The experiences of adolescents and young adults residing with their families in emergency shelters in Canada

Emergency homeless shelters can be stressful environments for families. They can be associated with emotional distress and feelings of restriction for parents, and with behavioural, social, and developmental challenges for children. However, little is known about the experiences of accompanied youth residing in shelter with their families, as the literature about this age group's experiences of homelessness has mainly focused on unaccompanied youth. Findings from the current study are drawn from qualitative interviews with 16 adolescents and young adults (aged 16–21) who were homeless and living with their families in family homeless shelters in Ottawa, Ontario, Canada. Youth described family homeless shelters as stressful environments but also found that the shelters provided support to them and their families. Youth discussed the various strategies they used to cope in facing the challenges of shelter life. These findings add to our understanding of youth who are homeless and highlight the ways in which they adapt to the challenges of living in a family homeless shelter with their families. Recommendations are included for ways that shelter staff and policymakers can enact operational and systemic changes that could potentially improve the experiences of such youth and their families.     

The need for safe spaces: Exploring the experiences of homeless LGBTQ youth in shelters

Studies indicate LGBTQ youth are at higher risk of homelessness (2–13 times) than their heterosexual cisgender counterparts and that they represent a substantial portion of youth utilizing housing and shelter services. Some authors have provided anecdotal (rather than empirical) examples of LGBTQ youth experiencing abuse or mistreatment in shelters; most studies focusing on LGBTQ homeless youth have been conducted in large cities and have rarely collected data from both youth and providers. Using an exploratory, grounded theory approach, this study utilized data from interviews with LGBTQ youth with a history of homelessness as well as service providers working with this population in a mid-sized Northeastern city. Findings suggest youth experience multiple challenges, barriers, and mistreatment in the shelters; further, data suggests several ideas about how to transform shelters to better meet the needs of LGBTQ youth.     

“I don't like to live nowhere but here”: The shelter as mediator of U.S. homeless youth's identity formation

Identity formation, from a sociocultural perspective, involves people choosing from among the variety of historical and cultural resources available to them for living their values, making a commitment to a particular life course, and grounding their hope in the future. Researchers in the past have argued that homeless shelters provide few such resources for children and youth to form healthy identities. At the same time, these researchers have not examined how young people themselves make sense of the shelters in which they live in the course of their own development. This article examines how children living in two small family shelters in a large southeastern city understand the shelter as a place they call home in relation to their families, friends, and themselves. Implications for the study of identity formation of homeless children and youth are discussed.     

Best practices for emergency shelters that serve male populations

Homeless men represent the majority of homeless people. While federal funding priorities have shifted to permanent housing solutions, quality emergency shelters are vital in communities to help these men. To determine the best practices in emergency shelter delivery to homeless men based on top agency representatives’ opinions. Leaders from 21 emergency shelters that serve single men throughout the U.S.A. were interviewed about their facilities, their opinions on the best practices of emergency shelters, and barriers that single men face in exiting homelessness. The main goal of emergency shelters is to offer a welcoming environment. Emergency shelters try to offer a variety of services on-site, but find it difficult to offer medical and dental services at facilities with smaller budgets. Access to beds, showers, drug and alcohol rehabilitation, case management, and access to medical services are seen as vital to the success of the emergency shelter. These emergency shelters have many services in place to help the single male population. The most important services are ones that address the basic needs of human beings first: food, showers, beds, medical services, and storage. Mental health and breaking substance dependency are also priorities.     

No Place Like Home: A Study of Two Homeless Shelters

Homelessness is one of the most pressing social problems today. Society has responded to the problem with the creation of homeless shelters. yet, the nature of the operation of the shelter is not defined. This study explored the operations of two single adult homeless shelters to understand how they operate in addressing the problem of homelessness. The study identified two different types of services, one called "house" and the other ((home." House services provided basic food, shelter, and linkage to social services, which fulfilled the basic definition of the problem of homelessness as defined by the Institute of Medicine. Home services provided the basic services of house but also went one step beyond by providing these services within the context of a supportive environment, thus creating informal social supports. The study discusses the implications of each of these modalities in addressing the problems associated with people who are homeless as well as the differences in policies and structures which contribute to one shelter providing house and the other home services.     

