Homeless kids face mental health risks

The tensions facing their families can create a wide range of behaviors in children, some of which can be misinterpreted.

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Ben Danielson, M.D., is medical director of the Odessa Brown Children’s Clinic of Seattle Children’s Hospital.

The tensions facing their families can create a wide range of behaviors in children, some of which can be misinterpreted.

The truest victims of homelessness are young children, who have no control over the decisions that put them there, and no power to change their circumstances.

The typical homeless families in the country are headed by young women in their 20s, typically with two children. Nearly half those kids are under age five.

The consequences of homelessness can be devastating and long-lasting for young children. By age 8, one in three homeless children has a mental health problem that affects their functioning, said Karen Hudson, social worker with Children’s Hospital of Philadelphia and a national expert on homeless children.

More than three-quarters of homeless children under age 5 have developmental delays. And nearly 40 percent exhibit emotional and behavioral problems, she said.  These early problems can set the stage for problems, including homelessness, later in life. Surveys have noted that more than one-quarter of homeless adults experienced homelessness when they were young.

Children who lack stable housing face a host of challenges that stress their developing systems, including lack of sleep, hunger, fear, and increased levels of stress hormones such as cortisol, which can wreak havoc on young brains.

Sleep deprivation or disruption can make a child look and behave as though they have severe behavioral problems such as oppositional defiant disorder, said Dr. Ben Danielson, medical director of the Odessa Brown Children’s Clinic of Seattle Children’s Hospital.

The symptoms that result from the stress of homelessness, can include anxiety, depression, extreme withdrawal, poor concentration or various forms of “acting out,” such as tantrums.

“We see attachment disorders, big time,” said Danielson.

Serious mental problems can go untreated because they are difficult to diagnose.

“Depression can look a lot different in kids,” said Danielson. “A child might not say, ‘I’m depressed,’ but might have real problems sustaining relationships with friend and performing in school.”

Children go through specific developmental stages between birth and 5. Those stages prepare their minds for learning, said Jill Klenota, who supervises parent child services for Wellspring Family Services, a Seattle-based nonprofit that works with homeless families.

“We have mothers living in motels by themselves, suffering PTSD,” she said. “They’re terrified. The question becomes how does the mother attend to a baby under those circumstances?”

Most homeless families have experienced trauma. The majority of homeless women are victims of violence, and one-third of mothers have Post Traumatic Stress Disorder, three-times rate of general female population, she said. More than 50 percent experience major depressive episode while homeless.

Under these circumstances, the brains of babies flood with the stress hormone, cortisol.

If the crisis is happening when a child is a toddler, they may act out more in the form of more frequent or extreme tantrums or defiant, challenging behavior.

Older children may become highly introverted. “They may be shy, reserved, quiet, making no trouble,” said Burr-Chellin. “Essentially they are trying to be invisible.”

Often the first sign of trouble is when the family’s life seems to be improving.

Klenota recently worked with a family where the child started shoplifting after the mom had gotten into housing. Now that the child feels safer, she’s acting out. “She’s showing she’s still a troubled 8-year-old.”

Therapists at Wellspring and elsewhere emphasized working with the whole family as a way to help children get back on track. Helping parents see what’s keeping them from meeting their children’s needs, and how to change their own behavior is one step. They often need help understanding normal child behavior and development and practice with parenting skills.

Building confidence is critical.

Parents who are homeless are often demoralized and depressed, said said Judy Burr-Chellin, director of Parent/Child Services for Wellspring. “But no matter what, they are still the most important person in their child’s life.”


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