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Presenter: M. Rosa Solorio, M.D., MPH, David Geffen School of Medicine at UCLA
Discussant/Mentor: Marvin Karno, M.D., UCLA

Emotional Distress and Mental Health Service Use among Urban Homeless Adolescents

Authors: M. Rosa Solorio, Norweeta G. Milburn, Ronald M. Andersen, Sharone Trifskin,
    Michael A. Rodriguez

Background: 
Homeless youth have high rates of mental health problems such as depression.  Depression among homeless adolescents is associated with risky sexual behaviors and substance use.  An important policy issue is that while need is associated with utilization of services, there is a large amount of evaluated need for mental health services in the homeless adolescent population that does not lead to service use.   

Purpose: 
To use the Expanded Behavioral Model for Vulnerable Populations to examine predisposing, enabling, and need factors associated with mental health service use in a homeless adolescent sample.   

Results: 
Our homeless adolescent sample (N = 688) included 35% Hispanics and 52% were males.  Among all homeless youth (N = 688), 32% perceived a need for help with mental health problems and 15% met Brief-Symptom Inventory (BSI) criteria for emotional distress.  The rate of mental health service use in our sample was 32%.  We found one enabling factor, having a case-manager/discussed mental health concerns [OR 2.9, 95% CI 1.8-4.8] and one need factor, met criteria for BSI [OR 3.9, 95% CI 2.2-6.7] to be associated with mental health service use in the past three months.  The majority of youth who used mental health services had obtained services from crisis centers.  Among those who perceived a need for help with mental health problems but who did not use services, the most common barrier was not knowing where to go or what service to use (57%). 

Conclusions: 
Our findings suggest that due to the high prevalence of mental health problems among homeless youth, it would be helpful for service providers coming into contact with youth to make them aware of existing community resources for mental health services; making youth aware of these resources may in turn decrease the rate of crisis center use and instead allow youth to receive mental health services in outpatient settings that provide continuity of care.