Speaking Out: Youth Led Research as a Methodology Used with Homeless Youth

Participatory action research is well documented with marginalized groups, but less is known about participatory action research with homeless youth. The use of youth led research as a methodology was examined among a population of homeless youth. Peer researchers (n = 10) reported on their experience utilizing youth led research methodology. Results indicate that youth led research is a promising methodology for use among homeless youth. Participants reported that the approach positively impacted the quality and quantity of data that could be collected from participants. Further, peer researchers reported individual benefits of feeling that participating in the project mattered, that people listened to them and that they had a voice.     

Gender Differences in the Path From Sexual Victimization to HIV Risk Behavior Among Homeless Youth

ABSTRACT

Experiencing sexual victimization prior to becoming homeless is common among homeless youth and is associated with increased HIV risk behavior. This study examined mediating variables that underlie this association, adding to the understanding of gender differences in these paths. Participants were homeless youth in Los Angeles recruited through service access centers who completed a computerized self-administered interview in English or Spanish using an iPad. Findings indicate a high presence of sexual victimization across both genders. Female participants experienced posttraumatic stress disorder and subsequent engagement with exchange sex, whereas male participants were primarily involved in substance use risk pathways. Results indicate paths in the association between sexual victimization and HIV risk behavior differ between male and female homeless youth. Gender-specific, mental-health-informed interventions targeting sexual risk reduction are warranted.     

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.     

Lesbian, gay, and bisexual homeless youth: an eight-city public health perspective

This article reports on results of a one-day public health survey conducted in six states by homeless youth providers to measure and compare risk factors between lesbian, gay, and bisexual (LGB) homeless youth and non-LGB homeless youth. This article intends to inform the child welfare field on existing gaps in services and areas where more training and technical support is necessary in providing services to homeless LGB youth. The findings point to substantial differences within the homeless youth sample and demonstrate that in addition to the public health risks young people face merely by being homeless, the risks are exacerbated for those who self-identify as lesbian, gay, or bisexual. The article informs child welfare providers and policymakers about the substantial vulnerability of LGB youth beyond that of non-LGB homeless youth and the need to fund programming, training, technical assistance and further research to specifically respond to the complex needs of this population.     

Barriers and facilitators to shelter utilization among homeless young adults

Rates of shelter use among homeless youth are low compared to use of other supportive services, yet research on barriers to shelter use has been conducted in limited regions, specifically in West Coast or Midwest cities. Additionally, while studies have generally focused on barriers to shelter use, studies on what might facilitate shelter use are lacking. This study explores barriers and facilitators to shelter use among homeless young adults from a large city in the Southwest region. Focus groups were conducted with a diverse sample of 49 homeless young adults ages 18–24. Drawing on models of health service use, findings were categorized into two domains – attitudinal and access. Themes related to attitudinal barriers include stigma/shame and self-reliance/pride. Attitudinal facilitators include the desire to extricate themselves from street life and turn their lives in a new direction. Access-related themes include barriers such as a lack of shelters and services available to meet the needs of youth, adverse shelter conditions, staff attitudes that are not acceptable to youth, restrictive shelter rules, restrictive definitions of homelessness, and a desire to differentiate themselves from older homeless individuals. Certain characteristics or circumstances (e.g., being pregnant), having supportive others, and shelters’ ability to connect them to other services emerged as access facilitators to shelter use. Implications for policymakers, service providers, and future research are discussed.     

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.     

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.     

