Behavioral Health Improvements Over Time among Adults in Families Experiencing Homelessness

This series of research briefs explores issues of family homelessness that are especially relevant to HHS, to state and local decision makers, and for programs. The Behavioral Health Improvements Over Time among Adults in Families Experiencing Homelessness brief explores parents’ behavioral health at the time the family was in emergency shelter and at 20 and 37 months after experiencing homelessness. This new brief examines psychological distress, alcohol dependence, drug abuse, and symptoms of post-traumatic stress disorder; examines what family characteristics and experiences prior to shelter were associated with behavioral health problems and changes over time; and examines the relationship between housing instability and behavioral health 37 months after a shelter stay.

• Parents in homeless shelters reported that they had high levels of behavioral health problems, including psychological distress, alcohol dependence, drug abuse, and symptoms of post-traumatic stress disorder (PTSD).
• All of these problems diminished over the next 37 months, with the exception of PTSD symptoms, which were unchanged.
• Family characteristics and experiences prior to entering shelters were associated with both initial levels of behavioral health problems and changes over time, with parents with the greatest levels of distress at the time they were in emergency shelters experiencing the largest improvements over time.
• Parents who had been in foster care as children or had experienced intimate partner violence as adults had greater psychological distress at the time of shelter entry than parents without those characteristics.
• Over the next 37 months, the behavioral health of parents who had attained housing stability improved more than the behavioral health of parents who had continued experiences of homelessness or doubling up.

This research brief takes advantage of data collected for the Family Options Study, sponsored by the U.S. Department of Housing and Urban Development. The study involves 2,282 homeless families with children who entered shelter in one of twelve communities across the country. To provide the strongest possible evidence of the effects of the housing and services interven­tions, the study uses an experimental research design with random assignment of families to one of the types of housing programs or to a control group.

While the Family Options Study sample is not nationally representa­tive, it has broad geographic coverage; and study families are similar in age and gender of parents, number and ages of children, and race and ethnicity to nationally representative samples of sheltered homeless families. Therefore, it is a good sample for studying the experience of families that have an episode of homelessness. The study followed the families over the next 37 months and surveyed them again 20 and 37 months after random assignment, collecting a rich set of information about changes to the employment, sources of income, use of benefit programs, and further episodes of homelessness.

The analysis conducted for this brief does not use the experimental design of the Family Options Study. Instead, it explores the behavioral health of mothers and fathers in families during and after a stay in emergency shelter, regardless of the intervention to which their families were randomly assigned. The analysis includes 1,866 mothers and 154 fathers who responded to either the 20-month survey or the 37-month survey. For families with two adults, the analysis includes information only on the mother’s behavioral health problems. The study interviewed the mother by preference in the baseline and both follow-up surveys because the study included parent reports on children, and children are more likely to stay with mothers if parents become separated.