{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:46:31Z","timestamp":1777661191235,"version":"3.51.4"},"reference-count":48,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"unspecified","delay-in-days":118,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2045796026100651_sec1a\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Homelessness is increasing and associated with poor mental health (MH). Few studies have examined how experiences of homelessness and sexual identity intersect to effect MH. We used an intersectional approach to examine MH inequalities related to sexual identity and past homelessness in a nationally representative private household sample, and whether associations were explained by discrimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796026100651_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Analysis of the 2007 and 2014 Adult Psychiatric Morbidity Surveys included 10,428 individuals aged 16\u201364 (58% female\/3.8% non-heterosexual). The Clinical Interview Schedule-Revised (CIS-R) identified common mental disorders (CMDs). Self-harm, attempted suicide, alcohol dependence, substance use, sexual identity, discrimination\/bullying, past homelessness and health behaviours were self-reported. Associations between sexual identity and homelessness were examined using multivariable Poisson regression. Prevalence ratios (PRs) for MH and health behaviours by intersectional sexual identity-past homelessness were examined using Poisson regression and adjusted for age, sex, area-level deprivation and further for discrimination\/bullying.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796026100651_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Bisexual (adjusted PR [aPR]: 2.52, 95% CI: 1.48\u20134.29) and gay\/lesbian (aPR: 1.76, 0.97\u20133.19) individuals were more likely to report past homelessness than heterosexual peers. Sexual minority (SM) and heterosexual individuals with past homelessness had higher prevalence of all MH outcomes compared to heterosexual peers without homelessness, with associations strongest in the SM-homelessness group (e.g., CMD: aPR: 2.67 [2.37\u20133.01] for heterosexual-homeless, aPR: 4.11 [3.00\u20135.63] for SM-homeless, aPR: 1.82 [1.45\u20132.28] for SM-not homeless groups), and similarly for depression\/self-harm\/attempted suicide. Likewise, the SM-homeless group had highest prevalence for drug dependence (aPR, 7.38 [3.15\u201317.29]) compared to the heterosexual-homeless (aPR, 4.03 [3.00\u20135.42]) and SM-not homeless (aPR, 2.19 [1.27\u20133.79]) groups. Adjustment for discrimination and bullying substantially attenuated point estimates, with the greatest attenuation (30\u201350%) in the SM-homeless compared to the heterosexual-homeless groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796026100651_sec4d\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individuals with past experiences of homelessness have significantly worse MH than heterosexuals without homelessness, with associations highest in the SM-homeless group. Considering experiencing homelessness and SM identity together identifies a group facing particular adversity, which is often lost when examined separately. Discrimination and bullying explained much of the worse MH in SM- and heterosexual-homeless groups, but especially the former. Investigation into the mechanisms leading to MH inequalities is needed, alongside policies and services to support this group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s2045796026100651","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:24:27Z","timestamp":1777447467000},"source":"Crossref","is-referenced-by-count":0,"title":["Mental health and sexual identity inequalities in individuals with past experiences of homelessness: findings from a nationally representative survey"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6327-2463","authenticated-orcid":false,"given":"Amal R.","family":"Khanolkar","sequence":"first","affiliation":[{"name":"Guy\u2019s Campus, King\u2019s College London"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"McManus","sequence":"additional","affiliation":[{"name":"City St George\u2019s, University of London"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayati","family":"Das-Munshi","sequence":"additional","affiliation":[{"name":"King\u2019s College London"},{"name":"Population Health Improvement (PHIUK)"},{"name":"King\u2019s College London ESRC Centre for Society and Mental Health (CSMH)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laia","family":"Becares","sequence":"additional","affiliation":[{"name":"Strand Campus, King\u2019s College London"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9661-5098","authenticated-orcid":false,"given":"Natasha","family":"Chilman","sequence":"additional","affiliation":[{"name":"Guy\u2019s Campus, King\u2019s College London"},{"name":"King\u2019s College London"},{"name":"Population Health Improvement (PHIUK)"},{"name":"King\u2019s College London ESRC Centre for Society and Mental Health (CSMH)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"S2045796026100651_ref32","doi-asserted-by":"publisher","DOI":"10.1080\/02673037.2022.2104819"},{"key":"S2045796026100651_ref1","unstructured":"Office for National Statistics (ONS) (2023b) Sexual orientation, England and Wales: census 2021. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/culturalidentity\/sexuality\/bulletins\/sexualorientationenglandandwales\/census2021 (accessed 15 August 2025)."},{"key":"S2045796026100651_ref39","unstructured":"Saunders, JB (1989) AUDIT Alcohol Use Disorders Identification Test. https:\/\/auditscreen.org\/ (accessed 15 August 2025)."