Youth homelessness is a complex problem exacerbated by the lack of available information regarding the unique circumstances experienced by these adolescents and further by the fact that this population is often hidden and therefore unnoticed by the general public and researchers. In any given year in the United States, 500,000 to 1.5 million youth will run away or be told to leave their homes. Most runaways return home, but others go on to establish an intermittent or prolonged period of homelessness. The number of homeless youth is difficult to estimate, but one national survey found that 7.6% of youth (1.6 million) between the ages of 12 and 17 were homeless, with approximately 200,000 of these individuals living on the street. Regardless of the exact number, youth homelessness is a cause for concern because of the unfavorable outcomes many of these youth experience: heightened risk of involvement in delinquent activities, drug and/or alcohol abuse, and persistent homelessness hindering their ability to become productive community members or successful adults. Furthermore, information regarding youth who do not survive is scarce.
Community agencies dedicated to assisting homeless persons frequently contribute to what is known about this population. However, information from this source may overlook a substantial portion of homeless youth given that many choose not to access these resources. Moreover, youth with the most significant challenges can be rejected from such facilities due to histories of substance abuse or psychosocial troubles. Little is known about treatment needs or effective intervention strategies for these adolescents, because research efforts have primarily focused attention on the circumstances that contribute to a youth’s decision to leave home. Knowledge about these variables may have implications for prevention efforts, but it is complicated by the variety of reasons adolescents choose to leave home. It is important to note that although some youth may be homeless along with their families, due to financial reasons, the focus of this entry is on youth who are separated from their families.
Causes of Homelessness in Youth
Homeless youth typically reside in unsafe living conditions that differ greatly from those of their peers both before and after leaving home. The home environment is generally characterized by dysfunctional experiences such as abuse, neglect, exploitation, rigid or inconsistent disciplinary practices, conflict, and parental substance abuse. Youth living in these homes experience a diminished sense of control and decreased self-esteem. In addition to unsafe home environments, many youth have encountered numerous, inconsistent living arrangements in alternative care settings by the time they reach the streets. As a result of these and other compounding adverse experiences, homeless adolescents commonly display many mental health and behavioral problems even before they leave home. These problems may be further compounded by discouraging educational experiences such as underachievement, inconsistent attendance, grade retention, poor relationships with peers and teachers, and disciplinary actions.
Defining Homeless Youth
Although all of these adolescents can be classified under the term homeless youth, several other terms have been used to describe the conditions surrounding a youth’s choice (or lack of choice) in leaving home and the unique circumstances the youth encounters while away from home. These distinctions are important, as they define intervention strategies that will be most appropriate for an individual’s circumstances. For example, youth who have been asked or forced to leave home or abandoned by their parents are typically classified as throwaways. Youth commonly associated with this category are those whose sexual orientation does not align with their parents’ expectations. Gay, lesbian, bisexual, transgender, and questioning (GLBTQ) adolescents represent a significant portion of youth who are asked or forced to leave their home setting. In this circumstance, seeking reunification with a family may not be an appropriate therapeutic goal.
Adolescents who leave home without parental consent or knowledge are termed runaways and may exhibit different patterns of runaway behaviors. A chronic runaway may demonstrate a pattern of leaving and returning home several times over a period of time while an acute runaway is described as an individual who has a single episode of leaving home and staying away for a significant length of time, resulting in the youth returning home for good or never returning at all. These families may be more appropriate for family-focused interventions such as multidimensional family therapy (MDFT) that emphasizes the use of multiple therapeutic models to reduce high-risk behavior and substance abuse in adolescents.
Once youth leave home, they pursue distinctive paths in an effort to survive. Homeless youth tend to reside in one of three environments: the street, shelters, or the system. Youth who live on the streets may or may not maintain contact with their families. For example, some may return home after short periods of working or living on the street, whereas other homeless youth identify the street as their home and have little, if any, contact with their families. These youth commonly have acute mental health difficulties and more significant histories of homelessness than other categories of homeless youth. Additionally, they are less likely to access available community resources. Conversely, there are homeless youth who mainly reside at homeless or emergency shelters and may have no experiences on the streets, similar to those youth who spend a majority of their time residing in alternative care settings such as foster homes, emergency shelters, or juvenile detention centers.
