Prevalence of Past Homelessness, Mental Health and Health Risk Behaviours Among Sexual Minority Young People in the UK: Insights from the Millenium Cohort Study

Aim: To examine the prevalence of past homelessness and rates of poor mental health and health-risk behaviours (HRBs) by sexual identity in adolescents. Methods: This study used data from the age 17 sweep of the UK-wide Millennium Cohort Study (N=10,232, 51% female, 21% sexual minority). Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ) emotional symptoms subscale for depression and anxiety, and self-reported actions of self-harm, attempted suicide, sleep quality and doctor-diagnosed depression. HRBs were six (like regular smoking and antisocial behaviour). Associations between sexual identity (heterosexual, mainly heterosexual, bisexual and gay/lesbian) and past homelessness were examined using multivariable logistic regression. Associations between past homelessness and mental health and HRBs, and whether these differed by sexual identity were examined using multivariable logistic regression with appropriate interactions between the homeless and sexual identity variables. Models were adjusted for sex, parental income and ethnicity. Results: Bisexual (adjusted-OR 2.92, 95% CI: 1.47-5.82) and gay/lesbian (adjusted-OR 1.87, 0.53-6.56) adolescents had higher odds for past homelessness compared to heterosexual peers. Prevalence of self-harm (homeless bisexual/gay/lesbian and heterosexual: 85% and 39% respectively, not homeless bisexual/gay/lesbian and heterosexual: 55% and 18% respectively) and attempted suicide were significantly higher in individuals with past homelessness with the highest rates among SM individuals. Similar pattern of findings was observed with regular smoking and antisocial behaviour. Conclusions: Sexual minority individuals are more likely to experience past homelessness. Although homelessness is associated with worse current mental health and HRBs regardless of sexual orientation, a greater proportions of sexual minority individuals with past homelessness reported worse mental health compared to heterosexual peers with the same experience