Working with Service Disconnected Homeless Youth: Engaging, Retaining and Linking

Purpose: Homeless youth are one of the most vulnerable populations in the country. Previous research shows that formal and informal support services predict decreased time spent homeless, and may be critical for helping youth exit homelessness (Slesnick et al., 2008). However, homeless youth are often difficult to locate and engage into services. For example, the shelter system often serves as the first point of service contact for homeless individuals (Pable, 2005), but homeless youth avoid using the shelter system (Ensign & Bell, 2004). Therefore, identifying strategies to connect homeless youth to services outside of the shelter system is a critical step towards addressing youth homelessness.  The focus of this study was to determine whether the use of strengths-based outreach is successful at engaging substance using homeless youth into various services. In order to be eligible for the study, youth must have been between 14 to 24 years, must not have sought services through a shelter, drop-in center, or substance use/mental health treatment program in the prior 3 months, and must have had one month of continuous homelessness.

Methods: Homeless youth (N = 80) were recruited from the streets, soup kitchens, and other public venues (libraries, fast food restaurants, etc.). Using a strengths-based outreach approach, youth were linked to an advocate who met with them over a period of 6 months with the goal to successfully address the youths’ needs and goals. The majority of participants were White (56%) or African American (33%) and male (56%).  About 72% of youth reported that getting enough to eat was a problem in the past 12 months, and a large number of youth reported a history of sexual (37.1%) or physical abuse (45.3%), as well as a prior suicide attempt (41.3%). In the last 30 days, all youth (100%) reported marijuana use, 85% reported alcohol use, 37.3% reported opioid use and 23% reported cocaine use.

Results: Of greatest interest is that the majority of youth were successfully retained in the intervention, with an average of 14 service meetings (range 0-67). Only 5 youth did not attend any service meetings. Following the intervention (6-months post-baseline), 62% of youth reported receiving government assistance (food stamps, cash assistance, etc.) compared to 34% at baseline. Furthermore, 33% of youth reported stable housing, and the number of youth reporting sleeping outdoors (in camps, under bridges, in parks) decreased from 57% to 21%. Only 15% of youth reported that they utilized shelter services.

Conclusions/implications: The findings from this study suggest that service disconnected youth who experience even greater marginalization and problem severity than youth connected to services, can be successfully engaged into services through the use of a strengths-based outreach and case management approach. However, the findings suggest that few youth were willing to seek assistance at a shelter, even with the support of an advocate. Shelters may be viable sources of engagement and support for adults experiencing homelessness, but other options may be needed in order to help the most disconnected homeless youth navigate the service system and exit homelessness.