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     

Longitudinal cost of services in a homeless sample with cocaine use disorder

ABSTRACT

Homeless people with cocaine use disorder have multiple comorbidities and costly service needs. This study examined service costs associated with cocaine use and substance service use in substance, psychiatric, and medical service sectors. 127 homeless participants with cocaine use disorder were interviewed annually. Self-report and agency-report service use and cost data were combined. Pairwise comparisons were made with cocaine abstinence and substance service use in relation to mean and yearly proportional service costs in 3 service sectors. Among substance service users, the achievement of abstinence was not associated with decreased substance service costs. Cocaine abstinence was associated with proportional reduction of substance service costs over time. Substance service use was associated with proportional reduction of psychiatric service costs over time among the abstinent subgroup. Conversely, substance service use was associated with continuing higher medical service expenditures in the abstinent subgroup and higher psychiatric service expenditures in those not abstinent. Homeless individuals who achieved cocaine abstinence after using substance services had decreased substance service expenditures. Individuals with continued substance service use had greater medical and psychiatric service costs. Policy-based on maximizing benefits while minimizing costs appears insufficiently complex to incorporate the multiple needs and associated with the costs of treating homeless populations.     

Homeless Youths’ Interests in Social Action via Photovoice

Engaging homeless youth in services is challenging. Novel methods are needed to better retain and empower this population. Photovoice, an innovative form of community-based participatory research, facilitates participants’ use of photography to document their everyday lives and struggles, while advocating for social change. This study examines, among 22 homeless youth, whether and why youth would be interested in participating in Photovoice activities, the types of social issues youth would be motivated to explore, and homeless youths’ opinions about committing to a longer-term, group-oriented project. Photovoice may represent promise in engaging marginalized and difficult-to-retain populations.     

Correlates of Engaging in Survival Sex among Homeless Youth and Young Adults

Using a sample of 1,625 homeless youth and young adults aged 10 to 25 from 28 different states in the United States, this study examines the correlates of having engaged in survival sex. Findings suggest that differences exist based on demographic variables (gender, age, race, and sexual orientation), lifetime drug use (inhalants, Valium?, crack cocaine, alcohol, Coricidin?, and morphine), recent drug use (alcohol, ecstasy, heroin, and methamphetamine), mental health variables (suicide attempts, familial history of substance use, and having been in substance abuse treatment), and health variables (sharing needles and having been tested for HIV). In addition to replicating previous findings, this study's findings suggest that African American youth; gay, lesbian, or bisexual youth; and youth who had been tested for HIV were significantly more likely to have engaged in survival sex than White, heterosexual youth, and youth who had not been tested for HIV, respectively. Implications for interventions with youth and suggestions for future research are discussed.     

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.     

Trading sex: voluntary or coerced? The experiences of homeless youth

This study examined the circumstances surrounding a homeless youth's "decision" to trade sex for food, money, shelter, or drugs. Forty homeless youth in 4 Midwestern states participated in individual in-depth qualitative interviews. Interviewers recruited youth both through service agencies and through street outreach. The findings revealed that approximately 1/3 of the sample had some experience with trading sex, whether it was in the form of having traded sex, having been propositioned to trade sex but having refused, or having friends or acquaintances that had traded sex. Young people's reports indicated that they had traded sex for things they deemed necessary in order to survive (i.e., food, shelter, money, or drugs), and that they did not want to trade sex, but did so because they were desperate and lacked alternatives. Additionally, others were coerced, manipulated, or forced to do so; thus indicating that the decision to trade sex is not always voluntary. We discuss the implications of these findings in terms of cumulative effects on youths' later development. Directions for future research among this population are also discussed.     

Social network characteristics associated with risky behaviors among runaway and homeless youth.

Runaway and homeless youth are at high risk for substance abuse and unsafe sexual behavior. Our study describes the personal social networks of these youth and examines network characteristics associated with risky behaviors. In 1995 and 1996, we interviewed a purposive sample of youth aged 14 through 21 who were living in Washington, DC and were identified on the streets or through shelters or other service agencies (N = 327). Although we found that most youth reported current social relationships, a significant minority (26%) did not. Youth without a social network were significantly more likely to report current illicit drug use, multiple sex partners, and survival sex than youth with a network. For youth with a network, the networks were small, strong in affective and supportive qualities, comprised primarily of friends, typically included an alcohol or illicit drug user, and usually were not a source of pressure for risky behaviors. Our results indicate that networks had risk-enhancing and risk-decreasing properties in that network characteristics were associated in both positive and negative directions with risky behaviors.     

