Substance use, stressful life events and mental health: A longitudinal study among homeless women in Madrid (Spain)

Abstract

The objectives of this study were: (1) to assess the prevalence of substance use among homeless women; (2) to examine the correlates for drug abuse; (3) to analyze linkages between early stressful life events, drug abuse and mental health. The methodology was a longitudinal study of women homeless in Madrid (Spain), who were followed for a 24 months period. There were 138 participants interviewed at baseline and 73 participants interviewed at follow-up. We ran bivariate and multivariate analysis to examine the correlates for drug abuse. We also performed path analysis to test the interconnections between stressful life events, drug abuse and mental health. The results showed that tobacco, sedatives and alcohol were the most widely used substances in the previous month (70.1%, 48.6% and 36.2%, respectively). Women who abused drugs were more likely to be younger, report adverse experiences during childhood, have engaged in prostitution, and ever-attempted suicide. Path analysis provided support for our hypothesis that early stressful life events increased the vulnerability for subsequent negative outcomes amongst homeless women. These findings have significant implications for the understanding of how orienting prevention and intervention programs for homeless women in Spain