Homeless youth need more than treatment for substance abuse, study says

A new study of homeless youth suggests that treating substance abuse and mental health problems may not be enough to help get teens off the streets. Instead, researchers found that creating more opportunities for work, education and medical care were the most important factors in reducing homelessness.

A study of 180 homeless youth in New Mexico found that those with the most social stability, such as those who attended school more often or those who had a job, were most likely to reduce their homeless days over a six-month period.

While youth who had a history of abuse or mental health problems were more likely to become homeless, those same characteristics did not predict teens and young adults getting off the street six months later.

'It looks like the predictors of homelessness might be different than the predictors of exiting homelessness. So that means prevention targets should be different from intervention targets,' said Natasha Slesnick, lead author of the study and associate professor of human development and family science at Ohio State University.

'When you're homeless and you're entrenched in the homeless lifestyle, without housing and without stabilisation, it's hard to get out of it. It's hard to get homeless youth off of alcohol and drugs when they're still trying to get their basic needs met. And a lot of the kids use alcohol and drugs as a way to cope with being homeless,' she said.

The research was published recently in the Journal of Youth and Adolescence. The study was conducted between 2001 and 2005 and is one of the first to look at the predictors of homelessness in youth, as most of the research on the homeless focuses on adults. Research focused on 180 homeless youth between 14 and 22 years old who accessed New Mexico drop-in centres.

Those youth who were homeless for at least three months participated in follow-up interviews three and six months after beginning the program. They were given a care package of food, toiletries, socks and underwear at the initial interview and received $50 for each follow-up.

The study found that youth who engaged in high-risk behaviours were more likely to remain homeless and be more resistant to change. These teens and young adults reported participating in the most dangerous behaviours including unprotected sex, multiple sex partners, and intravenous drug use.

'Not only are they the ones at risk for HIV and sexually transmitted diseases but they're also entrenched in homelessness. These kids are probably the most vulnerable,' Slesnick said.

For these youth, more intensive one-on-one treatment was successful in reducing their homeless days after six months. These sessions focused on identifying and treating the individual's drug use and mental health problems, such as depression or suicidal behaviours.

'We have to figure out how to engage those kids who are linked to the street subculture and reengage them back into society through education, employment, and other more socially valued activities,' Slesnick said.

Part of the problem lies in the strong connections to other homeless youth who are participating in similar behaviours, she said. These connections play an important role in determining how kids deal with the stress and their likelihood of becoming chronically homeless adults.

Research also suggests that strong family support and identification with an individual's traditional culture is a strong predictor of change. Latino youth in the study were more likely to get off the street after six months than any other group. Slesnick found that this group had higher levels of attachment to family members and stronger support networks, resulting in lower substance abuse and reduced homeless days.

Males were also more likely to reduce their homeless days after six months. Previous studies have suggested that homeless males are more susceptible to environmental stress and thus, more likely to leave the street to escape that stress.

'I talk so much about the problems kids have, but it's a social problem and the kids are a victim of that problem. So what's really important is to prevent homelessness at a policy level and a higher government level. But meanwhile, we have a lot of kids who are suffering and we need to do something about that now,' Slesnick said.

Slesnick is currently conducting a study in Columbus, Ohio focusing on the differences between intensive intervention, case management and brief intervention methods on homeless youth.

Other authors in the study were Suzanne Bartle-Haring, professor and director of the Couple and Family Therapy Program at the Department of Human Development at Ohio State, Min Ju Kang, program coordinator for runaway and homeless youth projects at Ohio State, Pushpanjali Dashora, a doctoral student in human development and family science at Ohio State, and Erin Aukward, a master's student in human development and family science at Ohio State.