Homeless migrant families face multiple challenges: those shared with other migrant women, such as a lack of familiarity with the French healthcare system and their rights, a higher likelihood of foregoing medical care, language barriers, and discrimination; to which are added other challenges common to families in precarious situations, such as economic poverty, social isolation, and food insecurity. Furthermore, they face their “homeless” status, which entails particularly difficult housing conditions, such as severe residential instability and inadequate accommodations. Homeless families are thus caught in a spiral of economic hardship and social suffering that leads to high levels of stress and living conditions that can be detrimental to their mental health.

Our study thus showed that these mothers were on average 31 years old, the majority of whom were migrant women (78% born outside Europe), and half of whom were heads of single-parent families (52%). Their living conditions are harsh: 23% have been victims of domestic violence, 14% have spent the night outdoors, nearly 48% have been homeless for more than two years, and 39% experience residential instability (less than six months in their current housing). We observed a high prevalence of approximately 19% of PTSD over the past 12 months. PTSD was associated with pre-migration characteristics, such as leaving the country of origin due to violence, as well as vulnerability factors, such as depression over the past 12 months. However, post-traumatic experiences, such as living conditions in the host country, also appeared to play a significant role. These results highlight the multifactorial nature of PTSD and demonstrate that immigrant and homeless women face a combination of predisposing factors.

Housing instability refers to frequent, unpredictable, and unwanted moves that negatively impact the family support system, as well as children’s development and well-being. It captures the concept of community roots, which is essential for accessing care—such as familiarity with healthcare facilities, the ability to schedule regular appointments, and access to personalized support. Our study showed that residential instability was associated with PTSD.

Living conditions and difficulties with integration upon arrival in the host country raised concerns for us, as they can affect the mental health of mothers and their children. Currently, homeless families are housed in emergency shelters, which are therefore unsuitable for long-term stays. Indeed, housing conditions are not optimal for families, and there is a lack of infrastructure and material comforts, such as insufficient bedding and the absence of a kitchen or bathroom. The inability to host friends increases social isolation, and some accommodations are also located far from transportation, healthcare facilities, and social and administrative services. These conditions compound other challenges mentioned, such as difficulty speaking, writing, and reading French; unemployment or arduous, low-status work; and the accumulation of responsibilities, especially for single mothers. If women have also been victims of violence, they may be more likely to suffer from depression or post-traumatic stress disorder, which in turn can further isolate these families, whose access to healthcare is already limited. These various factors constitute significant barriers to the diagnosis and appropriate management of these conditions. We therefore felt it necessary to better characterize and understand the factors associated with these difficulties, especially since the short-term impact of these living conditions on the well-being and behavior of parents and their children can have significant repercussions on their future.

Exposure to trauma affects the mental health of both parents and children, whose emotional responses are closely linked. A study examining the association between child well-being and maternal PTSD, homelessness, substance abuse, and other psychiatric disorders shows that increased symptoms of depression and anxiety in children were primarily associated with the mother’s PTSD. Treating maternal PTSD symptoms can therefore be beneficial for children, regardless of whether the child was exposed to the traumatic experience.

In our study, the children were on average 5.4 years old, and more than half of them (57%) were born in France. Nearly 10% of children aged 6 to 12 were not enrolled in school. This percentage ranged from 21% for children who had moved more than once in the past 12 months, to 9% for those who had moved once, and 4% for those who had not moved at all. Furthermore, food insecurity did not spare the children. More than half of them (60%) were affected.

In a previous study, we examined children’s emotional difficulties using the Strengths and Difficulties Questionnaire (SDQ)^²—a brief behavioral questionnaire for children aged 3 to 16. In this study, the children had a higher total score than children in the general population in France (mean total score = 11.3 vs. 8.9, p<0.001). The children’s difficulties were associated with the region where their parents were born, their parents’ health status—including being overweight—and the mothers’ mental health (particularly maternal suicide risk). These results underscore the importance of addressing mothers’ mental health to create a virtuous cycle, both for themselves and for their children. Finally, emotional difficulties were also linked to living conditions such as sleep habits, the fact that children were teased at school, and their housing situation. Thus, emotional difficulties were linked to the fact that children disliked their living arrangements and experienced high residential mobility. Addressing the living conditions of these families is therefore a major public health issue, all the more so given that the current health crisis risks further widening social health inequalities and hitting these already vulnerable families particularly hard.