The Relationship Between Victimization and Mental Health Functioning in Homeless Youth and Adults

Abstract

This study examined the relationship between victimization and mental health functioning in homeless individuals. Homeless populations experience higher levels of victimization than the general population, which in turn have a detrimental effect on their mental health. A sample of 304 homeless adults and youth completed one-on-one interviews, answering questions on mental health, past victimization, and recent victimization experiences. A hierarchical linear regression showed that experiences of childhood sexual abuse predicted lower mental health functioning after controlling for the sex and age of individuals. The study findings are applicable to current support programs for victims in the homeless population and are relevant to future research on homelessness and victimization.

Keywords

homelessness victimization mental health

Homelessness can be defined in many ways. Definitions may include individuals without housing, those staying in emergency shelters, sleeping rough, or those living temporarily with friends or family (Library of Parliament, 2008). Approximately 200,000 people experience being homeless in Canada each year (Gaetz, Donaldson, Richter, & Gulliver, 2013). In Ottawa, 7,308 individuals used emergency shelters in 2012 for an average of 68 days (Alliance to End Homelessness [ATEH], 2013). Of those individuals, 45% are single men, 15% are single women, 5% are youth, and 36% are families (ATEH, 2013).

Victimization in Homeless Populations

Research on homeless individuals has shown that they experience higher frequencies of victimization than the general population (Evenson, 2009; Goodman, Dutton, & Harris, 1997; Khandor & Mason, 2007; Whitbeck & Simons, 1990). A study conducted in four U.S. cities found that half of the homeless sample had been victimized (Simons, Whitbeck, & Bales, 1989). A Canadian study found 49% of homeless women and 16% of homeless men had experienced childhood sexual abuse, compared with 13% of housed women and 4% of housed men (Mental Health Policy Research Group, 1998). Another Canadian study specifically looking at homeless youth found that 24% had experienced sexual, physical, or emotional abuse, and 42% had grown up in a chaotic home environment (Evenson, 2009). While homeless, individuals are also vulnerable to being victimized. A Toronto study found that 35% of the sample had been physically assaulted and 7% (21% women) had been sexually assaulted in the previous year (Khandor & Mason, 2007).

Homelessness, Victimization, and Mental Health

The links between victimization and mental health have been well established in the literature. Several studies have linked victimization and depressive symptoms in child and adult samples (Abada, Hou, & Ram, 2008; Bartholow et al., 1994; Finkelhor, Ormrod, & Turner, 2007; Wenzel, Koegel, & Gelberg, 2000; Whitbeck, Hoyt, & Yoder, 1999). In homeless populations, victimization has also been linked to low levels of mental health. One study found higher rates of mental health problems in homeless men who have a history of trauma (Kim, Ford, Howard, & Bradford, 2010). Another study found that homeless youth who had experienced sexual abuse reported significantly more suicide attempts than youth who had not experienced abuse (Ryan, Kilmer, Cauce, Watanabe, & Hoyt, 2000). Also, homeless youth who reported experiences of physical and sexual abuse had higher rates of depression and dysthymia than youth who experienced only one type of abuse or none at all (Ryan et al., 2000). Research into victimized homeless women showed that victims had poorer psychological well-being and higher rates of depression, anxiety, and hostility than non-victims (Nyamathi, Wenzel, Lesser, Flaskerud, & Leake, 2001).

Moreover, homeless individuals have unique experiences that further influence their mental health. Several studies have found higher rates of victimization among homeless individuals compared with housed individuals (Evenson, 2009; Goodman et al., 1997; Khandor & Mason, 2007; Whitbeck & Simons, 1990). Mental health problems can also contribute to becoming homeless and reduce housing stability (Aubry, Klodawsky, & Coulombe, 2012; Aubry, Klodawsky, Nemiroff, Birnie, & Bonetta, 2007). Because of these unique trends in homeless populations, the correlation between victimization and mental health is likely to be different for homeless individuals than for the general population.

A significant gap in the literature is research on the characteristics of victimization experiences and their influence on mental health. The literature commonly defines victimization as the experience of physical, sexual, and emotional abuse. However, victimization can be defined by a wide range of experiences, including bullying, theft, and witnessing violence (Finkelhor et al., 2007; Finkelhor, Ormrod, Turner, & Hamby, 2005).