A qualitative analysis of suicide risk factors,preferred means,and means restriction feasibility within a homeless shelter environment

Suicide completion rates among homeless individuals are approximately nine times higher than the general population. The purpose of this study was to capture the state of social support among homeless individuals, understand how homeless community members support peers in crisis, examine the awareness of suicidal ideation, identify common methods for suicide, and generate strategies for means restriction within a shelter. Twenty individuals residing at an emergency shelter were interviewed. Participants were of diverse cultural identities overrepresented in the sample relative to the general population. Interviews revealed that 40% of participants lacked social support. However, the majority indicated that if they encountered someone at risk for suicide, they would provide support and encouragement to the at-risk individual. Almost half of participants reported knowing of an individual in the shelter who had previously attempted suicide and/or was currently or previously feeling suicidal. Overdose was identified as a primary method for suicide; however, the majority of participants were unable to generate strategies for means restriction. The present study offers a glimpse into the experience of homeless individuals and provides valuable information regarding risk factors for suicide within this highly marginalized and underserved population.     

A typology of adolescent runaways

No single program seems adequate to serve a highly complex adolescent runaway and homeless youth population. A service program must have many components with each part addressing the needs of a specific and different population. This paper presents a typology of runaway behavior which has three categories. These categories distinguish among runaway and homeless youth by reference to their family situation, psychological characteristics, and length of time out of home. The implications for intervention that follow from these categories are discussed.former Bush fellow at the University of California, Los Angeles.     

Moving Beyond Housing: Service Implications for Veterans Entering Permanent Supportive Housing

As a result of efforts to end homelessness among U.S. veterans, more former service members are entering permanent supportive housing (PSH). While PSH has been successfully used to house homeless veterans, more research is needed about services beyond housing placement and retention. This study uses the Gelberg–Andersen behavioral model for vulnerable populations to determine associations between predisposing, enabling, and need characteristics and recent service use (i.e., services to satisfy basic needs, occupational development, financial, healthcare, mental health) among unaccompanied homeless veterans (N?=?126) entering PSH in Los Angeles. Among the significant findings, as indicated using univariable logistic regression models, were veterans who had incarceration histories were more likely to utilize basic needs services, compared to those without incarceration histories. Veterans who received an honorable discharge were more likely to utilize occupational development services, compared to veterans with other discharge statuses. Veterans who had a case manager were more likely to utilize mental health services than those without a case manager, while those who received social security were less likely to utilize mental health services compared to veterans who did not receive social security. Veterans who met criteria for a psychological disability and veterans who met criteria for probable PTSD were more likely to use basic needs services and mental health services than veterans who fell below these thresholds. Clinical implications for social workers including “equal access to services,” “enhancing economic stability,” “providing safe and affordable housing with trauma-informed services,” and “training service social workers to deliver well-informed linkages and services” are discussed.     

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.     

A portrait of older homeless men: Identifying hopelessness and adaptation

Using participant observation as a homeless shelter volunteer and through face-to-face long interviews with four homeless elders (50+) and six service providers throughout the Greater Cincinnati Metropolitan area, data revealed unique coping strategies and patterns of service use of older homeless people. A state of hopelessness characterized many older homeless people who adapted and functioned in their culture of poverty. Sources of hopelessness were identified. Unique adaptations were noted for certain individuals who either learned to use the services opportunities provided or learned to exploit/abuse the service network. This group of people have found a social niche in which they can function and meet basic survival needs.     

A Portrait of Older Homeless Men: Identifying Hopelessness and Adaptation

Using participant observation as a homeless shelter volunteer and through face-to-face long interviews with four homeless elders (50+) and six service providers throughout the Greater Cincinnati Metropolitan area, data revealed unique coping strategies and patterns of service use of older homeless people. A state of hopelessness characterized many older homeless people who adapted and functioned in their culture of poverty. Sources of hopelessness were identified. Unique adaptations were noted for certain individuals who either learned to use the services opportunities provided or learned to exploit/abuse the service network. This group of people have found a social niche in which they can function and meet basic survival needs.