Street Outreach Programs Reach Out to Youth With Diverse Needs

Photograph of a city crosswalk at night.

Through the Family and Youth Services Bureau's Street Outreach Program for Older Homeless Youth, youth-serving agencies across the Nation conduct outreach to build trust and relationships between program staff and street youth. FYSB-funded street outreach programs serve and protect runaway and homeless youth and youth on the streets who have been, or are at risk of being, sexually abused and exploited. They offer a range of education, intervention, and prevention services to provide positive alternatives for youth, ensure their safety, and maximize their ability to take advantage of available opportunities.

This issue of NCFY Reports explores the conditions of young people living on the streets as well as the dangers street outreach workers face and how programs can minimize those dangers. It also discusses peer outreach as a tool for reaching street youth and looks at the pressing issue of human trafficking of young people.

Helping Young People Leave the Streets

“I’ve never felt so privileged as when I get to go up and just listen to stories of people living on the street, find out who they are, and get to know them,” street outreach worker Jasmine Pettet says.

Pettet works for the street outreach program at Janus Youth Programs, a youth-serving agency in Portland, Oregon. She and a partner search for runaway and homeless youth who need a hand. They get to know some of the hardest-to-reach young people and build relationships with them. They offer them what they need to survive and positive choices and opportunities. The goal is to help these young people leave the streets for good.

Since 1996, the HHS/Administration for Children and Families/Family and Youth Services Bureau (FYSB) has provided funding for street outreach programs like the one at Janus. These programs serve and protect runaway and homeless youth and youth on the streets who have been, or are at risk of being, sexually abused and exploited.

Harry Wilson, Associate Commissioner of FYSB, describes street outreach as the only way some youth can be connected. “Street outreach programs help connect young people to the services and supports they need,” he says. “For a lot of youth, it’s a gateway to other services and opportunities that can help put them on a path toward healthy, independent lives.”

FYSB’s street outreach programs conduct outreach to build trust and relationships between program staff and street youth. They offer a range of education, intervention, and prevention services to provide positive alternatives for youth, ensure their safety, and maximize their ability to take advantage of available opportunities. FYSB recognizes that the need is great.

Every day, across the country, more than 1.3 million young people run from or are asked to leave homes characterized by abuse, neglect, or parental drug or alcohol abuse. Every night, these young people live on the streets or in unstable living situations, such as their friends’ homes or overcrowded apartments. Once on the streets and away from adult supervision, many youth risk being sexually exploited or abused by adults for pleasure or profit.

But to a street outreach worker trying to help a young person who is hungry, cold, lonely, afraid, abused, or sick, there is only one. One youth in need of housing, food, clothing, or health care. One youth who needs assistance applying for food stamps, finding mental health or substance abuse counseling, getting an education, locating work, and accessing other services. One youth with many needs.

One-to-one interaction between staff and youth is what makes street outreach efforts successful, outreach workers say. A street outreach worker’s ability to be in the moment, focus on the individual, and meet young people “where they’re at” is critical.

True, outreach workers encounter many young people during the course of a night, but each one, they say, requires individual attention, support, and guidance. This may mean providing street-based education, on-the-spot counseling and referrals for other services, crisis intervention, emergency shelter, or survival aid.

But meeting youth “where they’re at” means more than meeting them “on their turf.” Outreach workers say it means helping youth in their own time, when they’re ready.

“I want to help as many kids as I can, but I want to make sure that I don’t work harder than they do,” says Nicole Bush, a street outreach worker at Urban Peak in Denver, Colorado. “They have to put forth an effort too.”

Street outreach workers empower youth to make their own choices, and when youth are ready, staff help them explore the gap between where they are and where they want to be. Then staff link youth to resources that can bridge that gap. If a young person is not ready to explore those options, street outreach workers simply remain available to them until they are.

Most youth appreciate knowing that there are people willing to help. “Knowing that there is somebody out there just wanting to hear about your day,” Pettet says, “whether it’s a kid living on the street or anyone else, it can really have a profound impact on someone’s life.”

Street Outreach Basics

Who is a street youth?

A street youth is an unaccompanied young person who has no permanent place to stay and does not live with a parent or guardian. Street youth might sleep “on the street”—in a park, on the stoop of a store, under a bridge, in a car—or they might crash on a friend’s couch.

In more rural areas, street outreach workers might find youth living together in a cramped trailer or garage, or sleeping alone in an abandoned shed or barn.

Ryan Barrieau, street outreach supervisor at Child and Family Services, a FYSB grantee in Manchester, New Hampshire, says his outreach teams target young people who live on the river banks near the downtown area as well as youth who live 10 to a studio apartment. “It’s the same population and the same needs,” he says.