One study compared physical victimization (robbery by force, physical assault, sexual assault) and non-physical victimization (theft and threats with a weapon) as predictors of mental health in homeless individuals. They found that non-physical victimization was directly related to depressive symptoms but physical victimization was not (Perron, Alexander-Eitzman, Gillespie, & Pollio, 2008). However, this study considers neither the differences between physical and sexual victimization nor the gendered experiences of victimization. An older study on types of victimization reported increased symptom severity with higher frequencies and multiple types of victimization in homeless women, illustrating the importance of considering multiple victimization experiences (Goodman et al., 1997). Research into Canadian adolescents found physical abuse and verbal aggression directly related to higher levels of depression (Abada et al., 2008). These findings highlight the importance of examining the frequency and characteristics of victimization experiences. There is a need to study this concept more closely with a focus on those who have experienced homelessness.

Sex Differences

Much of the literature divides victimization by sex. Studies have found that homeless men and women experience different types of victimization at different rates, with women more likely to experience sexual abuse and men physical abuse (Tyler, Whitbeck, Hoyt, & Cauce, 2004; Whitbeck, Hoyt, & Ackley, 1997; Whitbeck et al., 1999). There are also sex differences in the relationship between victimization and mental health. Whitbeck et al. (1999) found that childhood victimization is directly related to depressive symptoms in homeless men and indirectly related to depressive symptoms in homeless women. Unlike men, the experience of childhood victimization in women increased the risk of having unconventional peers and engaging in deviant subsistence strategies (e.g., panhandling, shoplifting, stealing money or food, or selling drugs), risky sexual behaviors, and substance use, each of which increase the risk of depressive symptoms. Consequently, it is the post-victimization behaviors that increase the risk of depressive symptoms in homeless women, rather than the victimization itself (Whitbeck et al., 1999). Future victimization research with the homeless population needs to take these sex differences into account.

Sex differences in victimization may be further exacerbated by sex differences in homeless experiences. Men and women cite diverse reasons for becoming homeless and have different access to services while homeless (Tessler, Rosenheck, & Gamache, 2001). It is possible that the intensified stress of experiencing homelessness and victimization may be compounded uniquely in each gender.

Adult Versus Youth Experiences of Victimization

In the mental health literature, adults and youth are consistently measured as separate groups. Specifically, no studies to date compare adults and youth on victimization and mental health. However, one U.S. study has compared adults and youth on rates of violent victimization (Hashima & Finkelhor, 1999). Their findings showed that youths are significantly more likely than adults to experience victimization (Hashima & Finkelhor, 1999). Another study looked at homeless adults and youth in relation to mental health and substance abuse problems (Aubry et al., 2012). They found that adults were more likely to be categorized as “higher functioning” than youth. Furthermore, when considering gender and age group differences, there were more male youth in the “substance abuse” category and more female youth in the “mental health and substance use” category than in any other subgroups (Aubry et al., 2012). These studies illustrate some of the differences between homeless youth and adults in their separate experiences of mental health and victimization. It is expected that these differences will also be present when considering the relationship between victimization and mental health.

The Current Study

The literature has several gaps that will be addressed in the current study. Comparing youth and adults with regard to experiences of victimization and mental health functioning has yet to be studied. Such comparisons might provide better insight into the different needs of youth and adult victims, as well as the distinct needs of males and females in each age group. There is also little research pertaining to specific types of victimization and their relations with mental health functioning. This study will consider four types of victimization: Childhood sexual abuse, childhood physical abuse, childhood experience of witnessing abuse, and recent physical assault. Finally, these comparisons will be made within a homeless sample, providing insight into the relationship between victimization and mental health in this marginalized population.

This research is intended to answer the following questions: (a) Is there a relationship between type of victimization and mental health functioning among people who have been homeless after controlling for sex and age? and (b) Are there sex differences in the relationship between victimization and mental health functioning above and beyond the main effect relationship between the two variables?

Method

Panel Study on Homelessness

This cross-sectional study uses data collected in a previous study. The study involved two sets of interviews conducted for 2 years apart from the initial interviews completed between October 2002 and October 2003 (Aubry, Klodawsky, Hay, & Birnie, 2003). Only baseline data were used for this study. Interviews were administered by trained researchers in quiet, private rooms located within the organization where the participants were recruited. Participants were informed about their rights, and consent forms were reviewed and signed before interviews began. All procedures were approved by the Social Sciences Research Ethics Board at the University of Ottawa.