Risks of Youth Homelessness
Regardless of the location where homeless youth reside, all are at significant risk of unfavorable developmental outcomes. Survival mechanisms, sometimes valued as street skills, employed by homeless youth often place them at increased risk for a host of deleterious consequences. These adolescents lack adult guidance and support as well as other basic needs such as food, shelter, and health care. Many homeless youth suffer drug and alcohol addictions and may be involved in distribution for monetary gain or in exchange for material needs. Others may engage in prostitution or survival sex, defined as sexual favors exchanged to get basic needs met. Such practices place youth at risk of sexually transmitted diseases, victimization, and exploitation. Activities viewed by mainstream society as delinquent or criminal are often used by homeless youth as a means of survival. In addition to panhandling, various degrees of stealing such as shoplifting, swindling, or pickpocketing may be utilized. The contradictory norms of the general culture and the street culture may contribute to the difficulty these youth experience when attempting to reintegrate into society.
At the most basic level, homeless youth experience poor nutrition, limited access to health care, and unsafe living conditions, which place many at risk for illness, infections, and diseases. In addition to physical harm, they commonly experience multiple mental health problems, many of which were present prior to leaving home and are intensified once on the streets. Many homeless youth have endured significant abuse and assault from trusted authority figures, either at home or while away from home, making it difficult for them to trust others. Fear, loneliness, and feelings of worthlessness are also common amongst this group. Depression and suicidal ideation are maintained due to minimal encouraging experiences.
Interventions for Homeless Youth
The current literature regarding empirically based interventions for use with homeless adolescents is insufficient. Given that much of the available information addresses the behaviors the youth exhibited and the experiences he or she had prior to leaving home, an appropriate area of focus should be directed toward prevention of youth homelessness. Prevention approaches might include connecting the family to needed resources, family-focused therapy (e.g., MDFT or multisystemic family therapy) for those at high risk, and wraparound services for the youth and family. Because of the complexity of the issues that lead to youth homelessness, it is unrealistic to expect that any unidimensional approach will be sufficient to improve family and youth functioning. A systemic model is needed to more completely address the needs of these youth and their families.
Prevention is critical, because once youth have left home, it is difficult for service agencies to gain access to these adolescents. Few homeless youth choose to approach community resources because of fear and mistrust of adults, lack of willingness to follow the rules associated with an agency, or lack of knowledge of the resources that exist. Therefore, when counseling does occur, it is typically involuntary and tends to be the result of a referral for family therapy by social or shelter services, or it is court ordered for the youth and his or her family. Reuniting young people with their families may seem the most reasonable intervention; however, in some instances this may produce harmful results rather than benefiting the youth. Therefore, it is important to carefully evaluate the reasons why the youth left home and the current family environment before establishing reunification as a goal.
When youth voluntarily access services either for general or for mental health support, there remain a number of barriers that might make effective service provision difficult. Lack of control and constant unsuccessful experiences with adult figures frequently interfere with the ability of these youth to trust others and may result in heightened expressions of resistance. Furthermore, the high mobility rate among this population presents limitations to building a trusting relationship. It has been suggested that the most effective services will be those that are brought to the youth (e.g., parks, urban settings) to facilitate access. Those who provide services need to consider their approach, as coming on too strong might scare youth, yet an approach that is too reserved might inadvertently reinforce the idea that adults do not care. It has also been noted that services should be culturally compatible; that is, the provider should be respectful and understanding of youth and their circumstances. It is important to reinforce the youths’ sense of control and choice (as appropriate) and minimize restrictions and requirements. Developmentally, these youth may need to work toward establishing a sense of identity, feelings of competency, and connectedness to others. The therapeutic relationship may also include life skills education such as safe sexual practices, needle exchange, and other mechanisms by which to stay safe.
Because some youth grow tired of living on the street, programs that focus on helping youth reintegrate into society may be appropriate. In doing so, it is critical that youth are taught the skills they need to be successful and reduce the chances of further rejection and disapproval, which might increase their risk for continued homelessness. One program, First Voice, was originally designed to help adolescents in foster care transition to independent living as adults. Its emphasis on independence, belonging, mastery, and generosity (after the circle of courage model) may represent a useful approach for transitioning youth from street or shelter environments to becoming productive community members.
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