“No one knows what happens to these kids”

After 3 years the young people who remained in the study ranged in age from 19 to 22 years with an average age of 20.4 years. By now, their life experiences had taken what may be a permanent toll on their emotional and physical well-being. At our most conservative estimates, dropping diagnostic criteria that may be associated with experiencing homelessness, at least one half met 12-month criteria for antisocial personality disorder (APD) and at least one fourth met 12-month criteria for major depressive episode (MDE) (see Chapter 13, this volume). Using “raw” estimates, without accounting for potential contextual effects, the 12-month prevalence rates were higher: 67.5% APD, 30.4% MDE, 35.5% posttraumatic stress disorder (PTSD), and 49% substance use disorders (SUDs). These rates of mental and substance use disorders alone portend serious problems in meeting the challenges of successful adulthood. When we factor in their current education, employment, and living arrangements the challenges are even greater.