Meeting the mental health needs of homeless students in schools: A Multi-Tiered System of Support framework

The number of homeless youth in the U.S. has reached an all-time high and this represents a growing social problem. Research indicates that homeless youth are significantly at-risk for experiencing a range of negative life-outcomes such as school dropout, the development of mental health problems, use/abuse of illicit substances, suicidality, and even early mortality. Thus, effective interventions and mental health supports are needed to help address their complex mental health needs. Fortunately, however, many homeless youth regularly attend school, especially younger youth (i.e., under 13 years old) and youth who are members of homeless families. Therefore, as important members of school communities, school-based mental health professionals can help support these students. With this aim in mind, this paper discusses the use of a Multi-Tiered System of Support (MTSS) framework to meet the mental health needs of homeless students in schools. More specifically, following a public health service delivery model, service delivery is discussed at universal, selective, and indicated levels. Lastly, to address the diverse needs of homeless students, integrated service-delivery across various systems of care is discussed.     

A Community Response to Tragedy: Individualized Services for Families

The murder of a 13-year-old young woman mobilized one community to initiate a wraparound service model for their most hard-to-reach families. These families struggled with parental substance abuse, youth at high risk, and associated complex needs cutting across existing categorical programs. The strength and empowerment based program, in which interventions were designed specific to each family, presented challenges in evaluating outcomes with traditional standardized instruments. This paper describes the project, its outcomes for families and youth, and the evaluation design that evolved to measure outcomes in a strength-based program with no uniform intervention.     

Legal Challenges Facing Lesbian and Gay Youth

Legal constraints on minors can be especially problematic for lesbian and gay youth, who frequently lack support from their families and from school authorities, and whose circumstances are often misunderstood or disregarded by authorizes throughout the juvenile system. Legal mechanisms exist or can e crafted to meet the needs of lesbian and gay youth who have been rejected by their families of origin. School welfare and juvenile justice administrators must become sensitive to personal, economic, and societal pressures faced by lesbian and gay youth, and must tailor bureaucratic responses to the youthÆs particular needs. Finally, it is imperative that adults in the lesbian and gay communities take responsibility for protecting the interest of younger members of the community.     

Chapter 10: Issues in HIV/AIDS Service Delivery to High Risk Youth

Homeless and runaway youth engage in behavior that puts them at risk for infection with HIV, the virus that causes AIDS. Prevalence of HIV disease in homeless and runaway youth is higher than it is among other adolescents. In addition, homeless and runaway youth are often forced to engage in sex as a means of survival. Although they engage in high risk behavior, AIDS education programs have neglected them as a target group for education. To some extent, they have been included in other more general categories of persons with AIDS risk behaviors, such as men who have sex with men or intravenous drug users. However, the number of adolescents receiving age-specific HIV/AIDS information is far below the number infected (Hein et al., 1992). Often high risk youth are disenfranchised, having been forced from home by their families after disclosing their gay or lesbian identities. Lacking a political voice and having no spokesperson, they represent a group with complex unmet needs. These youth typically have immediate needs for food, shelter, and clothing. In addition, they often need medical management, mental health and drug counseling, crisis management, and HIV/AIDS information. These needs are often overwhelming to the agencies that serve youth. This article examines the barriers and issues that exist in providing services to high risk youth. Then, suggsetions for removing those barriers by empowering both service providers and youth are offered. Some of the suggestions are based upon the authors' own experience in providing HIV/AIDS in-service training to service providers to high risk youth. The article makes recommendations for policy on youth and HIV/AIDS.     

Evaluating child and youth homelessness

Following a review of approaches taken to generate accurate estimates of the scale of child and youth homelessness in America, this article documents the methods and results of a multipronged count of homeless children and youth in New Haven, Connecticut. The survey used in this count accessed demographics and service needs, and was administered on the streets and in a wide range of service provision settings. A total of 170 homeless families were located, comprised primarily of young, single, African American women and their children. These families included 323 children, suggesting an annual prevalence of 1,688 in this community. This work addresses the paucity of information on homeless children and youth located in small to midsized cities     

A long road ahead: A progress report on educating homeless children and youth in america

The plight of contemporary homelessness in American society has been well documented, including the growth in homeless families with school age homeless children and independent homeless youth. The impact of homelessness on schools and schooling has resulted in a school-age population with complex problems for which no simple solutions exist. This article chronicles the progress made in recent years in addressing the educational needs of homeless children and youth in America and notes particular areas of concern that remain to be solved if education is to hold a meaningful place in their disrupted lives. Specifically, concerns regarding awareness and perceptions of homelessness, early childhood educational needs, intervention with special populations, interagency collaboration in service delivery, and the need for comprehensive evaluations of homeless education efforts are discussed. Additionally, suggestions for improving policy and practice salient to educating homeless students are offered     