The goal of the original study was to examine the factors facilitating and impeding persons who are homeless to reestablish themselves in housing. In this study, “homelessness” is defined as a situation in which an individual has no housing and is staying in a temporary form of shelter (including couch surfing, sleeping rough, staying in emergency shelters, sleeping in their car, etc.). The study’s sample was made up of single individuals and adults with dependent children. Youth were defined as anyone accessing youth services, ranging in age from 17 to 20. The sampling strategy for the study was designed to draw a representative sample of homeless persons within specific subgroups of single individuals, adults, youth, men, women, and individuals in families from the clients of 18 different emergency shelters. The details of the sampling methods can be found in Aubry et al. (2003).

A total of 412 homeless individuals participated in one-on-one interviews in French (n = 30), English (n = 382), and Somali (n = 14). Sixteen of those interviews were conducted in English with the assistance of translation services by a cultural interpreter. For the purposes of this study, individuals categorized as families were removed due to the inability to distinguish the number of individuals within the family unit. The final sample size was 325 homeless adults and youth.

Measures

SF-36 Mental Health Scale

This study used Version 2 of the SF-36 (Ware, Kosinski, & Dewey, 2002). The mental health summary measure consists of four subscales on vitality, social functioning, emotional role, and mental health, with scores calibrated around 50. The following questions were included: How much of the time in the past 4 weeks did you accomplish less than you would like as a result of any emotional problems? How much of the time in the past 4 weeks did you feel full of life? and During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities? Scores were standardized and compared with U.S. norms as Canadian norms are not available. High scores indicate higher mental health functioning (Ware, Kosinski, & Dewey, 2000).

This scale has been tested in several studies for psychometric properties and found to have internal consistency above .80, exceeding the minimum standard of .70. Similar satisfactory results were also found when tested with a homeless sample (Cronbach’s α = .81). Results from this study showed a range of scores from 5.27 to 68.87 with a standard deviation of 13.06. This scale has also been translated and culturally validated in French, but not in Somali (Leplege, Ecosse, Verdier, & Perneger, 1998).

Victimization

Four questions were asked regarding the participants’ experience with victimization. Participants were asked directly about childhood abuse experiences: Were you ever physically abused by someone close to you? Did you experience sexual abuse (while you were a child or teenager)? and Did you witness abuse in your family (while you were a child or teenager)? Also, participants were asked whether they had experienced a physical injury in the last 12 months. Individuals who responded “yes” were questioned further about how the injury occurred. Injuries that were identified as being the result of a physical assault were identified as “having experienced recent victimization.” All of the victimization variables were coded dichotomously (i.e., either having experienced the specific type of victimization or not).

Analyses

Frequencies of the four victimization experience responses were first calculated to show the prevalence rates of each type of victimization experienced. Missing data were deleted listwise, making the final sample size n = 304 with 21 deleted cases. Missing data were randomly distributed, except for two variables: more females than males and more adults than youth had missing data. A chi-square analysis was conducted to compare sex and age group differences in victimization prevalence rates. To examine the relationship between victimization and mental health, a hierarchical linear regression was conducted. The predictor variables were added into the regression equation in five steps in the following order: (a) demographic characteristics (i.e., sex and dichotomous age groups [that is, adult or youth]), (b) childhood victimization, (c) recent victimization, (d) interactions between sex and childhood victimization, and (e) interaction between sex and recent victimization. The predicted variable was the composite standardized score of mental health functioning on the SF-36 measure (refer to Ware et al., 2002, for calculations).

Results

Demographics Characteristics of Study Participants

Demographics divided by subgroups are presented in Table 1. Average age for the adult sample was 39 years and for the youth sample was 19 years. On average, individuals had been homeless for 12.1 months over their lifetime and had experienced almost three different episodes of homelessness. The majority of participants were single (72%), 5% were married or living in a common law relationship, and 16% were separated or divorced. Thirty-five percent of the sample had children, although 86% did not live with their children. Fifteen percent of the sample was born outside Canada.

