The past few years have seen an increased interest in studies of mental illness among homeless populations. Some mental illness may be attributed to homelessness (Morrissey & Dennis, 1986), and the deinstitutionalization of the mentally ill has led to many becoming homeless (Reich & Siegel, 1978). The stresses of homelessness and the lack of support systems mean that the homeless are constantly threatened psychologically as well as physically (La Gory et al., 1990; Rossi et al., 1987; Radford et al., 1989). Several studies have determined that the rate of depression is greater among the homeless in general (Burnam & Koegel, 1988; Rossi et al., 1987), but few studies have been undertaken on homeless or street youth. None of those that are available provide detailed information on the predictors of depression. This paper presents the results of a study of factors related to depression among street youth in Toronto, Canada.
Depression and other psychiatric problems among the homeless or street population have been studied in several cities. These studies show that homeless, bowery, or shelter populations have high rates of psychiatric problems. Fischer (1989) reviewed 75 studies of psychiatric status in homeless populations conducted since 1980 and found that the rates of psychiatric problems varied between 10% and 90%, but the mean seemed to be around 50%. Almost all of these studies involved adults, and few focused on depression, the most common psychiatric problem. Vernez et al. (1988) found that 22% of the homeless adults in three areas of California had a major affective disorder. Hier et al. (1990) researched social adjustment and symptomatology among 52 runaway and throwaway adolescents in Brisbane, Australia. Clinical levels of depression were found for both types of homeless adolescents. La Gory et al. (1990) studied depression among homeless adults in Alabama. Almost 60% showed the signs of "probable clinical caseness" on the Center for Epidemiological Studies Depression Scale. Depression was greater among younger persons, those who had experienced more undesirable life events and more hospitalizations for mental illness, and those with fewer social supports. Alcohol and drug problems were not included as variables in that study, although many studies have shown them to be common among the homeless (Fischer, 1989).
Several studies have shown that depression and substance abuse are related among adolescents in general and in college and school populations. Crumley (1990) reviewed studies of adolescent substance abuse and suicide and found that the degree of association varied from one study to another, but up to 43% of actual suicides among adolescents were related to substance abuse. Levy and Deykin (1989) found that major depression and substance abuse were independent and interactive risk factors for suicide in college students.
In some studies, high levels of depression and suicidal ideation have been found among homeless youth. Robertson et al. (1989) noted that 26% of street youth in Hollywood were depressed, based on DSM-III criteria as assessed by the Diagnostic Interview Schedule. Radford et al. (1989), in a study in Canada, also found that about a quarter of street youth had suicidal thoughts. Neither of these studies analyzed the factors related to depression, such as drug abuse. However, Stiffman (1989) studied lifetime suicide attempts among runaway youth seen at shelters in St. Louis, finding that suicide attempts were related to sex (female), substance abuse, negative life events, running away, behavior problems, and family instability, but not to coping ability. No measures of alcohol or drug problems were used, but scores on a composite drug-use variable were positively related to suicide attempts.
The present paper reports the results of a study of current depression among street youth in Toronto. It attempts to extend knowledge of this group by examining the association of depression with alcohol and drug use and related problems, social supports, self-esteem, family background, and alcohol and drug use among family members. …