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Young people: health risks

Young homeless people have health needs related to mental and eating disorders, malnourishment, drug/alcohol abuse, sexual health, and other acute (short term) or chronic (long term) problems. Health care workers can advocate for a young person in a generalist service (for example a hospital) or by referring to a specialist service for young people.

Depression. Mental ill-health amongst homeless youth is about ten times the rate of that found in normal adolescents, and is both a cause and a consequence of homelessness. Amongst homeless youth who suffer depression, symptoms can differ from those experienced by adults. Also, the young person may not have the experience to recognise their feelings as depression. Common symptoms are low motivation, boredom, daytime sleepiness and increased eating. Sufferers may be aggressive and abusive. They may inflict harm upon themselves, and may be involved with drugs.

Self-mutilation / Slashing. These acts can stem from increasing self-hatred and depression, unresolved anger, aggression and powerlessness, causing tension and loss of control. Mutilation relieves the tension and allows some control to be regained over the emotions. Feelings of guilt and worthlessness follow, further lowering self-esteem. Working with these young people requires the establishment of trust, the recognition of feelings which are present, and the identification of alternative methods for coping with these feelings and thus achieving positive release.

Drug / Alcohol abuse. Tobacco, alcohol, minor tranquillisers (see "The 'Pams'") and other prescription drugs, as well as over-the-counter and illicit drugs, are used by many homeless young people. Intentional and unintentional overdose is common. Harm minimisation works through advice on safer drug and needle use, and needle exchange. Give advice about drugs and their effects (for side effects of psychiatric drugs see 'Psychiatric drugs'), and about drug and alcohol services. Support and encourage, but be realistic. Work with the young person's goals and expectations, recognising that unfortunately these may not be your own preferred goals for this person.