Missed Opportunities: Childhood Learning Disabilities as Early Indicators of Risk among Homeless Adults with Mental Illness in Vancouver, British Columbia

Missed Opportunities: Childhood Learning Disabilities as Early Indicators of Risk among Homeless Adults with Mental Illness in Vancouver, British Columbia

This study examines self-reported learning disabilities (LD) in childhood as predictors of duration of homelessness, mental and substance use disorders, physical health, and service utilisation in a sample of homeless adults with current mental illness (Authors).

OBJECTIVES:

It is well documented that early-learningproblems and poor academic achievement adversely impact childdevelopment and a wide range of adult outcomes; however, theseindicators have received scant attention among homeless adults. Thisstudy examines self-reported learning disabilities (LD) in childhood aspredictors of duration of homelessness, mental and substance usedisorders, physical health, and service utilisation in a sample ofhomeless adults with current mental illness.

DESIGN:

This study was conducted using the baseline sample from a randomised controlled trial (RCT).

SETTING:

Participants were sampled from the community in Vancouver, British Columbia.

PARTICIPANTS:

Thetotal sample included 497 adult participants who met criteria forabsolute homelessness or precarious housing and a current mentaldisorder based on a structured diagnostic interview. Learningdisabilities in childhood were assessed by asking adult participantswhether they thought they had an LD in childhood and if anyone had toldthem they had an LD. Only participants who responded positively to bothquestions (n=133) were included in the analyses.

OUTCOME MEASURES:

Primaryoutcomes include current mental disorders, substance use disorders,physical health, service utilisation and duration of homelessness.

RESULTS:

Inmultivariable regression models, self-reported LD during childhoodindependently predicted self-reported educational attainment andlifetime duration of homelessness as well as a range of mental health,physical health and substance use problems, but did not predict reportedhealth or justice service utilisation.

CONCLUSIONS:

Childhoodlearning problems are overrepresented among homeless adults withcomplex comorbidities and long histories of homelessness. Our findingsare consistent with a growing body of literature indicating that adversechildhood events are potent risk factors for a number of adult healthand psychiatric problems, including substance abuse. TRIALSREGISTRATION NUMBER: This trial has been registered with theInternational Standard Randomised Control Trial Number Register andassigned ISRCTN42520374 (Authors).

JOURNAL: BMJ Open
VOLUME: 2
ISSUE: 6
PAGES: 1-10
PUBLICATION DATE: 2012
LOCATION: Vancouver, British Columbia, Canada