Table 1.

Demographics.

Variable	Total	Adult female	Adult male	Youth female	Youth male
Sex
Male	159 (51%)		73		77
Female	151 (49%)	82		78
M age		39	38	20	19
SD		11.6	9.7	0.7	0.9
Marital status (%)
Single	72	40	67	84	95
Living with partner	6	3	4	10	5
Married/common law	5	14	1	5	0
Divorced/separated	16	38	27	0	0
Widowed	2	6	1	0	0
Children: Yes (%)	35	69	39	17	12
Born outside of Canada (%)	15	30	9	14	7
Highest level of completed education (%)
< high school	64	37	43	87	90
High school diploma	25	37	39	13	10
College/trade/apprenticeship	9	18	16	0	0
University degree	3	8	2	0	0
Currently employed (%)	13	14	11	13	13
Self-reported victimization (%)	64	66	45	80	68
Childhood physical abuse	45	37	31	65	48
Childhood sexual abuse	28	43	18	42	12
Childhood witness to abuse	48	48	34	60	49
Recent victimization	10	11	9	8	12
Average number of months homeless	12.1	7.3	18.5	9.1	13.0
SD	26.5	14.7	44.5	13.1	17.2
Average number of homeless episodes	3.1	2.5	2.9	3.3	3.6
SD	1.9	1.6	1.8	2.1	2.1

Victimization

More than half of the sample reported experiencing victimization during their lifetime (n = 199, 64%). Of the entire sample, 48% reported witnessing abuse during childhood, 45% had experienced physical abuse as a child, 28% had experienced sexual abuse as a child, and 10% had experienced an injury due to physical assault in the last 12 months. Multiple victimization experiences were reported by 39% of the sample.

As shown in Table 1, among the subgroups, female youth reported the highest rates of childhood victimization: 78% reported some form of abuse as a child in comparison with their male peers at 65%. Among adults, a similar trend merged with 63% of women and 44% of men reporting childhood victimization. Recent victimization was much less prevalent: 11% of adult females, 9% of adult males, 8% of female youth, and 12% of male youth reported recent physical assault.

A chi-square analysis was used to determine significant differences in victimization prevalence between subgroups. When compared by sex, women were more likely to experience childhood sexual abuse, χ²(1, N = 304) = 23.79, p < .001. All other victimization variables did not differ by sex. When compared by age, youth had significantly higher rates of physical abuse, χ²(1, N = 304) = 15.64, p < .001, and witnessing abuse, χ²(1, N = 304) = 5.56, p = .02, than adults. Rates of childhood sexual abuse, χ²(1, N = 304) = .412, p = .52, and recent physical abuse, χ²(1, N = 304) = .06, p = .80, were not significantly different for adults and youth.

Multiple Regression Results

A hierarchical linear regression was completed to test the relationship between victimization and mental health. We set an alpha level of .05 for significance in the analysis. No multicolinearity between variables was found. Results are displayed in Table 2, and the summary of bivariate analyses is presented in Table 3.

Table 2.

Hierarchical Linear Regression Predicting Mental Health Functioning from Sex, Age, and Type of Victimization.

	Coefficients		t value	Significance	R² changed
Variables	B (U)	β (S)	t value	Significance	R² changed
Step 1
Sex	−5.34	−.21	−3.64	.00	.04
Age group	−1.07	−.04	−0.73	.47
Step 2
Sex	−3.07	−.12	−2.08	.04	.10
Age group	−0.12	.01	0.09	.93
Childhood physical abuse	−3.30	−.13	−1.82	.07
Childhood sexual abuse	−4.87	−.17	−2.75	.01
Childhood witness of abuse	−3.44	−.13	−2.00	.05
Step 3
Sex	−3.06	−.12	−2.07	.04	.00
Age group	0.13	.01	0.09	.93
Childhood physical abuse	−3.30	−.13	−1.82	.07
Childhood sexual abuse	−4.87	−.17	−2.75	.01
Childhood witness of abuse	−3.47	−.13	−2.01	.05
Recent victimization	0.50	.01	0.21	.83
Step 4
Sex	−3.84	−.15	−1.83	.07	.07
Age group	0.08	.00	0.05	.96
Childhood physical abuse	−1.99	−.08	−0.76	.45
Childhood sexual abuse	−8.59	−.30	−2.82	.01
Childhood witness of abuse	−4.12	−.16	−1.68	.10
Recent victimization	0.44	.01	0.19	.85
Sex × Childhood physical abuse	−2.11	−.07	−0.59	.56
Sex × Childhood sexual abuse	5.54	.17	1.48	.14
Sex × Childhood witness of abuse	0.89	.03	0.26	.80
Step 5
Sex	−3.72	−.14	−1.75	.08	.01
Age group	0.05	.00	0.03	.97
Childhood physical abuse	−2.06	−.08	−0.78	.44
Childhood sexual abuse	−8.60	−.30	−2.82	.01
Childhood witness of abuse	−4.14	−.16	−1.68	.09
Recent victimization	1.43	.03	0.44	.66
Sex × Childhood physical abuse	−2.08	−.07	−0.58	.56
Sex × Childhood sexual abuse	5.55	.17	1.48	.14
Sex × Childhood witness of abuse	1.03	.04	0.30	.77
Sex × Recent victimization	−2.12	−.03	−0.45	.66

