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Published Online: September 2013

Factors Influencing Service Use Among Homeless Youths With Co-Occurring Disorders

Nicole Kozloff, M.D., Amy H. Cheung, M.D., M.S., Lori E. Ross, Ph.D., Heather Winer, M.A., Diana Ierfino, M.S., Heather Bullock, M.S., and Kathryn J. Bennett, Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 64, Number 9
https://doi.org/10.1176/appi.ps.201200257
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Abstract

Objective

Given high rates of co-occurring mental and substance use disorders among homeless youths and poorly understood facilitators of and barriers to service use, this study explored factors influencing service use among homeless youths with co-occurring disorders.

Methods

Focus groups were conducted with 23 youths age 18 to 26 with co-occurring disorders. Group discussion was audio-recorded and transcribed verbatim, and transcripts were examined with thematic content analysis.

Results

The factors identified as influencing service use were grouped into three broad categories: individual (motivation, support, and therapeutic relationship), program (flexibility and comprehensiveness of services and availability of harm reduction services), and systemic (stigma and accessibility).

Conclusions

Multilevel factors appear to influence service use among homeless youths with co-occurring disorders. Given the lack of evidence to support specific treatments in this population, these findings may be used to guide the development of thoughtfully designed interventions to engage homeless youths with co-occurring disorders.

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Information & Authors

Information

Published In

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Cover: Man, by Ben Shahn, 1946. Tempera on composition board. Gift of Mr. and Mrs. E. Powis Jones, The Museum of Modern Art, New York. © Estate of Ben Shahn/Licensed by VAGA, New York. Digital image © The Museum of Modern Art/Licensed by SCALA/Art Resource, New York.

Psychiatric Services
Volume 64 • Number 9 • September 2013
Pages: 925 - 928
PubMed: 24026839

History

Published in print: September 2013
Published online: 15 October 2014

Authors

Details

Nicole Kozloff, M.D.
Dr. Kozloff is affiliated with the Department of Psychiatry, University of Toronto, 250 College St., Suite 841, Toronto, Ontario M5T1R8, Canada (e-mail: [email protected]). Dr. Cheung and Ms. Ierfino are with the Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario. Dr. Ross, Ms. Winer, and Ms. Bullock are with the Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario. Dr. Bennett is with the Department of Clinical Epidemiology and Biostatistics and Offord Centre for Child Studies, McMaster University, Hamilton, Ontario. Portions of this report were presented at the annual meetings of the American Academy of Child and Adolescent Psychiatry, New York City, October 26–31, 2010, and the Canadian Academy of Child and Adolescent Psychiatry, Montreal, Quebec, September 30 to October 2, 2012.
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Amy H. Cheung, M.D., M.S.
Dr. Kozloff is affiliated with the Department of Psychiatry, University of Toronto, 250 College St., Suite 841, Toronto, Ontario M5T1R8, Canada (e-mail: [email protected]). Dr. Cheung and Ms. Ierfino are with the Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario. Dr. Ross, Ms. Winer, and Ms. Bullock are with the Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario. Dr. Bennett is with the Department of Clinical Epidemiology and Biostatistics and Offord Centre for Child Studies, McMaster University, Hamilton, Ontario. Portions of this report were presented at the annual meetings of the American Academy of Child and Adolescent Psychiatry, New York City, October 26–31, 2010, and the Canadian Academy of Child and Adolescent Psychiatry, Montreal, Quebec, September 30 to October 2, 2012.
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Lori E. Ross, Ph.D.
Dr. Kozloff is affiliated with the Department of Psychiatry, University of Toronto, 250 College St., Suite 841, Toronto, Ontario M5T1R8, Canada (e-mail: [email protected]). Dr. Cheung and Ms. Ierfino are with the Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario. Dr. Ross, Ms. Winer, and Ms. Bullock are with the Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario. Dr. Bennett is with the Department of Clinical Epidemiology and Biostatistics and Offord Centre for Child Studies, McMaster University, Hamilton, Ontario. Portions of this report were presented at the annual meetings of the American Academy of Child and Adolescent Psychiatry, New York City, October 26–31, 2010, and the Canadian Academy of Child and Adolescent Psychiatry, Montreal, Quebec, September 30 to October 2, 2012.
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Heather Winer, M.A.
Dr. Kozloff is affiliated with the Department of Psychiatry, University of Toronto, 250 College St., Suite 841, Toronto, Ontario M5T1R8, Canada (e-mail: [email protected]). Dr. Cheung and Ms. Ierfino are with the Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario. Dr. Ross, Ms. Winer, and Ms. Bullock are with the Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario. Dr. Bennett is with the Department of Clinical Epidemiology and Biostatistics and Offord Centre for Child Studies, McMaster University, Hamilton, Ontario. Portions of this report were presented at the annual meetings of the American Academy of Child and Adolescent Psychiatry, New York City, October 26–31, 2010, and the Canadian Academy of Child and Adolescent Psychiatry, Montreal, Quebec, September 30 to October 2, 2012.
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Diana Ierfino, M.S.
Dr. Kozloff is affiliated with the Department of Psychiatry, University of Toronto, 250 College St., Suite 841, Toronto, Ontario M5T1R8, Canada (e-mail: [email protected]). Dr. Cheung and Ms. Ierfino are with the Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario. Dr. Ross, Ms. Winer, and Ms. Bullock are with the Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario. Dr. Bennett is with the Department of Clinical Epidemiology and Biostatistics and Offord Centre for Child Studies, McMaster University, Hamilton, Ontario. Portions of this report were presented at the annual meetings of the American Academy of Child and Adolescent Psychiatry, New York City, October 26–31, 2010, and the Canadian Academy of Child and Adolescent Psychiatry, Montreal, Quebec, September 30 to October 2, 2012.
View all articles by this author
Heather Bullock, M.S.
Dr. Kozloff is affiliated with the Department of Psychiatry, University of Toronto, 250 College St., Suite 841, Toronto, Ontario M5T1R8, Canada (e-mail: [email protected]). Dr. Cheung and Ms. Ierfino are with the Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario. Dr. Ross, Ms. Winer, and Ms. Bullock are with the Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario. Dr. Bennett is with the Department of Clinical Epidemiology and Biostatistics and Offord Centre for Child Studies, McMaster University, Hamilton, Ontario. Portions of this report were presented at the annual meetings of the American Academy of Child and Adolescent Psychiatry, New York City, October 26–31, 2010, and the Canadian Academy of Child and Adolescent Psychiatry, Montreal, Quebec, September 30 to October 2, 2012.
View all articles by this author
Kathryn J. Bennett, Ph.D.
Dr. Kozloff is affiliated with the Department of Psychiatry, University of Toronto, 250 College St., Suite 841, Toronto, Ontario M5T1R8, Canada (e-mail: [email protected]). Dr. Cheung and Ms. Ierfino are with the Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario. Dr. Ross, Ms. Winer, and Ms. Bullock are with the Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario. Dr. Bennett is with the Department of Clinical Epidemiology and Biostatistics and Offord Centre for Child Studies, McMaster University, Hamilton, Ontario. Portions of this report were presented at the annual meetings of the American Academy of Child and Adolescent Psychiatry, New York City, October 26–31, 2010, and the Canadian Academy of Child and Adolescent Psychiatry, Montreal, Quebec, September 30 to October 2, 2012.
View all articles by this author

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