How do outreach workers know a youth is homeless?

“Most of them will tell you,” says Ben Solheim, outreach supervisor at Orion Center, a program of FYSB grantee YouthCare in Seattle, Washington. “You just ask.”

As easy as that sounds, Mary Jo Meuleners, a community health specialist and former street outreach worker in Minneapolis, Minnesota, emphasizes the importance of questioning youth sensitively. “I do it by saying what I do, not, ‘Are you homeless?’” she says.

Outreach workers say they take care not to pigeonhole young people based on appearances. They don’t assume a young person on the street is homeless, nor do they speak only to homeless youth. Says Barrieau, “When we talk about street youth, they don’t fit a particular stereotype. There are hundreds of street youth. They could look like any other kid. If we see kids on the street, we talk to just about every kid we encounter.”

Often, outreach teams hear about street youth from other street youth. “It’s usually the kids themselves who tell us, ‘This is so-and-so. He’s new,’” Solheim says.

Meuleners looks for youth carrying big overnight bags or wearing tattered shoes. But, she cautions, these aren’t definitive indicators of homelessness. The shoes could be a sign of poverty, rather than homelessness, she says. “If they have a backpack and a sleeping bag, they could be homeless, or they could be camping,” she adds.

Meuleners also tries to observe youths’ demeanor: do they seem comfortable or anxious being on the street? If a young person is “looking all alone and nervous,” she says, she’ll make sure to approach that youth.

Where do outreach workers find homeless youth?

Outreach workers in a particular city or area know the best places to find young people on the streets. They often find youth in social spaces, such as coffee shops or 24- hour restaurants, in the parts of town where services for homeless people cluster, at places that serve free meals, or in public parks and basketball courts.

The Night Ministry, a faith-based grantee serving homeless youth and adults in Chicago, reaches out to young people as they leave school for the day, through a program called PASS, or Preventive Afterschool Support Services. PASS focuses on the Chicago high schools with the highest enrollment of homeless students.

“Afterschool snacks attract a lot of kids,” says Heather Bradley, the Night Ministry’s youth outreach coordinator. “Then we tell them about the survival supplies and services we offer.”

In many areas, homeless youth have different hangouts depending on the time of year. In the summer, Meuleners says, homeless youth in Minneapolis camp by the river or sleep beneath underpasses or in wooded areas of the city. In winter, many youth leave town for warmer places, and most of those who stay move off the streets.

“Street traffic and street life slows down in winter,” Meuleners says, explaining that in colder months, Minneapolis outreach staff spend more time working at drop-in centers and shelters, though they still do street outreach, except on the most frigid days.

Who can help outreach workers find homeless youth?

Barrieau says social service providers and other homeless shelters sometimes inform his agency about a young person on the street. He’s also gotten calls from neighborhood people, such as shop owners who find young people sleeping in their thresholds.

But more often that not, he says, people in the community know too little about youth homelessness. “In Manchester, people are oblivious to the scope of the problem,” he says. “They might not realize the kid on their doorstep is homeless.”

On the contrary, Vicki Lawton, program coordinator of the street outreach program at Panhandle Community Services in rural Gering, Nebraska, says, “Things that might be ignored in a big city aren’t in a small town.”

Lawton often gets calls from community members who report seeing a young person hanging around somewhere for several days in the cold. She also gets calls from school officials.

To increase awareness, Barrieau sometimes takes community leaders or agency donors on a street outreach shift. “We try to make sure that people outside of social services are informed about the epidemic,” he says.

Outreach workers say that because street youth often view police with suspicion, outreach teams must work hard to appear impartial if they collaborate with police to identify homeless youth. Despite that caveat, Barrieau sees greater opportunity for working with law enforcement. “We’re attempting to partner with police to offer services to kids they pick up,” he says.

Bradley’s agency regularly makes presentations about youth homelessness to congregations, business people, coaches, teachers, guidance counselors, health professionals, mental health counselors, and staff of afterschool programs, YMCAs, and Boys and Girls Clubs. The sessions teach adults how to be receptive and nonjudgmental so a homeless young person might be more likely to confide in them.

And with the aim of enlisting young people themselves in the fight against youth homelessness, Bradley and her staff speak to high school students about the issue. “It’s going to make it more likely that if they encounter a friend that’s at risk, they’ll know where to send them and how to help them,” she says.

Safety's the Rule for Street Outreach Workers

It didn’t matter that the gun he waved at them was fake. Mary Jo Meuleners and her partner tried not to show their fear, sitting motionlessly on their park bench as the man, a crack addict, yelled and cussed.

“Next time, this gun’ll be real, and I’m gonna [expletive] kill you!”