Table 3.

Summary of Bivariate Analyses.

Measure	1	2	3	4	5	6	7	8	9	10
1. SF-36: Mental Component Scores
2. Sex	−.21**
3. Age group	−.05	.03
4. Childhood physical abuse	−.27**	.15*	.25**
5. Childhood sexual abuse	−.29**	.32**	−.01	.36**
6. Childhood witness to abuse	−.27	.13*	.14*	.57**	.31**
7. Recent victimization	−.02	−.02	.00	.08	.04	.12*
8. Sex × Childhood physical abuse	−.27**	.59**	.18**	.66**	.41**	.39**	.01
9. Sex × Childhood sexual abuse	−.24**	.52**	.01	.29**	.83**	.28**	.02	.55**
10. Sex × Childhood witness to abuse	−.27**	.61**	.09	.40**	.41**	.63**	.07	.71**	.56**
11. Sex × Recent victimization	−.08	.22**	−.03	.06	.11*	.13*	.66*	.16*	.16*	.26**

p < .05. **p < .001.

The first step in the model found sex to be significant at β = −.21, t = −3.53, p < .001. Sex continued to be significant until the final model with female participants reporting lower mental health functioning than male participants. Age group, however, was not significant (β = −.04, t = −0.73, p = .47). The second step added three types of childhood victimization to the model. Childhood sexual abuse and experiences of witnessing abuse were both significant (β = −.17, t = −2.76, p = .006 and β = −.13, t = −2.00, p = .047). Specifically, individuals who experienced childhood sexual abuse or witnessed abuse during childhood have lower mental health scores than individuals who did not experience these types of childhood victimization; childhood physical abuse was not significant (β = −.13, t = −1.82, p = .07). Recent victimization was then added to the model but was found to be non-significant (β = .01, t = 0.21, p = .83). The fourth step added interactions between sex and childhood victimization variables; however, none of the interactions were significant. A final step added a sex and recent victimization interaction, and this was also not significant (β = −2.12, t = −0.03, p = .66). The final model predicted 15% of the variance between victimization and mental health scores, R² = .15, F(10, 293) = 5.21, p < .001.

Discussion

The purpose of this study was to consider the relationship between types of victimization experiences and mental health functioning in a homeless sample after controlling for sex and age. This study also examined whether age and gender moderate the relationship between victimization and mental health functioning.

This sample showed high rates of victimization, with 58% reporting experiencing childhood victimization or recent victimization. This is comparable with the high rates of victimization in other homeless samples found throughout the literature (Evenson, 2009; Khandor & Mason, 2007; Whitbeck & Simons, 1990; Whitbeck et al., 1997). The high rates of multiple childhood victimization are also comparable with another published study (Evenson, 2009). However, only 10% of this sample had experienced recent physical assault. This was surprising compared with the findings by Khandor and Mason (2007), who had found 35% of their sample had experienced physical assault in the past year. This low percentage could be due to how this variable was measured, with participants being asked about injuries due to physical assault as opposed to a direct question.

