Invisible Needs of Transition-Age Youth with Developmental Disabilities in Access to the Permanent Supportive Housing Services

Background and Purpose

Transition-age youth (TAY) from 16 to 24 years old are among the most vulnerable subgroups of the homeless population (Hagan & McCarthy, 2005; Sullivan-Walker et al., 2017), experiencing multiple challenges transitioning into adulthood. TAY is at a higher risk of being chronically homeless, with even greater homeless risk for TAY with developmental disabilities (DD) (O’Connor & MacDonald, 2018). With a lack of disability assessment and documentation, the specific needs of TAY with DD are often undetected, leading to maladjustment in a homeless shelter and exclusion from homeless services and policies (Collins et al., 2018). This creates overwhelming barriers for TAY in accessing housing services. However, their unique challenges remained largely unexplored. Permanent supportive housing (PSH) intervention, as a combined model of affordable housing and supportive services, has been proven effective for individuals experiencing homelessness with multiple risk factors (Rog et al., 2014). Thus, this study aims to critically examine the factors that contribute to PSH eligibility to better accommodate the complex needs of TAY with DD.

Methods

13,815 unhoused participants and 1,155 PSH housed participants were selected from a homeless service collaborative in San Antonio, Texas (01/2018 - 10/2021). Each group was divided into TAY and older participants. We calculated percentages of participants by race/ethnicity, gender orientation, type of disabilities, and PSH accessibility. ANOVA and independent t-test were conducted to compare the total mean score and the mean score of each subsection of the SPDAT (Service Prioritization Decision Assistance Tool) test by age range and housing status.

Results

Overall, unhoused TAY participants were overrepresented in all racial/ethnic groups (American Indian, Black, Multi-racial, Native Hawaiian) when compared to both the unhoused adults and housed group. There was a housing disparity in TAY, comprising 2.2% of the housed participants, compared to the 9.9% of unhoused participants. In addition, unhoused TAY had a 4.7 times higher prevalence of developmental disabilities than the housed group and 1.8 times more than unhoused older adults. Housed TAY had a high percentage of both physical disabilities and developmental disabilities, and all had substantial mental health issues. There were no significant differences in total SPDAT mean score between unhoused TAY and housed TAY (p>.05). However, housed TAY had higher need scores in mental health, physical health, substance abuse, and medication subsections. Unhoused TAY demonstrated higher needs in self-care, daily living skills, social relationships, personal administration, money management, and managing tenancy.

Conclusions and Implications

This study found significant housing disparities among TAY with DD. The current practices prioritize visibly severe disabling conditions in access to housing services. Invisible difficulties such as having DD, limited self-care, daily living skills, and personal administration skills were not examined as important factors when considering housing eligibility, potentially leading to long-term homelessness in the youth’s future. There should be a more thorough examination of the invisible, potential risk factors in the assessment for housing eligibility. In addition, preventive policy and practices are critical to support TAY with DD to receive tailored services to achieve housing stability and successful transition into adulthood.