Molnar and colleagues (1998) conducted a cross-sectional retrospective study of homeless youth to investigate the relationship between past abuse and subsequent suicide attempts. This hidden population, known as street youth, has been notoriously difficult to research due to their transitional living arrangements and distrust for adults, especially service professionals. Through creative recruitment strategies and a monetary incentive, this study was able to assess 775 adolescents ranging in age from 12 to 19 years of age.
Street were sampled from several large urban communities, including New York, San Francisco, and Denver. Participants were asked a series of questions related to abuse and suicidal behaviors. Interviewers were trained to respond to answers with nonjudgmental reactions to encourage the open disclosure of personal and painful information without the fear of stigmatization. A large proportion of the street youth reported prior maltreatment. Approximately 70% of girls identified themselves as victims of sexual abuse with 35% reporting physical abuse.
Thirty-five percent of males also reported physical abuse with 24% disclosing their past involved sexual abuse. As predicted by the researchers involved in this study, the maltreatment of youth often results in later behavioral disturbances. The results of this study indicated an alarming correlation between prior abuse and the likelihood that a youth would attempt suicide, often multiple times. Street youth that reported previous sexual and/or physical abuse were 1. 9 to 4. 3 times more likely to attempt suicide than other homeless teens that did not report abuse.
Once a participant had attempted suicide it was likely there would be multiple attempts. The mean number of self-injurious acts for females was 6. 2 with 5. 1 times the mean number for males surveyed in this study. Considering the participants surveyed are obviously not members of the subgroup that complete suicide, these statistics should alarm professionals working to assist this vulnerable population. Article Critique This study provides a window into the needs of a unique and desperate hidden group of adolescents.
While exceptionally informative about the underlying consequences of child abuse, the design of the study by Molnar et al. has several limitations. A retrospective study relies on the memories of participants. Early childhood memories are often questioned when surveyed from a typical population, but street youth have additional characteristics that make their reports even more questionable. First, the exact reason many runaway teenagers leave their homes is unknown. Relying on their perspective may not garner a comprehensive picture of the home environment.
Undoubtedly most (if not all) of the participants who reported abuse were the unfortunate victims of these horrible experiences, but even the memory of these youths may falter. The high prevalence of drug abuse among street youth adds a further challenge to the use of survey questions that rely on memories of events that may have occurred decades ago. The discussion provided by the researchers emphasized the distinct and immediate needs of this at-risk population, but a more specific all for future directions with this group would have strengthened the overall value of this article.
As a practitioner in a field that works with at-risk youth, this study illuminates higher rates of abuse and suicidal behavior among street youth. The question remains: What should I do with this information? A brief review of potential intervention programs that would address these issues or a specification of which areas of this problem need further study would have greatly improved the dissemination of this research. Given its limitations, the research by Molnar and colleagues contributed a study with a relatively large sample size to a knowledge base that is virtually nonexistent.
These researchers accepted and rose to the challenge of surveying an exceptionally difficult group of young people and illuminating a problem that is essentially threatening their survival. The lengths that researchers and field workers exhausted to gather over 750 participants were surely not detailed in the content of this publication, but they have not gone unnoticed by this reviewer. Their ingenuity and dedication to street youth may spark the interest in other researchers who can now benefit from the blueprint outlined by the work of Molnar et al.
Even more far-reaching than the arduous work dedicated to this research is the de-stigmatizing tone in which the conclusions of the study were discussed. Homeless individuals, including street youth, often encounter judgment and blaming from those in the community. This study provides an alternative perspective from the rebellious teen that most view as a representation of street youth. Molnar and colleagues made it clear that most of the homeless adolescents they surveyed had strong reasons to be distrustful of adults. With the hardships of living on the streets, it is often a safer residence than the former homes of street youth.
As a practitioner, this article has motivated me to develop a self-awareness of stigmatizing thoughts, attitudes, and beliefs that could be barriers to my provision of services to street youth. While memory is questionable for empirical use, it’s certainly an important indicator of a client’s mental health. If support is not provided to heal the scars of the past, they can become the wounds of tomorrow.
References
Molnar, B. E. , Shade, S. B. , Kral, A. H. , Booth, R. E. , & Watters, J. K. (1998). Suicidal behavior and sexual/physical abuse among street youth. Child Abuse & Neglect, 22, 213-222