Supporting the emotional and psychological well being of sexual minority youth: Youth ideas for action

Gay, lesbian, bisexual and transgender (GLBT) populations are susceptible to stress-related mental health disorders because of daily imposed stigma and prejudice. Yet minimal information exists from the perspective of sexual minority youth about how to support them in managing a challenging social environment during critical stages of development. Through the lens of youth from two geographic communities this study examined what is needed to support GLBT adolescent mental health. The study employed inductive secondary analysis of qualitative and quantitative data gathered through Concept Mapping needs assessments. Findings include 61 unduplicated ideas for support across the two groups of youth; 14 primary themes emerged with 22 stated needs common among both groups. Areas of need in multiple service systems are identified. The importance of the supports for meeting youths' emotional needs varied between the two communities. Ideas generated represent youth ideas for improving conditions which contribute to disparate community supports needed to develop positive emotional and psychological well being. The findings are conceptualized with regard to psychological and physical safety; community impact on emotional well being; schools and psychosocial supports; and access to relevant mental health and health care. Discussion includes implications for practice and policy.     

Recruitment and retention strategies for out-of-school-time programs

Many out-of-school-time (OST) practitioners seek ways to maximize enrollment, enhance frequency of participation, and ensure retention in OST programs, so that the multiple potential benefits of these programs are realized. Three critical areas of program quality are important underpinnings for success in recruitment and retention of youth in OST programs: a sense of safety and community; committed program staff; and challenging, age-appropriate, and fun activities. In addition, a review of over sixty OST evaluations reveals five promising recruitment strategies to boost enrollment: (1) matching the program to participants' needs (offering activities not readily available elsewhere or offering flexible schedules), (2) demonstrating the importance of participation to young people and their families, (3) reaching out directly to youth and their families in their homes and communities, (4) recruiting in peer circles, and (5) making a special effort to recruit at-risk youth. Finally, the evaluation literature points to five promising strategies to enhance regular participation and longterm program retention: (1) sending a clear message that regular attendance is important; (2) setting realistic goals to promote regular attendance, especially as youth grow older; (3) finding a balance among academic and other activities; (4) using incentives; and (5) keeping teens involved with opportunities for leadership, community service, and paid employment.     

Examining Missing Person Police Reports to Identify the Service Needs of Runaway Youth and Their Families

Abstract

This study examined situational and demographic characteristics in a sample of 47 children missing person police reports obtained from a law enforcement agency to identify the service needs of runaway youth and their families. Results show that runaways represented the only category of missing children contained in the data. The present findings are consistent with national data which suggest that: a typical runaway youth is most likely engaging in acting out rebellious behavior; more girls than boys ran away; most were 14 or 15 years old and most had a prior history of running away. These results support the need for a comprehensive integration between social work research and practice and are used to provide recommendations for the service needs of runaway children and their families. Social work practice recommendations include: (1) community campaigns, (2) training, and (3) increased collaboration between law enforcement and child welfare agencies.     

Community resilience for youth and families: Facilitative physical and social capital in contexts of adversity

Studies that focus on community-level factors associated with the resilience of youth and families reflect a shift in perspective from community deficits to the potential of communities to facilitate the mobilization of human and physical resources. Physical and social capital (both informal relationships and formal service provision) give communities the potential to recover from dramatic change, sustain their adaptability, and support new growth. This paper reviews key concepts such as these as they relate to how young people access informal supports and formal services that promote resilience. A discussion of the relevant research highlights the way protective processes function when children, youth and families are exposed to catastrophic human-made and natural events. Five principles are suggested to help promote community resilience. Implications for the design and implementation of interventions are discussed with a focus on making informal supports more available and formal services coordinated, continuous, co-located, negotiated, culturally relevant and effective.     

Going the distance: serving the needs of older youth at scale

Few communities have developed successful strategies for attracting large numbers of older youth to their out-of-school-time programs. In addition to meeting the unique developmental and programmatic needs of this population, communities have struggled with the challenge of creating communitywide integrated approaches to service delivery and resource development. Communities wanting to build a system of supports for older youth must do so in the context of a communitywide strategy as opposed to fragmented, individually operating programs and services. A communitywide strategy creates greater opportunity for strategic mobilization of resources, greater funding leverage, evaluation and assessment consistency, and more powerful input into creating a public voice and public will for supporting and serving older youth as they make the transition to adulthood.     

