Adverse childhood experiences and related outcomes among adults experiencing homelessness

People who are homeless experience significant physical, mental and social challenges that are linked with poor health and functioning. Rates of substance use issues, mental health difficulties, injury and chronic disease are significantly higher among people who are homeless compared to people who have secure housing.

It is recognised that adverse childhood experiences (ACEs), which include early trauma such as abuse, neglect or domestic violence, are strong risk factors for homelessness.

This systematic review and meta-analysis, published in The Lancet Public Health, analyses the prevalence of ACEs and their associations with health-related issues and functioning among homeless adults.

Findings

• The lifetime prevalence of one or more ACEs among homeless adults was 89·8%
• The lifetime prevalence of four or more ACEs was 53·9%
• ACEs were consistently linked with high suicidality, major depressive disorder, substance use, and adult victimisation.

Given the striking results, the authors suggest that policy efforts and interventions designed to reduce ACEs are urgently needed. They also recommend that anyone working with this population should be trained in trauma-informed care.