Role of Informal Networks In Predicting Service Utilization Among Runaway & Homeless Youth

Purpose: Rates of mental health and substance abuse problems tend to be disproportionately higher among runaway and homeless youth (RHY) relative to the general adolescent population (Greene et al., 1997; Solorio et al., 2006). Even with such documented needs, it has been found that formal service utilization among RHY tends to be low (Kurtz et al., 2000; Hudson et al., 2010). Social network characteristics have been known to be influential in motivating people's decision to seek care and could provide us with significant information about how these factors are associated with service utilization and how they can be incorporated in future interventions to facilitate greater service use (Pescosolido, 1992; Birkel & Reppucci, 1983; Knowlton et al., 2005; Deri, 2005). It has been hypothesized that social networks act as social ties through which individuals are able to access and exchange resources that affect their decision to seek out services (Lin et al., 2001). Utilizing Pescosolido's Network Episode Model (1992) as a guiding framework, the purpose of this study is to identify and examine the structure and content of network ties and their associations with service utilization among RHY. Methods: A non-probability sample of 136 adolescents was recruited June 2008 in Los Angeles, California at one drop-in agency serving homeless adolescents. Clients age 13 to 24 were eligible to participate. The survey consisted of two components (1) a computer-administered self-reported survey of health and service-utilization attitudes and behaviors and (2) a face-to-face social network survey, which assessed the structure and content of each youth's personal network, delivered at the agency, lasting 60 minutes. Results: Only 27% of the youth in the study reported that they had used any kind of substance abuse treatment and 34% of youth reported that they had used any kind of mental health treatment. Multivariate logistic regression models suggest that social network variables are crucial in understanding service utilization in this sample of homeless youth. Homeless youth who maintained ties to pro-social influences (defined as parents, caseworkers, peers who are social service users & home based ties), relative to those who did not, reported significantly lower rates of substance abuse treatment (OR=.88, p<.05). Density was significantly associated with both substance abuse and mental health treatment utilization. Youth who had denser networks were less likely to utilize both substance abuse treatment and mental health treatment (OR=.01, P<.05). Implications: Despite the preliminary nature of these data, these findings have significant intervention and practice related implications. Given these results, practitioners who work with homeless youth should pay careful attention to incorporating social networks as potential barriers or facilitators to service use. It can also be suggested that specific social network characteristics and understanding the types of support that is received from these ties will help practitioners tailor interventions based on the unique needs of their clients. Specifically, since these results indicate that youth tend to rely on informal sources of support from family and friends, it would be prudent to use these networks to motivate homeless youth to seek formal services.