Child welfare involvement among children in homeless families

An analysis of 8251 homeless children in New York City found that 18% of them received child welfare services over the five-year period following their first shelter admission, and an additional 6% had a history of having received such services before their first shelter admission. Recurrent use of public shelters, exposure to domestic violence, older age at first episode of homelessness, and larger number of children in a household were associated with an increased risk of child welfare involvement. The high rate of crossover between homelessness and the child welfare system suggests the need for service coordination for children in homeless families.     

“If you’re gonna help me,help me”: Barriers to housing among unsheltered homeless adults

Despite a legally-mandated right to shelter and extensive outreach efforts, an estimated 3,675 homeless individuals were living on the streets of New York City in 2018. Through interviews with 43 unsheltered homeless individuals in the borough of Manhattan (age range 21–74 years), this qualitative study examined barriers they face in accessing housing and other services as well as experiences surviving on the street. Through thematic analysis of the interview data, the most common barriers found were obtaining required identification documents, lack of accessibility of shelters amid complex healthcare needs, waiting as part of the process, and exclusion of pets from shelters and housing options. Themes capturing survival on the street included sleeping safe, avoiding shelters, and meeting daily needs. Virtually all barriers street homeless New Yorkers face stem from bureaucratic policies that, however well-intentioned, do not address their diverse needs. Thus, long delays and poor communication, combined with crowded, unsafe shelters, lead to frustration and alienation. While homelessness is ultimately the result of a severe and chronic shortage of affordable housing, creating accessible, safe, pet-friendly shelter and safe haven options and instituting a smoother, more transparent process for moving from the streets could substantially reduce street homelessness.     

Rural Homeless Shelters: A Comparative Analysis

Although there has been some increased attention to the issue of homelessness and homeless shelter services, little effort has been made to understand the operation of rural homeless shelters. This situation persists despite decades of effort showing that the rural environment provides a very different context for the delivery of services than an urban environment. This study hypothesized that contextual differences in rural environments would produce various strategies of service delivery among homeless shelters. A typology of rural environments was created. Homeless shelters within each of four cells of the typology were selected. Comparative case study analysis provided partial support for the hypothesis.     

Emergency departments and street-involved youth: factors influencing utilization

Homeless youth often have untreated health problems and experience barriers to care. Existing evidence suggests that homeless youth use emergency departments (EDs) more frequently than other youth. We hypothesized that street youth with access to primary care services would be less likely to utilize EDs for health care. Data were drawn from a study of housing security and changes to it over time among 150 youth (16–20 years) recruited from service agencies for street-involved youth. Our findings show that those with access to primary care were actually more likely to use the ED, suggesting that access may encourage further engagement with the health care system. Findings support the need to better understand why access to primary care increases ED use and what could be done to change this pattern.     

“I’m not homeless,I’m houseless”: identifying as homeless and associations with service utilization among Los Angeles homeless young people

Little is known about homeless young people’s identification of being homeless and how that identity may or may not be associated with service utilization. This study of 444 homeless young people attending Los Angeles area drop-in centers explores the associations of demographic characteristics, homelessness characteristics, negative lifetime experiences, mental health symptoms, technology use, and past month service utilization with identifying as homeless. Fifty-two percent of the sample identified as being homeless. Being Black, a current traveler, and history of injection drug use were all significantly associated with a decreased likelihood in identifying as homeless. However, having fair/poor health, accessing shelter services, and reporting one’s own substance use as a reason for homelessness were all significantly associated with identifying as homeless. There are important service implications for reaching young people who are in need of services but may not identify with the target population label of homeless.     

