Methods: Homeless Management Information System administrative data were collected between January 2015 and May 2017 (n=10,922) by service providers in 16 communities across the U.S. Data featured initial housing assessments administered to YEH. Multinomial logistic regressions were used to explore indicators of behavioral health and victimization associated with specific living situations among YEH under age 18 (minors) and transition age youth (TAY) between 18-24. Models estimated the relative risk YEH would couch-surf or sleep outside relative to staying in an emergency shelter program.
Results: Approximately 69.8% of YEH were TAY and 30.2% were minors. More than three-quarters (76.3%) were staying in shelter, 7.1% were couch-surfing, and 16.6% were sleeping outside. The average length of homelessness was 9.3 months (SD=11.6). Among TAY, experiencing homelessness due to family violence (RRR=2.44,p<.01) or an abusive relationship (RRR=4.71,p<.01) was associated with an increased likelihood of couch-surfing relative to staying in a shelter. Being physically attacked since becoming homeless was negatively associated with couch-surfing (RRR=.61,p<.01) and positively associated with sleeping outside (RRR=3.16,p<.01). Mental health and substance use issues were solely associated with an increased risk of sleeping outdoors. In contrast, minors who reported substance use issues (RRR=1.72,p=.04), using marijuana before the age of 12 (RRR=1.82,p=.02), or threatening to harm themselves or others in the past year (RRR=1.77,p=.01) were significantly more likely to couch-surf. Experiencing homelessness due to family violence was negatively associated with couch-surfing (RRR=.36,p<.01) and positively associated with sleeping outside (RRR=1.79,p=.02) for minors.
Conclusions: Findings challenge common preconceptions regarding the relative safety or stability of couch-surfing among YEH, highlighting behavioral health issues and experiences of victimization associated with couch-surfing. While family and interpersonal violence often serve as precursors to homelessness, they can also be intimately intertwined with where YEH are couch-surfing; precariously housed YEH frequently endure unsafe living situations due to having no place else to stay. Behavioral health issues associated with couch-surfing among minors may similarly serve as a precursor to and consequence of housing instability, as unstable housing situations can often promote engagement in risky behaviors such as substance use. Understanding the unique circumstances and vulnerabilities of couch-surfing YEH is vital to designing more responsive homeless policy and establishing more equitable service systems.