Homeless youth who identity as lesbian, gay, bisexual, transgender, or queer (LGBTQ) face considerable issues including victimization, mental health needs, and substance use, yet are less likely than their heterosexual, cisgender homeless peers to utilize services. Although research in this area is growing, studies are largely cross-sectional and tend to focus on the experiences and service use of homeless youth in drop-in or emergency shelters, instead of longer-term transitional living programs (TLPs). Therefore, the purpose of this study was two-fold: 1) to examine the differences in sociodemographic characteristics, victimization, mental health and substance use histories, and service utilization patterns by LGBTQ identity of homeless youth in a TLP, and 2) explore the relationships between their LGBTQ identity, service utilization, and mental health and substance use impairment over time. This study used secondary longitudinal data, which I extracted from the closed case files of runaway and homeless youth (N = 101) between the ages of 16 and 20 who accessed services in a mid-Michigan TLP between 2011 and 2018. I used independent sample t-tests and Chi-square to assess differences by LGBTQ identity in sociodemographic characteristics, victimization, mental health, and substance use histories. I used multilevel modeling (MLM) to examine the relationship between LGBTQ identity, service utilization and mental health and substance use impairment over time. LGBTQ homeless youth in this sample were more likely than their heterosexual, cisgender homeless peers to identity as female, report being sexually victimized, and have greater mental health-related issues. Overall, youth underutilized available services, but LGBTQ youth had higher mental health impairment at intake and their use of services did not reflect this difference. LGBTQ identity was associated with increased mental health impairment at intake, but not substance use impairment at intake. LGBTQ identity was not associated with a change in mental health or substance use impairment over time. Number of months in the program was inversely related to mental health and substance use impairment over time, regardless of LGBTQ identity. Utilization of substance use treatment was associated with a decrease in mental health and substance use impairment over time for all youth. Finally, average number of clinical sessions per week was inversely related to substance use impairment over time for both LGBTQ and non-LGBTQ youth, but no relationship was found between average number of clinical sessions per week and mental health impairment over time. The findings from this exploratory study confirm the vulnerability of LGBTQ homeless youth in TLPs and provide essential information regarding service utilization for homeless youth practitioners and policy makers including the need for trauma-informed and LGBTQ-specific services. Additionally, the data suggest that service providers must engage and encourage youth participation in services that are offered within TLPs. Future studies should include larger and more diverse samples of homeless LGBTQ youth in TLPs, examine youth experiences sequentially in relation to identity disclosure, and include youth perception of the usefulness of services within TLPs.
Read