The outreach workers, then members of StreetWorks Collaborative, a group of human services agencies that work together to reach street youth in Minneapolis, Minnesota, held still and didn’t utter a word. When the man finally backed away, they left as quickly as they could.

“I’ve had some really crazy stuff happen to me,” says Meuleners, now a community health specialist at Minneapolis’s Red Door Clinic, run by the Hennepin County Human Services and Public Health Department, “which is why I take safety really seriously.”

Often, outreach workers walk streets where fights, gunfire, prostitution, and drug exchanges form a regular backdrop and where many inhabitants view them as outsiders. Agencies need to have—and workers need to follow—safety guidelines, because one never knows what will happen next, Meuleners and others say.

“The whole environment of the street is unpredictable, and there are so many different people with different agendas and so many forces that can contribute to an environment that you can’t always predict what will happen next,” Meuleners says.

Knowing how to avoid risks and keep out of harm’s way takes a combination of instinct and experience, says Ryan Barrieau, street outreach supervisor at Child and Family Services, a FYSB grantee in Manchester, New Hampshire.

“If I know we need to leave immediately, then we need to leave immediately,” he says. “You have to act on instinct. That instinct is developed over time. At the same time, seasoned outreach workers can fall into the trap of ‘nothing’s happened to me, so I’ll go off by myself.’”

Often, that’s when something goes wrong. And without his or her partner as backup, an outreach worker can find it more difficult to get away from a hostile person or the overwhelming press of a crowd of youth wanting supplies and snacks.

So, it’s important for outreach workers to stick together and to mind the rules of safety, not only to protect themselves, but also to protect their partners and the young people they work with, Meuleners says. “I’ve got your back, and I want to feel that you have mine.”

Heather Bradley, a youth outreach coordinator at the Night Ministry, a FYSB grantee in Chicago, offers another perspective and stresses the importance of remembering that, every day, street youth face greater dangers than staff, who can go home at the end of their shifts.

“These kids have been violated and exploited by adults. I think my safety risks are so low compared to them,” she says. “I’m no hero. It’s not dangerous what I do. I’m just hanging out with kids.”

Safety Tips

The relative danger of the streets an outreach team roams depends on the neighborhoods or areas in which they work. Vicki Lawton at Panhandle Community Services in Gering, Nebraska, says, “It may not be as bad in the rural areas, but there are just certain common sense things that we all need to follow.” Indeed, safety measures may vary slightly among agencies and different outreach teams, but some general principles apply. Among them:

Never work alone. Outreach workers say they always use the buddy system, working in teams of two or sometimes three. StreetWorks, in Minneapolis, has refined its approach into what it calls the “Batman and Robin” protocol, Meuleners says. “Batman is the lead, and Robin hangs in back to keep things safe,” she explains.Sidekicks buffer their partners from distractions around them, helping them to focus on their conversations with young people.

Working as a team can also protect outreach workers from false allegations of misconduct, says Ben Solheim, outreach supervisor at Orion Center, a program of FYSB grantee YouthCare in Seattle, Washington. “It’s a cover-your-own-butt kind of thing. You never know what kinds of things people might say against you.”

Let people know who you are. Always introduce yourself to people in the neighborhood you’re working, Meuleners says. Otherwise, she says, “People might make wrong assumptions. They might think you’re a cop.”

Depending on their agency’s policies, workers can identify themselves either by talking to people or by wearing a badge or T-shirt from the agency or collaborative.

Don’t dress to impress. Outreach workers say they don’t wear jewelry or clothing that will make them stand out. Barrieau calls this cultivating a “nonpersonal” appearance. “Jewelry, talking on a cell phone— personal things allow people to talk about non-street-outreach stuff,” he says.

Meuleners wears comfortable, casual clothes and “shoes I can run in.” And Barrieau tells staff members not to wear sunglasses, “so people can look them in the eye.”

Pare down the personal items you carry. Meuleners carries car keys, identification, cash, and her cell phone in her pockets. That way, if she ever has to leave her backpack behind, all the items she needs are with her.

Barrieau sees other advantages to paring down. By leaving their wallets behind, Barrieau says, his staff can respond honestly to panhandling youth. “It allows us not to get into a conversation about whether we have money,” he says.

Be consistent, trustworthy, and ethical. “We see the same kids day in, day out,” Solheim says. He tells his staff to “be a consistent figure on the streets and just kind of let them know we’re there if they need our help.”

That philosophy has kept Solheim safe, he says, because young people will protect outreach workers when necessary. He cites a recent incident when Orion Center’s street outreach van ran out of socks, a valuable commodity on the streets.

One young man, about 20 years old, showed his displeasure. “He raised his voice and cursed, created a scene,” Solheim says. “His peers stepped in and told him to calm down.”

