Homeless Teens at Increased Risk for Suicide, Substance Use

Adolescents of color and teens who identify as gay, lesbian, or bisexual are much more likely to experience homelessness, a new study suggests.

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Teens who experienced homelessness were more than twice as likely to seriously consider, plan, or attempt suicide.Getty Images

More than 1 in 20 U.S. high school students have experienced homelessness, putting them at increased risk for a wide range of mental health and substance use problems, a new study suggests.

As of 2019, before the COVID-19 pandemic shuttered schools and created an avalanche of emotional and financial challenges for American families, 5.6 percent of U.S. high school students were homeless, the study found. Youths without housing were significantly more likely to be male, Black, Hispanic, or identify as gay or lesbian, researchers report yesterday in JAMA.

Compared with teens with secure housing, those who experienced homelessness were more than twice as likely to seriously consider, plan, or attempt suicide, the study found. Homeless teens were also more than twice as likely to binge drink or misuse prescription opioids, and roughly 13 times more likely to use heroin, approximately 8 times more likely to use cocaine, about 7 times more prone to using methamphetamine or injected drugs, and more than 5 times more likely to use ecstasy.

“Our study found that homeless adolescents experienced significantly worse mental health and more substance use than their housed counterparts,” senior study author Rishi Wadhera, MD, of Beth Israel Deaconess Medical in Boston, said in a statement.

For the study, researchers examined data from the National Youth Behavior Survey, which high school students can complete voluntarily and anonymously. Overall, the study included data on almost 106,000 teens who had secure housing and roughly 4,500 adolescents who experienced homelessness, which researchers defined as lacking a “fixed, regular, or adequate nighttime residence.”

One limitation of the study is the possibility that it underestimated the disproportionate burden of homelessness among LGBTQ+ youth because most high school students left questions about their sexual orientation and gender identity blank. Another drawback is that researchers lacked data on whether homeless teens were on their own or living with a family.

Beyond this, it’s likely that the problem has only gotten worse since the start of the pandemic, Dr. Wadhera said.

“The U.S. is facing a youth homelessness crisis, which will only be exacerbated by challenges presented by the COVID-19 pandemic, including parental deaths, housing evictions, and worsening poverty,” Wadhera said. “We need to implement policies and interventions that improve broad health, social, and educational outcomes among homeless adolescents, and perhaps more importantly, prevent and end adolescent homelessness altogether.”