Homeless youth in London: II. Accommodation, employment and health outcomes at 1 year

Background. While there is considerable evidence of a high prevalence of ps ychiatric disorder among homeless youth, much less is known about its long- term course or the impact it may have on accommodation outcomes. Method. A random sample of 161 homeless people 16-21 years of age were recr uited from consecutive attendees at two of London's largest facilities for homeless young people. These young people were traced and re-interviewed a year later to examine accommodation, occupation and health outcomes. Results. A total of 107 (67%) people were successfully re-interviewed. Psyc hiatric disorder was identified in 55% at follow up. Two thirds of those wi th a psychiatric disorder at index interview remained symptomatic at follow -up. Persistence of psychiatric disorder was associated with adverse childh ood experiences and rough sleeping. Satisfactory accommodation outcomes wer e achieved by 45 subjects (42 %). Better accommodation outcomes were associ ated with three variables measured at the index assessment: ethnic minority status; educational achievement; and, the presence of accommodation plans negotiated through a resettlement agency. While psychiatric disorder at ind ex interview was not associated with accommodation outcome, persistent subs tance use in the follow-up year was associated with poor accommodation outc ome. Over half of the young people had been involved in petty crime and jus t under a third had been convicted for more serious criminal activity. Offe nding and antisocial behaviour in the follow-up year were related to a hist ory of conduct disorder, persistent substance abuse and poor accommodation outcomes. Conclusions. Young homeless people are characterized try multiple social an d medical needs. Successful resettlement of this population may depend upon integrated services that address problems of persisting substance use and mental illness as well as the immediate housing need.