A high percentage of homeless women and girls have experienced physical or sexual violence as children and/or adults, and have experienced substance abuse or mental health problems (including attempted suicide) as a result.
Facts and Discussion Points:
1--Ninety-two percent of homeless mothers have experienced physical and/or sexual assault.1
2--More than 66% of homeless mothers have experienced severe physical violence by a caretaker and 43% were sexually molested during childhood. Sixty percent of homeless mothers were abused by the age of 12.2
3--Abuse often continues into adulthood. Sixty-three percent of homeless mothers have been victims of intimate partner violence and 32% are current or recent victims of domestic violence.2
4--More than half of homeless mothers who have been abused by an intimate partner were physically injured as a result of the abuse, and 27% required medical treatment.2
5--Over 39% of homeless women who have been abused have experienced PTSD, more than three times the level of the general female population. Forty-seven percent have had a major depressive disorder, more than twice the rate of the general female population.3
6--One-third of homeless women who have experienced violence have attempted suicide at least once.3
7--Forty-five percent of homeless women who have experienced abuse during their lives have subsequently been alcohol or drug dependent at some time.3
8--Seventy percent of women living on the streets or in shelters report abuse in childhood. Over 70% of girls on the streets have run away from violence in their homes.4, 5
9--Ninety-seven percent of mentally ill homeless women have experienced severe physical and/or sexual abuse, and 87% experienced this abuse both as children and as adults.6
10--Childhood abuse has been correlated with increased adolescent and young adult truancy, running away, and risky sexual behavior. Many of these children are homeless or living in shelters.7
11--More than 40% of women on welfare with repeated incidence of leaving the welfare rolls were sexually abused as children. These women often become homeless along with their children.8
1---Violence is pervasive in the lives of homeless and other extremely poor women. SAMHSA should examine its current and future programs to ensure that they respond to the impact of trauma on women. In addition, SAMHSA should work with other Department of Health & Human Services (HHS) agencies and other departments providing services to homeless women (U.S. Department of Housing and Urban Development [HUD], U.S. Department of Labor, etc.) to ensure the same response.
2---Many homeless and homeless-related service programs serving women do not address the impact of trauma on the lives of homeless women and are sometimes retraumatizing. Service providers and program administrators should make their services and programs more responsive to the needs of women. Such efforts might include:
A---Education/training on the pervasiveness of violence on homeless and other poor women for providers (such as health and mental health clinicians, substance abuse treatment providers, shelter workers, welfare case workers, etc.) who work with women and their children.
B---Development and broad dissemination of sensitive violence screening and referral processes to be used in a variety of social service settings. Training should be provided to ensure proper use.
* SAMSHA should support a knowledge development and application effort designed to integrate and coordinate violence and homeless related services and delivery systems for women at the community level.
* Many shelters and programs for the homeless receive federal money; all perform substance abuse and mental health assessments. Trauma/violence should be added to these assessments.
* Homeless shelters and programs should be assessed for safety and to uncover any policies/practices that might re-victimize homeless persons. Persons seeking shelter should be assessed for histories of trauma.
* Homeless and formerly homeless persons should be involved in every aspect of program design and management.
1. Bassuk, E. L., Weinreb, L. F., Buckner, J. C., et al. (August 28, 1996). The characteristics and needs of sheltered homeless and low-income housed mothers. JAMA, The Journal of the American Medical Association, 276(8), pp. 640-6.
2. Browne, A., & Bassuk, S. S. (April 1997). Intimate violence in the lives of homeless and poor housed women: Prevalence and patterns in an ethnically diverse sample. American Journal of Orthopsychiatry, 67(2), pp. 261-78.
3. Bassuk, E. L., Buckner, J.C., Perloff, J. N., Bassuk, S. S. (November 1998). Prevalence of mental health and substance use disorders among homeless and low-income housed mothers. American Journal of Psychiatry, Vol. 155(11).
4. Goodman, L. A. (October 1991). The prevalence of abuse among homeless and housed poor mothers: A comparison study. American Journal of Orthopsychiatry, Vol. 61(4): 489-500.
5. Chesney-Lind, & Shelden. (December, 1998). What to do about girls? Promising perspectives and effective programs. ICCA Journal.
6. Goodman, L. A., Dutton, M. A., & Harris, M. (January 1997). The relationship between violence dimensions and symptom severity among homeless, mentally ill women. Journal of Traumatic Stress, 10(1), pp. 51-70.
7. Briere, J. (1992). Child abuse trauma: Theory and treatment of the lasting effects. CA: Sage Publications.
8. DeParle, J. (November 28, 1999). Life after welfare. The New York Times.