311 - Baseline Characteristics of Sleep-related Impairment and Mental Health Comorbidity among Youth Experiencing Homelessness: The HOME Trial

Poster Number: 311
Publication Number: 311.2260

Background: Approximately 12.5% of youth aged 18-25, and a higher proportion of those who are racially and gender-minoritized, experience homelessness, which elevates risks of substance use and mental health challenges. Unsafe sleep environments further contribute to poor sleep, and are linked to depression, suicide, and substance use. Little research explores the comorbidity of sleep deficiency and psychiatric conditions among youth experiencing homelessness (YEH).

Objective: This study assesses baseline measures of sleep impairment and mental health symptoms among youth participating in a Housing First intervention trial.

Design/Methods: A baseline sample of 240 YEH, 75.0% Black or Multiracial and aged 18-24 years, was included from the randomized clinical trial: housing, opportunities, motivation, and engagement (HOME). HOME aims to address the opioid crisis among YEH through housing and strength-based preventative services. Participants completed baseline visits from June 2020 to March 2023. Outcomes included sleep-related impairment, which was self-reported using Patient-Reported Outcomes Measurement Information System (PROMIS) at baseline, 3-month, and 6-month follow-up visits. We report on the prevalence of sleep-related impairment, prior diagnosis of mental health conditions, and suicide risk.

Results: About 61.3% of youth reported parents with a history of homelessness. All youth experienced homelessness at baseline, with 48.0% reporting sleep-related impairment. The sample exhibited substantial mental health comorbidity, with 26.7% reporting high risk for suicide and a large proportion reporting prior diagnosis of psychiatric conditions, 33.8%, 28.3%, and 23.3% for major depressive, generalized anxiety and bipolar disorders, respectively.

Conclusion(s): This study examines sleep health patterns in a predominantly Black, transition-aged YEH sample. Close to half of YEH in the study had sleep-related impairment and a substantial number had comorbid psychiatric conditions. With exacerbated racial disparities in homelessness and sleep due to the COVID-19 pandemic and structural racism, housing could be a prevention tool to improve sleep health equity in this high-risk population. Affordable and safe housing policies are essential to address housing needs among transition-age YEH. But also, future work could explore what additional supports are needed alongside housing. Given the level of youth psychiatric comorbidity among YEH, housing alone may not be sufficient to improve outcomes.