When comparing types of childhood victimization, the results showed that having experienced childhood sexual abuse predicted mental health functioning among the respondents. This finding is unique to this study as these variables have not been previously tested in the homelessness literature. A similar study on homeless adolescents showed higher rates of depression and suicide attempts in individuals who had experienced sexual and physical abuse than those who experienced only one type of abuse or none (Ryan et al., 2000). Studies of adult-housed populations support this finding (Bartholow et al., 1994; Goodman & Fallot, 1998). These results indicate an important contribution to the homelessness literature, emphasizing the need to address the repercussions of childhood sexual abuse in homeless populations.

Childhood experiences of physical abuse were found to be not significant in the final model. Although a unique finding in this study, similar studies challenge the veracity of this finding. Ryan et al. (2000) found childhood physical abuse directly related to mental health symptoms in homeless youth. In this study, witnessing abuse during childhood also became non-significant in the final model. Again, this contradicts the literature where all types of victimization, including witnessing abuse have been linked to traumatic symptoms in children (Finkelhor et al., 2007a). These findings indicate that there is no difference in mental health scores for males and females, who have witnessed abuse or experienced physical abuse.

Recent victimization was not predictive of mental health functioning beyond the other variables within the model. Although not discussed in previous literature, this does conflict with Wenzel et al.’s (2000) study, which showed that victimization was related to mental health functioning in homeless adults. There are several possible explanations for this result; it could be the individual’s cognitive appraisal of the victimization experience (Folkman, Lazarus, Dunkel-Schetter, DeLongis, & Gruen, 1986). Research has shown that age influences the cognitive appraisal of a situation, making it more likely for adults to appraise the situation as less stressful or easier to cope with than children (Smith & Carlson, 1997). Our findings may be consistent with the theory that adults are more likely to appraise a victimization situation as less stressful and have more tools to cope with the situation than youth, thereby increasing their overall mental health functioning.

The most surprising finding in this study was the lack of difference between youth and adults. Most of the literature considers youth and adults in separate studies, making it difficult to compare these groups. Furthermore, Hashima and Finkelhor (1999) found significantly higher rates of victimization in youth than in adults, implying that these two groups have different experiences of victimization. However, Hashima and Finkelhor (1999) did not distinguish between victimization experiences during childhood and recent victimization experiences. Results from the current study may indicate that it is not the current age of the individual, but the age at the time of the victimization that impacts mental health. Further research into homeless youth and adult victimization is needed to confirm this finding.

In the final analysis, the interaction of sex and type of victimization was not predictive of mental health functioning. Bjorklund, Hakkanen-Nyholm, Huttenen, and Kunttu (2010) also found no difference in the relationship between victimization and mental health functioning in men when compared with women. This raises question about the importance of investigating the interactions between gender and type of victimization experience more fully, as opposed to sex differences per se in these experiences.

Limitations

There were several limitations in this study. First, victimization was only measured using childhood physical abuse, childhood sexual abuse, childhood witnessing of abuse, and recent physical assault producing an injury. Other types of victimization, such as victims of theft, adult sexual assault, or verbal abuse may show different correlations with mental health. Furthermore, research into re-victimization rates and individuals who have experienced multiple types of victimization may show different mental health trends.

The mental health functioning measure was also limited in its scope. The majority of questions were asked about mental health symptoms, rather than positive mental health or well-being. Having an absence of mental health symptoms does not necessarily indicate good mental health or overall well-being. Moreover, the limited amount of variance explained by this model may indicate other unmeasured factors that may moderate the victimization and mental health relationship. Future research should include more inclusive measures of mental health functioning and other potential moderating variables.

There are several methodological limitations to this study. First, this study used convenience sampling as a way to access a marginalized population. Although this method provided a more equal representation of homeless subgroups, it failed to recruit individuals who do not access services in the community. This limits the generalizability of the results to those who access shelters and services geared toward homeless individuals. Recall bias of the participants is also a concern, as all collected data relied exclusively on the recall of past traumatic events. Limited memories of these events may have impacted prevalence rates of victimization. Finally, all variables were measured using quantitative measures only. Qualitative measures would provide further insight into the different experiences of victimization and how mental health changes with victimization.