Step-Up: Promoting Youth Mental Health and Development in Inner-City High Schools

African American and Latino youth who reside in inner-city communities are at heightened risk for compromised mental health, as their neighborhoods are too often associated with serious stressors, including elevated rates of poverty, substance abuse, community violence, as well as scarce youth-supportive resources, and mental health care options. Many aspects of disadvantaged urban contexts have the potential to thwart successful youth development. Adolescents with elevated mental health needs may experience impaired judgment, poor problem-solving skills, and conflictual interpersonal relationships, resulting in unsafe sexual behavior and drug use. However, mental health services are frequently avoided by urban adolescents who could gain substantial benefit from care. Thus, the development of culturally sensitive, contextually relevant and effective services for urban, low-income African American and Latino adolescents is critical. Given the complexity of the mental health and social needs of urban youth, novel approaches to service delivery may need to consider individual (i.e., motivation to succeed in the future), family (i.e., adult support within and outside of the family), and community-level (i.e., work and school opportunities) clinical components. Step-Up, a high school-based mental health service delivery model has been developed to bolster key family, youth and school processes related to youth mental health and positive youth development. Step-Up (1) intervenes with urban minority adolescents across inner-city ecological domains; (2) addresses multiple levels (school, family and community) in order to target youth mental health difficulties; and (3) provides opportunities for increasing youth social problem-solving and life skills. Further, Step-Up integrates existing theory-driven, evidence-based interventions. This article describes Step-Up clinical goals, theoretical influences, as well as components and key features, and presents preliminary data on youth engagement for two cohorts of students.     

Using primary and secondary stakeholders to define facility-to-community transition needs for adjudicated youth with disabilities

Stakeholder participation, specifically the primary beneficiary, enhances evaluation results by increasing the overall validity of the evaluative measure. This article provides an example of how the addition of adjudicated youth, the primary beneficiary, as a stakeholder group in a needs assessment provided additional information important for program development of a multi-agency transition program. The needs assessment consisted of five regional community forums comprised of youth correctional facility and community-based service providers (n=127), as secondary stakeholders. A nominal group process was completed defining both supports and barriers to the development of the service delivery model. Additionally, qualitative in-depth interviews were conducted on adjudicated youth (n=33) to describe their perception of the barriers and supports necessary for a successful transition from either a youth correctional facility or off of probation. Both groups identified and ranked the top 12 supports and barriers. Common themes emerged from both groups with substantive differences providing information that helped shape the program service delivery model to accommodate needs of both the adjudicated youth and secondary stakeholder participants. Implications for the development of the service delivery model are described.     

Cultivating knowledge of resiliency and reintegration among military youth through a national youth leadership program

Youth in military families are frequently challenged by the adjustment demands associated with the deployment and reintegration of a parent. A positive youth development approach was undertaken by the Boys and Girls Clubs of America to develop and implement a Military Teen Ambassadors (MTA) training for youth in military families that would facilitate knowledge of resiliency and reintegration and foster leadership skills to build assets for themselves as well as their peers within their local communities. To determine if MTA was functioning as intended and to refine future programming, this preliminary formative study assessed perceived participant learning outcomes associated with MTA on variables pertaining to knowledge acquisition, perceived skill acquisition, and community needs awareness. Data were collected prior to the training, immediately following the training, and 6 months after the training. Repeated measures analysis indicated significant mean increases over time in knowledge and awareness of resiliency and reintegration; perceived leadership skills; and community awareness. Qualitative findings provided triangulation in the aforementioned areas. These findings strengthen the body of knowledge on resiliency by demonstrating that the 7 Cs model may be an effective strategy to incorporate into leadership development programs seeking to build knowledge of resiliency among military youth. Study limitations, lessons learned, and recommendations for further research are delineated.     

