Objective: To establish the mental health needs of homeless children and families before and after rehousing. Design: Cross sectional, longitudinal study. Setting: City of Birmingham. Subjects: 58 rehoused families with 103 children aged 2-16 years and 21 comparison families of low socioeconomic status in stable housing, with 54 children. Main outcome measures: Children's mental health problems and level of communication; mothers' mental health problems and social support one year after rehousing. Results: Mental health problems remained significantly higher in rehoused mothers and their children than in the comparison group (mothers 26% v 5%, P = 0.04; children 39% v 11%, P = 0.0003). Homeless mothers continued to have significantly less social support at follow up. Mothers with a history of abuse and poor social integration were more likely to have children with persistent mental health problems. Conclusions: Homeless families have a high level of complex needs that cannot be met by conventional health services and arrangements. Local strategies for rapid rehousing into permanent accommodation, effective social support and health care for parents and children, and protection from violence and intimidation should be developed and implemented.

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Fifty-four children and adolescents (age 8-17) were assessed two years after a clinical intervention trial of cognitive-behavioural vs. non-focused treatment for depression. Eleven (20.4%) subjects fulfilled criteria for depression, while 21 (38.9%) reported significant depressive symptoms during the previous year. Seventeen young people (31.5%) had a psychiatric disorder (including depression). Overall, the sample maintained the improvement since the termination of treatment, without detecting specific treatment effects. Presence of depression at two-year follow-up was best predicted by self-esteem ratings before and after treatment, and co-morbidity at post-treatment. Depression in young life carries a high risk of recurrence, despite initial remission. Continuation or preventative treatment for young people at risk of relapse needs development and evaluation.