Implications of the Findings

Findings can be applied not only to future research but also to social services for the homeless population. Because of the high prevalence rates of childhood abuse, there is a need for service providers to be trained to understand and support victims of childhood trauma. A few studies are beginning to look into programs and services for trauma in homeless populations, but more research is still needed (Christensen, Hodgkins, Garces, & Estlund, 2005). Furthermore, programs and services need to be sensitive to how childhood victimization may impact mental health functioning, offering support to individuals who may require additional support to cope.

Conclusion

These findings have furthered the research in homelessness and victimization, going beyond the current literature on homelessness and victimization, and moving toward a more comprehensive understanding of the victimization experience and its consequences for the individual. Being homeless is a stressful experience with mental health consequences, and this population also experiences high rates of victimization, which further affects their mental health. Furthermore, mental health problems can contribute to the challenges of being homeless, causing increasing challenges with few available resources. Future research needs to look beyond the general population experiences of victimization and address the unique needs of this minority population.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was administered by the City of Ottawa with funding from the Supporting Communities Partnership Initiative funding pool from Human Resources and Skills Development Canada, Government of Canada. There are no specific grant numbers.

Author Biographies

Stephanie Rattelade is currently completing a doctoral program in experimental psychology at the University of Ottawa. Her research focuses on homelessness, mental health, and gender. After graduating, she hopes to continue research with marginalized groups.

Susan Farrell is the Clinical Director of the Community Mental Health Program at The Royal, an Assistant Professor in the Faculty of Medicine, Clinical Professor in the School of Psychology and Senior Researcher with CRECS, University of Ottawa.

Tim Aubry is a Professor in the School of Psychology and Co-Director of the Centre for Research on Educational and Community Services at the University of Ottawa. He is currently the holder of the Faculty of Social Sciences Research Chair on Community Mental Health and Homelessness at the University of Ottawa.

Fran Klodawsky is a Full Professor in the Department of Geography and Environmental Studies at Carleton University. Her areas of expertise include: public policy and social inclusion/exclusion in cities, especially in relation to housing, and feminist perspectives on cities, on community organizing, on housing and on homelessness. Her work utilizes both quantitative and qualitative methods within a collaborative, community-based framework.

References

Abada

Hou

Ram

(2008). The effects of harassment and victimization on self-rated health and mental health among Canadian adolescents. Social Science & Medicine, 67, 557-567.

Alliance to End Homelessness. (2013). The report card on ending homelessness in Ottawa Jan to Dec 2012. Ottawa, Ontario, Canada: Author.

Aubry

Klodawsky

Coulombe

(2012). Comparing the housing trajectories of different clusters within a diverse homeless population. American Journal of Community Psychology, 49, 142-155.

Aubry

Klodawsky

Hay

Birnie

(2003). Panel study on persons who are homeless in Ottawa: Phase 1 results. Retrieved from http://www.evaluationcanada.ca/distribution/200312_aubry_tim_klodawsky_fran_hay_elizabeth_birnie_sarah.pdf

Aubry

Klodawsky

Nemiroff

Birnie

Bonetta

(2007). Panel study on persons who are homeless in Ottawa: Phase 2 results. Ottawa, Ontario, Canada: Centre for Research on Community Services.

Bartholow

Doll

Joy

Douglas

Bolan

Harrison

. (1994). Emotional, behavioural, and HIV risks associated with child sexual abuse among homosexual and bisexual men. Child Abuse & Neglect, 18, 745-761.

Bjorklund

Hakkanen-Nyholm

Huttenen

Kunttu

(2010). Violence victimization among Finnish university students: Prevalence, symptoms and healthcare usage. Social Science & Medicine, 70, 1416-1422.

Christensen

Hodgkins

Garces

Estlund

(2005). Homeless, mentally-ill and addicted: The need for abuse and trauma services. Journal of Health Care for the Poor and Underserved, 16, 615-622.

Evenson

(2009). Youth homelessness in Canada: The road to solutions. Retrieved from http://www.raisingtheroof.org/RaisingTheRoof/media/RaisingTheRoofMedia/Documents/RoadtoSolutions_fullrept_english.pdf

10.

Finkelhor

Ormrod

Turner

(2007a). Polyvictimization and trauma in a national longitudinal cohort. Development and Psychopathology, 19, 149-166.

11.

Finkelhor

Ormrod

Turner

Hamby

(2005). The victimization of children and youth: A comprehensive national study. Child Maltreatment, 10(5), 5-25.