Multiple Perspectives of Teams’ Experiences of a New Zealand Wraparound Process

Since it was first introduced in the 1980s, Wraparound has been defined as ‘a philosophy,’ ‘an approach,’ and ‘a service’ which is designed to work with youth and families with high and complex needs. Wraparound is most commonly understood as an intensive, individualised care planning process. It aims to achieve positive outcomes through a structured, creative, and individualised team planning process, which results in effective and more relevant plans for the youth and family. The purpose of this qualitative study was to explore the experiences of Wraparound facilitators, caregivers, youths, and team members to gain a multi‐perspective insight into the process. Sixteen families and Wraparound teams participated in the study which resulted in 56 semi‐structured interviews being conducted involving 16 Wraparound facilitators (some facilitators were interviewed more than once because they served multiple families who participated in the study), 16 caregivers, eight youth, and 16 team members (one person from the team, i.e., teacher, social worker, or mentor). Thematic analysis gave seven themes organised into three broad domains: (1) key elements of the Wraparound process including the Wraparound facilitator, Wraparound's philosophies and principles, and the supportive nature of the process; (2) the outcomes achieved throughout the process including family empowerment and hope, improved family dynamics and relationships as well as individual parent and youth change; and (3) the challenges and feedback respondents identified through the process, which included personal and systemic challenges, improved transition, and continuity of care, role clarity, and accessibility of the service. Overall, the findings from this study support Wraparound as an effective process for youth and their families, identify the importance of key aspects of the process, and suggest some improvements to increase the efficacy of and accessibility to the process.     

Building effective working relationships across culturally and ethnically diverse communities

Amherst H. Wilder Foundation's Social Adjustment Program for Southeast Asians is implementing two collaborative, best practice, mental health and substance abuse prevention service models in Minnesota. It faced several issues in effectively bridging multiple cultural groups, including building a diverse collaborative team, involving families and youth, reconciling cultural variation in meeting styles, and making best practice models culturally appropriate. Researchers and program staff used multiple strategies to address these challenges and build successful partnerships. Through shared goals, flexibility, and a willingness to explore and address challenges, collaboratives can promote stronger relationships across cultural communities and improve their service delivery systems.     

Needs-led child and youth care: Main characteristics and evidence on outcomes

Needs-led child and youth care has three main characteristics: a continuous focus on clients' needs, client participation in the care process (including decision making), and practitioners' displays of needs-led attitudes and skills. The primary aim of this review was to establish whether there is evidence for using a needs-led approach when working with children and families in need. We performed a literature search to find reviews and outcome studies of child and youth care for school-aged children and their families which included the core characteristics of needs-led care, and related them to outcome measures. Only a few studies attributed positive outcomes of care to the attention given to clients' needs and goals. Most studies referred to participation in terms of clients' involvement or engagement. Higher levels of participation were associated with positive changes in child behaviors and parenting stress, client satisfaction, higher completion rates, safety for children, feelings of well-being and empowerment, and better service coordination. Significant professional attitudes and skills included listening to clients and working in active partnership with them. There is some proof for the relevance of core characteristics of needs-led child and youth care, although that evidence is limited by the lack of rigorous studies. This study indicates that needs-led child and youth care can make a difference. Future research should pay attention to the intertwinement of the characteristics of the needs-led approach in care.     

Understanding service provision and utilization for vulnerable youth: Evidence from multiple informants

Research has demonstrated that the ability of children to cope well with risk exposure can be partly attributed to the social ecology that surrounds them, including their access to resources. Few studies however have explored the interaction of services that many vulnerable children receive in relation to surrounding risks and available resources. This study reviews data of a paired sample of 166 Canadian multiple service using youth (at least using two of five public service systems) and a youth-nominated person most knowledgeable (PMK) focused on the contextual risk factors, service use variables, and pscychosocial outcomes of youth participants. Despite low to moderate correlations between youth and PMK (the person who is most knowledgeable about youth's lives) reports, findings showed that both PMKs and youth perceive service provision as a mediator between risk and pscychosocial outcomes. For youth however, better quality of service provision is key to improved developmental outcomes. Furthermore, the more risk factors youth face at home and at school, the less likely they are to perceive their services as helpful or appropriate to their needs. Youth data also reflects far more complex interactions between risks, service provision and outcomes than PMK data. Greater sensitivity is needed to both an adult and youth's perceptions of risk and related service needs if service access is to be provided optimally.     

Supporting older youth: what's policy got to do with it?

The nonschool hours are an underused tool in supporting older youth in their transition to adulthood. Given competing demands on many teens' time and a host of other developmental realities, effective strategies for engaging high schoolers look much different from those of their younger counterparts, and those differences have programmatic and policy implications. Effective youth policies reflect an overarching vision that is about changing lives--a vision that addresses a range of risk and protective factors, simultaneously supports discrete programs and builds coherent pathways to success, and recognizes that children and youth grow up in families and communities. This chapter highlights policy innovations related to teens' involvement in out-of-school-time activities and then looks at three principles that can help ensure that youth policy supports the full range of older youth's unique developmental, social, and economic needs.     

Optimizing out-of-school time: the role of free-choice learning

Free-choice learning, a new paradigm for the learning that youth and their families engage in outside school, can play an important role in the healthy development of youth, their families, and communities.