Rural Homeless Shelters: A Comparative Analysis

Although there has been some increased attention to the issue of homelessness and homeless shelter services, little effort has been made to understand the operation of rural homeless shelters. This situation persists despite decades of effort showing that the rural environment provides a very different context for the delivery of services than an urban environment. This study hypothesized that contextual differences in rural environments would produce various strategies of service delivery among homeless shelters. A typology of rural environments was created. Homeless shelters within each of four cells of the typology were selected. Comparative case study analysis provided partial support for the hypothesis.     

Social Ecological Factors of Sexual Subjectivity and Contraceptive Use and Access Among Young Women in the Northwest Territories,Canada

Adolescent women in the Northwest Territories (NWT), Canada, experience many sexual health challenges that are linked to a history of colonization and intergenerational effects of trauma. This study was informed by social ecological theory and explored how young women in the NWT develop sexual subjectivity within the context of contraception use and access during this time of decolonization. A total of 41 participants (aged 13 to 17 years) attended the Fostering Open eXpression among Youth (FOXY) body-mapping intervention in six NWT communities and then completed semistructured interviews. Framework analysis identified barriers to the development of sexual subjectivity that included a culture of stigma and shame surrounding sexuality; pervasive alcohol use in communities; predatory behaviors by older men; poor quality sexual health education offered in schools; and issues with accessing health services. In addition, analysis identified the following facilitators: comprehensive sexual health education; widespread access to free condoms; and positive health support networks with female relatives, peers, and some teachers. Our findings suggest the need for multiple intervention strategies within a complex social ecological framework, including arts-based interventions that focus on developing self-esteem and self-efficacy of youth, combined with interpersonal interventions that strengthen communication skills among supportive adults, and community-level campaigns that target stigma reduction and shift cultural norms.     

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.     

Youth homelessness and self identity: a view from Canada

ABSTRACT

This paper is based on the analysis of data collected from the National Canadian Homeless Youth Survey and addresses the question: why do some youth who received support from social service agencies that cater to the needs of homeless youth self-identify as being homeless while others do not? According to self-report survey data obtained from 1103 young people from over 50 youth homeless service centres from across Canada, findings show that youth who self-identified as being homeless shared several backgrounds and current situational characteristics not common among youth in the sample who did not consider themselves to be homeless. The findings illustrate the importance of past trauma and the intensity of day to day hardship in self-identifying as a homeless young person.     

The invisibility of disability for homeless youth

A largely unexplored complexity in the lives of youth who have experienced homeless is the presence of intellectual, developmental and/or learning disabilities. Although emerging research shows that youth with cognitive disabilities are more likely to become homeless and that rates of cognitive disabilities are higher among the homeless population than the population in general, exploring the intersection of disability and homelessness for youth has not been a priority. In this study, a critical disability and systems failure lens is brought to bear on the vulnerability of youth who experience this intersection. Based on interviews with key informants in the disability, homelessness, education, employment and child welfare sectors in three sites in Ontario, Canada, the invisibility of disability among homeless youth is brought to light. We explore the ways youth with a disability in the homelessness sector are made vulnerable, the insurmountable barriers to getting access to the requisite assessment for disability services and the siloed nature of the homelessness and disability service sectors. An argument is made that “working outside the box” to assist youth to navigate significant system disjunctures is insufficient.     

The system-of-care for homeless youth: perceptions of service providers

Service providers' perceptions of the system of care for homeless youth are described. Face-to-face structured interviews were conducted with staff at homeless youth agencies in Los Angeles County (L.A. County) regarding organizational and staff characteristics, issues affecting youth, types of available services, gaps in services, and barriers to service delivery.Overall, agencies were large, well established, and provided multiple services. Most agencies (62%) were concentrated in Hollywood, a cruise area of L.A. County. Clear distinctions emerged between large and small agencies; large agencies had more resources, more professional staff, were established longer, and were policy advocates. Typical of other US metropolitan areas, services for homeless youth in L.A. County are located in cruise areas, and are not as readily available in other geographic areas. Such geographic barriers to providing a comprehensive and coordinated system of care can affect youth's pathways out of homelessness.     

