Carmelina Barone1, Aiko Yamamoto2, Chris G Richardson3, Rebecca Zivanovic4, Daniel Lin5, Steve Mathias6. 1. Psychology Department, Simon Fraser University, RCB 5246 - 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. Electronic address: ccbarone@sfu.ca. 2. St. Paul's Hospital, 1081 Burrard St., Vancouver, BC V6Z 1Y6, Canada; University of British Columbia, Faculty of Medicine, 317, 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada. Electronic address: AYamamoto@providencehealth.bc.ca. 3. University of British Columbia, School of Population and Public Health, 2206 E Mall, Vancouver, BC V6T 1Z3, Canada. Electronic address: chris.richardson@ubc.ca. 4. Foundry, 201 - 1190 Hornby St., Vancouver, BC, V6Z 2K5, Canada. Electronic address: rebeccazivanovic@gmail.com. 5. St. Paul's Hospital, 1081 Burrard St., Vancouver, BC V6Z 1Y6, Canada; University of British Columbia, Faculty of Medicine, 317, 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada; Providence Health Care Inner City Youth Program, 1260 Granville St., Vancouver, BC, V6Z 1M4, Canada; Foundry, 201 - 1190 Hornby St., Vancouver, BC, V6Z 2K5, Canada. Electronic address: DLin@providencehealth.bc.ca. 6. St. Paul's Hospital, 1081 Burrard St., Vancouver, BC V6Z 1Y6, Canada; University of British Columbia, Faculty of Medicine, 317, 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada; Providence Health Care Inner City Youth Program, 1260 Granville St., Vancouver, BC, V6Z 1M4, Canada; Foundry, 201 - 1190 Hornby St., Vancouver, BC, V6Z 2K5, Canada. Electronic address: SMathias@providencehealth.bc.ca.
Abstract
INTRODUCTION: Homeless and precariously housed young people are a complex, vulnerable population frequently perceived as being difficult to engage in health and social services. Although unrecognized deficits in cognitive functioning may adversely affect their ability to access assistance and meaningfully participate in programming, few researchers have examined these deficits. The purpose of this study was to examine the extent of global and domain-specific cognitive impairment of street involved young people. METHODS: A retrospective chart review was conducted using intake data from 494 clients (64% male; average age of 21 years) enrolled in a community-based inner city mental health program in Vancouver, Canada. Descriptive statistics were used to examine performance on six cognitive domains for a subsample (N = 44) referred for neuropsychological evaluation and bivariate statistics were used to compare youth who were and were not referred. RESULTS: Cognitive impairment was evident in 80% of referred clients, with the most frequent difficulties involving attention and processing speed. Approximately 51% of clients referred for testing did not have more than a grade ten education and only 5% received government support for those with significant disabilities. Apart from alcohol use disorder, no significant differences were identified on sociodemographic and mental health variables between groups of referred and non-referred clients. CONCLUSIONS: Significant cognitive impairment was found in 80% of the young people referred for neuropsychological evaluation. This level of impairment combined with high levels of early school exiting and low levels of government support highlight the need for targeted screening to facilitate early identification and intervention.
INTRODUCTION: Homeless and precariously housed young people are a complex, vulnerable population frequently perceived as being difficult to engage in health and social services. Although unrecognized deficits in cognitive functioning may adversely affect their ability to access assistance and meaningfully participate in programming, few researchers have examined these deficits. The purpose of this study was to examine the extent of global and domain-specific cognitive impairment of street involved young people. METHODS: A retrospective chart review was conducted using intake data from 494 clients (64% male; average age of 21 years) enrolled in a community-based inner city mental health program in Vancouver, Canada. Descriptive statistics were used to examine performance on six cognitive domains for a subsample (N = 44) referred for neuropsychological evaluation and bivariate statistics were used to compare youth who were and were not referred. RESULTS:Cognitive impairment was evident in 80% of referred clients, with the most frequent difficulties involving attention and processing speed. Approximately 51% of clients referred for testing did not have more than a grade ten education and only 5% received government support for those with significant disabilities. Apart from alcohol use disorder, no significant differences were identified on sociodemographic and mental health variables between groups of referred and non-referred clients. CONCLUSIONS: Significant cognitive impairment was found in 80% of the young people referred for neuropsychological evaluation. This level of impairment combined with high levels of early school exiting and low levels of government support highlight the need for targeted screening to facilitate early identification and intervention.