Investigating the impacts of COVID-19 among LGBTQ2S youth experiencing homelessness
Open accessAbstract
BACKGROUND: LGBTQ2S youth are overrepresented among youth experiencing homelessness and experience significantly higher rates of mental health issues compared to heterosexual and cisgender youth. COVID-19 related challenges for LGBTQ2S youth experiencing homelessness remain unknown. To address this gap, this study aimed to understand the impacts of the COVID-19 pandemic on LGBTQ2S youth at risk of, and experiencing, homelessness in the Greater Toronto Area, Ontario, Canada and surrounding areas. METHODS: Utilizing a mixed-methods convergent parallel design, LGBTQ2S youth experiencing homelessness were recruited to participate in virtual surveys and in-depth one-on-one interviews. Surveys included standardized measures and were administered to measure mental health outcomes and collect information on demographic characteristics, and health service use. Survey data were analyzed with descriptive statistics and statistical tests for difference of proportions. Interviews were analyzed using an iterative thematic content approach. RESULTS: Sixty-one youth completed surveys and 20 youth participated in one-on-one interviews. Quantitative and qualitative data showed that youth have been significantly impacted by the COVID-19 pandemic in various ways, including experiencing poor mental health, such as suicidality, depression, anxiety, and increased substance use, and lack of access to health and social support services. CONCLUSION: Our study highlights the need for LGBTQ2S inclusive and affirming health care and support services for precariously housed adolescents to address the pre-existing social and health issues that have been exacerbated by the pandemic.
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Exposure therapy enables individuals to gradually and systematically confront their fears, leading to a reduction in anxiety and avoidance behaviors.
“Exposure therapy enables individuals to gradually and systematically confront their fears, leading to a reduction in anxiety and avoidance behaviors (27).”
From A systematic review on the efficacy of virtual reality and gamification interventions for managing anxiety and depression (2023) · cites this paper as [27]
The Methods section describes measuring anxiety, and the Results section discusses mental-health outcomes and virtual care; neither addresses exposure therapy. Searches for exposure therapy, confronting fears, and avoidance behaviors found no passage explaining the therapy or its effects. No page numbers were available in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measuredExposure therapy is widely recognized as the gold standard for treating anxiety disorders.
“Exposure therapy, a cognitive-behavioral intervention widely recognized as the “gold standard” for treating anxiety disorders, operates on the principle of gradually exposing individuals to feared situations, enabling them to confront and tolerate their fears, ultimately leading to a reduction in anxiety and avoidance behaviors (27, 33).”
From A systematic review on the efficacy of virtual reality and gamification interventions for managing anxiety and depression (2023) · cites this paper as [27]
The Methods (Quantitative methods; page unavailable) describe using the GAD-7 to measure anxiety, not treating it with exposure therapy. Searches for exposure therapy as a “gold standard” and for gradual exposure found no passage in our copy addressing the claim. (LLM, conf=0.76)
Experimental — accuracy not yet measuredExposure therapy operates on the principle of gradually exposing individuals to feared situations, enabling them to confront and tolerate their fears, ultimately leading to a reduction in anxiety and avoidance behaviors.
“Exposure therapy, a cognitive-behavioral intervention widely recognized as the “gold standard” for treating anxiety disorders, operates on the principle of gradually exposing individuals to feared situations, enabling them to confront and tolerate their fears, ultimately leading to a reduction in anxiety and avoidance behaviors (27, 33).”
From A systematic review on the efficacy of virtual reality and gamification interventions for managing anxiety and depression (2023) · cites this paper as [27]
The Methods (Quantitative methods) describe measuring anxiety with the GAD-7, and the Results (COVID-19 impact on mental health and substance use) report participants’ anxiety levels. Neither passage addresses exposure therapy, gradual exposure to feared situations, or reductions in avoidance; searches for those concepts and for cognitive-behavioral treatment found no relevant passage. (LLM, conf=0.75)
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References 41 · Cited by 50
Research works printed but not linked: 5
- [4]Buchnea A, McKitterick M, French D. Summary Report: Youth Homelessness and COVID-19: How the youth serving sector is coping with the crisis. Toronto, ON: Canadian Observatory on Homelessness Press and A Way Home Canada; 2020. Available from: https://www.homelesshub.ca/coh-awh-youth-survey-covid19-2020
- [5]Abramovich A, Shelton J. Where Am I Going to Go? Intersectional Approaches to Ending LGBTQ2S Youth Homelessness in Canada & the US. Toronto: Canadian Observatory on Homelessness Press; 2017. Available from: https://www.homelesshub.ca/WhereAmIGoingtoGo
- [9]Ottawa GLBT Wellness Literature Review and Survey Instruments. Ottawa: Ottawa-Carleton GLBT Wellness Task Group; 2000. Available from: https://www.homelesshub.ca/resource/ottawa-glbt-wellness-project-literature-review-and-survey-instruments
- [21]Gaetz S, Barr C, Friesen A, Harris B, Hill C, Kovacs-Burns K, et al. Canadian Definition of Homelessness. Toronto: Canadian Observatory on Homelessness Press; 2012. Available from: https://www.homelesshub.ca/sites/default/files/COHhomelessdefinition.pdf
- [34]Creswell J, Plano Clark V, Gutmann M, Hanson W. Advanced mixed methods research designs. In: Tashakkori A, Teddlie C, editors. Handbook of mixed methods in social and behavioural research. Thousand Oaks: Sage Publications; 2003.
- Authors
- Abramovich, A., Pang, N., Moss, A., Logie, C. H., Chaiton, M., Kidd, S. A., & Hamilton, H. A.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- University of Toronto (CA)
- Corresponding author
- Abramovich, Alex
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2021-09-21
- Volume
- 16
- Issue
- 9
- Pages
- e0257693
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC8454954
- OpenAlex
- W3199673685
- Cited by
- 50
- References
- 41
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 10 · 2023: 15 · 2022: 19
- FWCI
- 12.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Making the Shift (R900206526)
- Topics
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- COVID-19 pandemic, youth homelessness, mental health, suicidality, depression, anxiety, substance use, health care access, social support services, Greater Toronto Area
- MeSH terms
- Sexual and Gender Minorities, COVID-19, SARS-CoV-2, Adolescent, Female, Ill-Housed Persons, Housing, Humans, Male, Mental Health, Ontario, Surveys and Questionnaires, Homeless Youth, Young Adult, Pandemics
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