Homeless mothers and depression: misdirected policy.

This paper is a critique of recent service-intensive shelter programs for homeless mothers and the policies that underlie these shelters. We first document the process by which mental health problems and family homelessness became so closely but mistakenly linked. We then demonstrate empirically that shelter programs for homeless families nonetheless presume that mental health problems are part of the causal nexus of family homelessness and indiscriminately deliver mental health services to homeless mothers. Simultaneously, shelter programs encourage the isolation of their residents from what they presume to be their "problematic" social networks. We show that, while mental health services had little impact on depression levels among homeless mothers, isolation from social networks did increase depression among homeless mothers. Our findings suggest that policy should put more emphasis on rapid reintegration into the community through providing housing, and it should put less emphasis on providing services.     

Barriers to healthcare for American Indians experiencing homelessness

Members of American Indian (AI) communities face many barriers to receiving both mental and physical healthcare. These barriers can have a negative effect on overall health. Barriers are compounded for AIs who are also experiencing homelessness, and AI make up a disproportionate percentage of the homeless population nationwide. In-depth semi-structured interviews were conducted with 12 service providers and 16 homeless participants in a mid-size Midwestern city to identify barriers to care for homeless participants. Key barriers identified in this study for homeless participants were: transportation, phone accessibility, discrimination, and cold and bureaucratic cultures of healthcare systems. Major barriers identified by service providers were: access to care, discrimination and mistrust, and restrictive policies. Given generally higher disease prevalence within the homeless population and health disparities within the AI community, steps should be taken to reduce barriers to healthcare.     

Qualitative exporation of relationships with important non-parental adults in the lives of youth in foster care

Foster youth are at risk of poor adult outcomes. Research on the role of mentoring relationships for this population suggests the value of strategies that increase their access to adult sources of support, both while in foster care and as they reach adulthood. We conducted semi-structured, individual qualitative interviews with 23 former foster youth ages 18-25 regarding their relationships with supportive non-parental adults. We sought to identify factors that influence the formation, quality, and duration of these relationships and to develop testable hypotheses for intervention strategies. Findings suggest several themes related to relationship formation with non-parental adults, including barriers (e.g., youth's fears of being hurt) and facilitators (e.g., patience from the adult). Distinct themes were also identified relating to the ongoing development and longevity of these relationships. Youth also described multiple types of support and positive contributions to their development. Proposed intervention strategies include systematic incorporation of important non-parental adults into transition planning, enhanced training and matching procedures within formal mentoring programs, assistance for youth to strengthen their interpersonal awareness and skills, and the targeting of specific periods of need when linking youth to sources of adult support. Recommended research includes the development, pilot-testing, and evaluation of proposed strategies.     

Applications of Machine Learning Methods to Predict Readmission and Length-of-Stay for Homeless Families: The Case of Win Shelters in New York City

ABSTRACT

New York City faces the challenge of an ever-increasing homeless population with almost 60,000 people currently living in city shelters. In 2015, approximately 25% of families stayed longer than nine months in a shelter, and 17% of families with children that exited a homeless shelter returned to the shelter system within 30 days of leaving. This suggests that “long-term” shelter residents and those that re-enter shelters contribute significantly to the rise of the homeless population living in city shelters and indicate systemic challenges to finding adequate permanent housing. This article focuses on our preliminary work with Win (Women-in-Need) shelters to understand the factors that predict readmission and length-of-stay of homeless families. We create a unified, comprehensive database of the homeless population being served by Win shelters, accounting for more than 6,000 homeless families. We apply logistic regression models and an unsupervised clustering algorithm to identify predictors of re-entry and long-term length-of-stay. Citizenship, age, medical conditions, employment, and history of foster care or shelter stays as a child are found to be significant predictors. The results of the K-means clustering identify three primary groups, consistent with previous typologies characterized by transitionally homeless, episodically homeless, and chronically homeless.