Service Histories, Resources, and Risk Behaviors Among Homeless Youth That Aged out of Foster Care

Introduction:  In spite of policies aimed at preparing foster youth for independent living, former foster youth comprise 20-50% of homeless youth populations (FYSB, 2014).  Prior research is mixed on whether these youth are unique from the overall population of homeless youth.  In addition, most research on homeless foster youth has examined them as a homogeneous group without examining indicators of which youth among those aging out may be at greatest risk. This study aims to fills these gaps by 1) examining the characteristics, resources and risk behaviors of homeless youth that have aged out of foster care compared to other homeless youth and 2) examining differences within the group of homeless youth that have aged out to identify which youth are most at risk for mental distress, substance use, and high risk sex.

 Methods: Survey data were collected at 47 locations over 4 weeks in one city.  Youth (18-24) in unstable housing situations were included (N=379).  Trained volunteers assessed eligibility, obtained consent, then youth self-administered the survey.  Youth self-reported whether they had aged out of foster care, been involved with juvenile justice, or had a prior mental health diagnosis. Trauma history was assessed using the Adverse Childhood Experiences (ACE) scale, mental distress was assessed with the Kessler-6.  Risk behaviors included whether youth traded sex, had sex without a condom or used substances.  Differences between youth that aged out and other homeless youth and differences within the group of youth that aged out were tested using chi-square and t-tests. 

Results:  Among the sample, 25.6% reported aging out of foster care (n=97).  Compared to other homeless youth, those that aged out had significantly higher rates of prior mental health diagnoses (83.9% vs. 64.4%), and higher rates of lifetime psychiatric medication use (56.5% vs. 43.4%). The aged out group also had greater involvement with special education (36.2% vs. 23.9%), juvenile justice (39.6% vs. 26.9%), higher scores on the ACE (mean 4.8 events vs 4.0; t=-2.20, df=364, p=.03) and were more likely to have Medicaid (39.1% vs. 20.8%) or SSI (24.1% vs. 10.1%) compared to other youth.  Current mental distress and risk behaviors did not differ significantly between the two groups.  Within the aged out group, prior diagnoses of bipolar, depression, and post-traumatic stress disorder were significantly associated with higher mental distress, trading sex, and use of illegal substances.  History of juvenile justice involvement was associated with greater mental distress.

Implications: Homeless youth that had aged out of foster care had histories that distinguished them from other homeless youth, yet their current mental status and risk behaviors were the same as other homeless youth. This may be a positive indicator that services are mitigating risk.  Within the group that aged out, those with prior mental disorder diagnoses and those with juvenile justice histories were at increased risk for mental distress and some risk behaviors.  Youth assessed with these risk factors may need services above those normally provided to youth who age out and targeted planning for housing stability prior to system exit.