},{"key":"S2045796026100651_ref40","doi-asserted-by":"publisher","DOI":"10.1023\/A:1024528427013"},{"key":"S2045796026100651_ref42","first-page":"9","article-title":"Homelessness and housing experiences among LGBTQ young adults in seven US cities","volume":"20","author":"Shelton","year":"2018","journal-title":"Cityscape"},{"key":"S2045796026100651_ref46","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001435"},{"key":"S2045796026100651_ref48","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13405"},{"key":"S2045796026100651_ref7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1990.tb01360.x"},{"key":"S2045796026100651_ref11","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-062227"},{"key":"S2045796026100651_ref12","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2023.0032"},{"key":"S2045796026100651_ref5","doi-asserted-by":"publisher","DOI":"10.1177\/0020731419885093"},{"key":"S2045796026100651_ref33","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz224"},{"key":"S2045796026100651_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31869-X"},{"key":"S2045796026100651_ref47","unstructured":"Wilson, BD , Choi, SK , Harper, GW , Lightfoot, M , Russell, S and Meyer, IH (2020) Homelessness Among LGBT Adults in the US the Williams Institute. 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England. https:\/\/england.shelter.org.uk\/media\/press_release\/at_least_354000_people_homeless_in_england_today_#:\u223c:text=Shelter\u2019s%20detailed%20analysis%20of%20official%20homelessness%20figures,rough%20and%20families%20trapped%20in%20temporary%20accommodation (accessed 15 August 2025)."},{"key":"S2045796026100651_ref25","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-6572439\/v1"},{"key":"S2045796026100651_ref16","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2022.2076874"},{"key":"S2045796026100651_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796024000659"},{"key":"S2045796026100651_ref15","doi-asserted-by":"publisher","DOI":"10.1080\/00918369.2019.1600902"},{"key":"S2045796026100651_ref3","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-025-12232-8"},{"key":"S2045796026100651_ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2021.10.039"},{"key":"S2045796026100651_ref44","doi-asserted-by":"publisher","DOI":"10.1136\/oem.55.4.272"},{"key":"S2045796026100651_ref17","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001115"},{"key":"S2045796026100651_ref13","doi-asserted-by":"publisher","DOI":"10.1080\/0145935X.2016.1151781"},{"key":"S2045796026100651_ref14","doi-asserted-by":"publisher","DOI":"10.1080\/00918369.2017.1413277"},{"key":"S2045796026100651_ref36","unstructured":"Office GE (2024) Lesbian, Gay, Bisexual and Transgender People\u2019s Experiences of Homelessness. https:\/\/www.gov.uk\/government\/publications\/lgbt-peoples-experiences-of-homelessness\/lesbian-gay-bisexual-and-transgender-peoples-experiences-of-homelessness#conclusion-5 (accessed 15 August 2025)."},{"key":"S2045796026100651_ref43","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.12966"},{"key":"S2045796026100651_ref37","unstructured":"Office for National Statistics (ONS) (2023a) People Experiencing Homelessness, England and Wales: Census 2021. https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/housing\/articles\/peopleexperiencinghomelessnessenglandandwales\/census2021#sexual-orientation (accessed 15 August 2025)."},{"key":"S2045796026100651_ref26","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-25429-7"},{"key":"S2045796026100651_ref29","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700030415"},{"key":"S2045796026100651_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckaf144"},{"key":"S2045796026100651_ref18","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000419"},{"key":"S2045796026100651_ref45","unstructured":"Trust, TAK (2015) LGBT Youth Homelessness: A UK National Scoping of Cause, Prevalence, Response, and Outcome. https:\/\/www.tandfonline.com\/doi\/epdf\/10.1080\/02673037.2022.2104819?needAccess=true (accessed 15 August 2025)."},{"key":"S2045796026100651_ref2","doi-asserted-by":"publisher","DOI":"10.1037\/ort0000478"},{"key":"S2045796026100651_ref31","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.14818"},{"key":"S2045796026100651_ref35","doi-asserted-by":"publisher","DOI":"10.1068\/a37168"},{"key":"S2045796026100651_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2017.10.006"},{"key":"S2045796026100651_ref21","doi-asserted-by":"publisher","DOI":"10.1080\/19361653.2021.1990817"},{"key":"S2045796026100651_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2021.100798"},{"key":"S2045796026100651_ref27","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2021.0473"},{"key":"S2045796026100651_ref19","unstructured":"England, E and Turnbull, N (2024) 2022-23 LGBTQ+ housing and homelessness survey final report. Cardiff. https:\/\/housingevidence.ac.uk\/publications\/lgbtq-housing-amp-homelessness-survey\/ (accessed 30 August 2025)."},{"key":"S2045796026100651_ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-007-9251-6"},{"key":"S2045796026100651_ref28","first-page":"article 8","article-title":"Demarginalizing the intersection of race and sex: A black feminist critique of anti\u2010discrimination doctrine, feminist theory and anti\u2010racist politics","volume":"1989","author":"Kimberly","year":"1989","journal-title":"The University of Chicago Legal Forum"},{"key":"S2045796026100651_ref30","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2008.02149.x"},{"key":"S2045796026100651_ref20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003750"},{"key":"S2045796026100651_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1428"}],"container-title":["Epidemiology and Psychiatric Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2045796026100651","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:24:37Z","timestamp":1777447477000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2045796026100651\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":48,"alternative-id":["S2045796026100651"],"URL":"https:\/\/doi.org\/10.1017\/s2045796026100651","relation":{},"ISSN":["2045-7960","2045-7979"],"issn-type":[{"value":"2045-7960","type":"print"},{"value":"2045-7979","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e28"}}