12.

Folkman

Lazarus

Dunkel-Schetter

DeLongis

Gruen

(1986). Dynamics of a stressful encounter: Cognitive appraisal, coping and encounter outcomes. Journal of Personality and Social Psychology, 50, 992-1003.

13.

Gaetz

Donaldson

Richter

Gulliver

(2013). The state of homelessness in Canada 2013. Toronto, Ontario: Canadian Homelessness Research Network Press.

14.

Goodman

Dutton

Harris

(1997). The relationship between violence dimensions and symptom severity among homeless, mentally ill women. Journal of Traumatic Stress, 10, 51-70.

15.

Goodman

Fallot

(1998). HIV risk behaviour in poor urban women with serious mental health disorders. Associations with child physical and sexual abuse. American Journal of Orthopsychiatry, 68, 73-83.

16.

Hashima

Finkelhor

(1999). Violent victimization of youth versus adults in the national crime victimization survey. Journal of Interpersonal Violence, 14, 799-820.

17.

Khandor

Mason

(2007). The Street Health Report. Retrieved from http://www.streethealth.ca/downloads/the-street-health-report-2007.pdf

18.

Kim

Ford

Howard

Bradford

(2010). Assessing trauma, substance abuse, and mental health in a sample of homeless men. Health & Social Work, 35, 39-48.

19.

Leplege

Ecosse

Verdier

Perneger

T. V.

(1998). The French SF-36 Health Survey: Translation, cultural adaptation and preliminary psychometric evaluation. Journal of Clinical Epidemiology, 51, 1013-1023.

20.

Library of Parliament. (2008). Defining and enumerating homelessness in Canada (Publication No. PRB 08-30E). Ottawa, Ontario, Canada: Parliamentary Information and Research Service.

21.

Mental Health Policy Research Group. (1998). Mental illness and pathways into homelessness: Proceedings and recommendations. Toronto, Ontario, Canada: Author.

22.

Nyamathi

Wenzel

Lesser

Flaskerud

Leake

(2001). Comparison of psychosocial and behavioral profiles of victimized and nonvictimized homeless women and their intimate partners. Research in Nursing & Health, 24, 324-335.

23.

Perron

Alexander-Eitzman

Gillespie

Pollio

(2008). Modeling the mental health effects of victimization among homeless persons. Social Science & Medicine, 67, 1475-1479.

24.

Ryan

Kilmer

Cauce

A. M.

Watanabe

Hoyt

(2000). Psychological consequences of child maltreatment in homeless adolescents: Untangling the unique effects of maltreatment and family environment. Child Abuse & Neglect, 24, 333-352.

25.

Simons

Whitbeck

Bales

(1989). Life on the streets: Victimization and psychological distress among the adult homeless. Journal of Interpersonal Violence, 4, 482-501.

26.

Smith

Carlson

(1997). Stress, coping, and resilience in children and youth. Social Service Review, 71, 231-256.

27.

Tessler

Rosenheck

Gamache

(2001). Gender differences in self-reported reasons for homelessness. Journal of Social Distress and the Homeless, 10(3), 243-254.

28.

Tyler

Whitbeck

Hoyt

Cauce

A. M.

(2004). Risk factors for sexual victimization among male and female homeless and runaway youth. Journal of Interpersonal Violence, 19, 503-520.

29.

Ware

Kosinski

Dewey

(2000). How to Score Version 2 of the SF-36 Health Survey. Lincoln, RI: Quality Metric Incorporated.

30.

Wenzel

Koegel

Gelberg

(2000). Antecedents of physical and sexual victimization among homeless women: A comparison to homeless men. American Journal of Community Psychology, 28, 367-390.

31.

Whitbeck

Hoyt

Ackley

(1997). Abusive family backgrounds and later victimization among runaway and homeless adolescents. Journal of Research on Adolescents, 7, 375-392.

32.

Whitbeck

Hoyt

Yoder

(1999). A risk-amplification model of victimization and depressive symptoms among runaway and homeless adolescents. American Journal of Community Psychology, 27, 273-296.

33.

Whitbeck

Simons

(1990). Life on the streets: The victimization of runaway and homeless adolescents. Youth & Society, 22, 108-125.