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Comment & Response
September 2016

An Important Cause of Child and Youth Homelessness—Reply

Author Affiliations
  • 1Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 2Division of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
  • 3Moi University, College of Health Sciences, School of Medicine, Eldoret, Kenya
  • 4Indiana University, Fairbanks School of Public Health, Indianapolis
  • 5Regenstrief Institute Inc, Indianapolis, Indiana
JAMA Pediatr. 2016;170(9):909-910. doi:10.1001/jamapediatrics.2016.1390

In Reply We thank the authors for their thoughtful letter and for identifying a major issue not well addressed in the literature about child and youth street involvement: mental health. Without a doubt, mental illness and poor psychosocial health affect children and youths who find themselves homeless. Children and youths connected to the street have a multitude of detrimental health outcomes, and we and others have found that even compared with other extremely vulnerable children, they are more likely to have posttraumatic stress disorder.13 Their life circumstances before and after the onset of homelessness likely contribute to serious mental health morbidity, particularly posttraumatic stress disorder, anxiety, feelings of hopelessness, depression, and substance use and addiction.1,2,4 These sequelae may be a result of physical and/or sexual abuse, maltreatment, and/or neglect sustained at home that ultimately led to their street involvement, as well as a result of the often violent and oppressive nature of life on the streets.

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