Session: Achieving Health and Mental Health Equity for Homeless Youth: Findings from the Homeless Youth Risk and Resiliency Survey (Society for Social Work and Research 22nd Annual Conference - Achieving Equal Opportunity, Equity, and Justice)

Background. Homeless youth (HY) die at rates 10 times higher than their same-aged, housed peers, primarily due to suicide and drug overdose (Auerswald et al, 2016). Relatively little is known about the lives and experiences of HY that may indicate sources of resilience and targets to facilitate their exit from homelessness and improve their health and mental health outcomes. To address this need, the Homeless Youth Risk and Resiliency Survey (HYRRS) was developed by a team of researchers across the United States. This symposium presents four papers that use data from this multi-city effort to better understand how to help young people exit homelessness and improve their health and mental health outcomes.

Methods. HYRRS is a mixed-methods study conducted in 4 cities (Denver, Los Angeles, Houston, and Phoenix) from 2016-2017. Each site recruited approximately 200 young adults (ages 18-26) from agencies serving homeless youth in their area. Researchers administered a quantitative survey, containing standardized measures and social network questions, to all youth, and a subset of 30 youth at each site also participated in a qualitative interview. All sites followed the same protocols and administered the same survey instruments, assessing a range of health outcomes and risk and resilience factors. Youth were eligible to participate if they were between ages 18-26 and had spent the prior night in a shelter, on the streets, in an unstable housing situation, or were housed through a program voucher. Each abstract examines different outcomes, using different samples from these overall data.

Results. The first paper, using egocentric social network (N=422), clarifies the need for education about Hepatitis C in this high risk population and the potential for using social networks to increase information transmission and increase testing rates. The second paper, using data across 4 cities (N=835) finds that the majority of HY report experiences of discrimination which are associated with a variety of mental health outcomes, underscoring the need for critical consciousness-raising with HY and community awareness efforts to decrease stigma. The third paper, using qualitative data from Phoenix (N=31), finds HY experience interrelated systemic, situational, and intrapersonal barriers to exiting homelessness and rely on both informal and formal supports, highlighting the need for integrated micro-mezzo-macro interventions. The fourth paper, using qualitative data from Denver (N=31), finds HY have big goals for their futures and think well beyond the immediate needs that are often the focus of HY services, requiring dual-focused services that support HY to pursue longer-term ambitions.

Conclusion: Together, these papers suggest promising directions to help youth exit homelessness and improve their health and mental health outcomes. Findings challenge the dominant approach to services for HY, indicating the need to approach HY ecologically and holistically. Services should consider the importance of HY's social networks as potential health supports while also acknowledging the detrimental influence of discrimination in broader society. Using integrated micro-mezzo-macro approaches, providers should also work with HY to develop their full potential beyond basic needs. Such efforts are likely to support HY in pursuing health and mental health equity.