexual abuse, the death of a parent, parental incarceration and placement in the child welfare system.

Those who experienced multiple negative events were determined to be more likely to suffer from depression, Kushel explained.

“For instance, having one childhood adversity [means] you have two times the odds of having moderate to severe depression today than people who had zero,” she said.

Straying from the norm in the ways they collected data, researchers sought out participants who live in encampments, sidewalks or homeless shelters rather than people in health care settings or those receiving other services.

“It was really important to us to include people who … may not use services,” Kushel said.

While the study’s participants live in Oakland, Kushel noted the findings could translate to homeless residents in San Francisco and throughout the U.S.

San Francisco has especially come under the national spotlight for its homeless population, which has reportedly hovered between 6,000 and 7,000 for at least the past five years.

In fact, combating that population estimate is the primary goal of San Francisco’s new Department of Homelessness and Supportive Housing. Jeff Kositsky, the department’s director, spelled out the timeline to achieve that goal at a Health Commission meeting Tuesday.

The department hopes to end chronic homelessness among veterans by 2017, according to Kositsky. The following year, the list of “high users of multiple systems” is expected to be cut in half; by 2019, the goal is to end family homelessness. And by 2020, the department hopes to end homelessness for 8,000 people.

Finding ways to prevent homelessness and better coordinating services and city departments are two efforts Kositsky believes will help reach those goals.

“Where we have fallen behind, I think, in other communities is how these services are all coordinated and how clients are provided services and how we prioritize our resources,” Kositsky said.

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