Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Comparisons of Substance Abuse, High-Risk Sexual Behavior and Depressive Symptoms among Homeless Youth with and without a History of Foster Care Placement

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Comparisons of Substance Abuse, High-Risk Sexual Behavior and Depressive Symptoms among Homeless Youth with and without a History of Foster Care Placement

Article excerpt

Homelessness, 2009). These young people are at risk for substance abuse, poverty, and severe mental illness; many never reconnect permanently with their biological family and often end up homeless (National Alliance to End Homelessness, 2009). We know very little about homeless former foster youth. It is known that homeless youth, in general, report barriers to drug seeking treatment, non-empathic mental health providers, and limited clinic sites (Hudson et al., 2009, 2010). We also know that 3% of the general population, who are not homeless, report a history of living in foster care, whereas the percent of homeless person with a foster care history can be as much as 19-27% (Park, Metraux, Brodbar, & Culhane, 2004; Piliavin, Sosin, Westerfelt, & Matuseda, 1993). Pecora et al. (2003) also found that 22% (N = 1,084) of transition-age foster youth were homeless for one or more nights within a year of leaving foster care.

BACKGROUND

The only study we found linking homeless youth and foster care was conducted by Martin et al. (2009). They explored homelessness with specific types of substances used, along with violence in a cohort of 478 street-involved youths in Vancouver, Canada. Among their sample of participants, 128 (51.6%) were in foster care at some point in their lifetime. Prevalent substances were cocaine, crack, heroin, and methamphetamine; however, authors did not report specific substance use among participants with a foster care history.

We are much more informed of mental health issues, sexual risk behaviors, and substance use among youth living in foster care. Using a nationally representative sample of US adolescents, Pilowsky and Wu (2006) found that adolescents in foster care had significantly more psychiatric symptoms, such as suicide ideation, were more likely to use alcohol, and were almost five times more likely to abuse substances than adolescents without a foster care history. Similarly, Jee et al. (2011) identified twice as many foster youth with social-emotional problems (emotional, conduct disorder, hyperactivity/ inattention), compared to non-foster care youth, when using a brief screening instrument compared to baseline verbal questioning of mood.

As they are at risk for negative psychological outcomes, foster youth also are at risk for engaging in risky sexual behaviors. Female adolescents in foster care, ages 15-18, are more likely to engage in unprotected sex compared to males (Thompson & Auslander, 2011). Among 167 adolescents in foster care, there was a significant relationship between severity of sexual abuse and HIV risk behaviors (Elze, Auslander, McMillen, Edmond, & Thompson, 2001). Risley-Curtiss (1997) explored prevalence of reported sexual activity among 846 foster care children/adolescents, ages 8-18. Children as young as eight years of age reported being sexually active; and more than one-third of those ages 8-18 reported sexual activity and non-use of contraception or protection from sexually transmitted infections.

Another high-risk activity is substance use. Kohlenberg et al. (2002) found that 34% of 231 adolescent respondents in foster care aged 12-17 had used alcohol at least once within the last year and 13% reported using alcohol within the last month. Approximately 20-50% of adolescents in foster care reported using alcohol and other substances while in care and continued use after leaving care (Taussig, Clyman, & Landsverk, 2001). Alcohol and marijuana were the most commonly used substances among foster youth (Thompson & Auslander, 2011).

Although little is known about differences in substance use or sexual risk behaviors among homeless former foster youth, alcohol and illicit substance use among homeless youth, in general, is well documented. The prevalence of substance use and alcohol use, ever, in a Denver cohort of 186 homeless youth and young adults (Van Leeuwen et al., 2004) was alcohol (69%), marijuana (75%), methamphetamine (18%), cocaine (19%), heroin (12%), hallucinogens (30%), and ecstasy (25%). …

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