A cluster-analytic study of substance problems and mental health among street youths.

Based on a cluster analysis of 211 street youths aged 13-24 years interviewed in 1992 in Toronto, Ontario, Canada, we describe the configuration of mental health and substance use outcomes. Eight clusters were suggested: Entrepreneurs (n = 19) were frequently involved in delinquent activity and were highly entrenched in the street lifestyle; Drifters (n = 35) had infrequent social contact, displayed lower than average family dysfunction, and were not highly entrenched in the street lifestyle; Partiers (n = 40) were distinguished by their recreational motivation for alcohol and drug use and their below average entrenchment in the street lifestyle; Retreatists (n = 32) were distinguished by their high coping motivation for substance use; Fringers (n = 48) were involved marginally in the street lifestyle and showed lower than average family dysfunction; Transcenders (n = 21), despite above average physical and sexual abuse, reported below average mental health or substance use problems; Vulnerables (n = 12) were characterized by high family dysfunction (including physical and sexual abuse), elevated mental health outcomes, and use of alcohol and other drugs motivated by coping and escapism; Sex Workers (n = 4) were highly entrenched in the street lifestyle and reported frequent commercial sexual work, above average sexual abuse, and extensive use of crack cocaine. The results showed that distress, self-esteem, psychotic thoughts, attempted suicide, alcohol problems, drug problems, dual substance problems, and dual disorders varied significantly among the eight clusters. Overall, the findings suggest the need for differential programming. The data showed that risk factors, mental health, and substance use outcomes vary among this population. Also, for some the web of mental health and substance use problems is inseparable.