Keeping high ethical standards and professional boundaries (no business with clients, no seeing them outside of work time, no spending time alone with them) has a similar effect, Bradley says.

Because staff of the Night Ministry have built trusting relationships with young people, “youth are very protective of us,” she says. “If someone’s rude, they immediately stand up for me.”

Be a good observer. A veteran street outreach worker once told Meuleners, “When you get somewhere, you don’t have to jump in right away. Drive through. Observe.”

Meuleners has practiced that advice, to good advantage. “I like to just sit,” she says. “People just come up to ask why I’m there. It’s a good way to get the hang of what’s going on.”

Share what you know about specific young people. “Everybody has certain clients they know better than others do,” Solheim says. “They might know what’s going on in their lives and can tell others when it’s best to engage with them or to stay away.” Some reasons to stay away might include a youth’s recently breaking the law or using more drugs. Solheim also recommends keeping some distance when a street youth dies, to give other young people time to mourn. “We give them room to be themselves … and let them approach us if they want to.”

Don’t get lulled into complacency. “Sometimes street outreach can get boring and it’s easy to get into ruts,” Meuleners says. “Because it can get boring, people can get careless. They think, ‘Nothing’s happened forever, so nothing’s gonna happen.’ They don’t realize how quickly things can change.”

One way to switch things up, she says, is to change partners occasionally, but she also notes that partners need to have trust and shared safety rituals.

Know the “gatekeepers.” These are people known and trusted in the neighborhood, and they can include convenience and other store owners. “They know everybody in the neighborhood,” Meuleners says. “They kind of have a feel for the community because that’s their livelihood. They’re your safety net when you need them.”

Gatekeepers can assist outreach staff, intervene if staff find themselves in conflict with community members, and vouch for street outreach workers’ motives. Meuleners points to her own experience with the man with the gun. After that incident, she approached Sam, a man who roamed around a strip mall acting as a sort of informal security guard for the neighborhood. Sam told her, “I’ll talk to him, and it will never happen again.”

“It never did,” Meuleners says. “And I didn’t stop going there.”

Keep an eye on neighborhood safety levels. A drug bust, an explosion of violent crime—knowing these things have happened recently in a neighborhood might make Barrieau reassess whether to send outreach workers there on a particular day. “This requires a relationship with the local police department, as these potential issues may be unbeknownst to us,” he says. “Or, if an area is known to be dangerous, we have called the police to ask if there have been any reported crimes during that day. Believe it or not, there have been occasions where we were advised not to go into certain neighborhoods.”

Establish a code word. Mentioning the secret word or phrase signals that the team should leave immediately for a safer place. “Some people might think it’s silly, but having those measures in place just makes me feel safer,” Meuleners says. She has long used the sentence “I need to call Karen.” A codeword might be agreed upon by partners, or it might be shared among everyone at the agency.

Know when to back off. Outreach workers say they stay away from the scenes of drug trades or other illegal activities. They avoid anyone with a weapon, people fighting, or someone obviously drunk or high. Barrieau describes things to look for: a tense look or facial expression, yelling or cursing, and aggressive behavior.

“If there’s a risky situation, we leave before it escalates to the point of danger,” Barrieau says. “So it’s important to recognize a risky situation well before it gets dangerous.”

Bradley looks for signs in crowds as well as in individual behavior. Is a group of people acting loud and rowdy? Are people tense and yelling, or are they just goofing around? Have you spent a good amount of time trying to calm people down to no effect?

One fight Bradley witnessed started as one person attacking another, with others trying to break it up. But then the tide turned. “It disintegrated into like a barroom brawl sort of thing, where everybody’s hitting everybody,” she says. “We backed off. … At the end, we pulled out the Band-Aids and the Bactine and asked people what we could do better next time to contain things.”

Show extra caution in isolated areas. Agencies differ in their policies about sending outreach workers into highly secluded areas. The Orion Center has the same policy for all staff. “We always go out in heavy traffic areas,” Solheim says. “We don’t go into squats or under bridges.”

But Manchester’s Child and Family Services differentiates between youth and adult staff members. “We don’t take teen staff under bridges or in secluded areas where it’s not in public areas,” Barrieau says. “Adults do that.”

Even so, when adult outreach workers go under bridges or into the woods, “we typically consult with outreach workers from other agencies to discuss potential risk factors associated with those locations,” he says.

Don’t give out personal phone numbers or talk about personal things. “Keep interactions safe,” Solheim says. “Don’t engage in personal conversations that might reveal your place of residence or loved ones. Always keep in mind you’re out there working and you’re not their friend.”

Use basic deescalation techniques when confronted by angry or aggressive community members. These are simple methods for defusing a tense situation. For instance, Barrieau says, a worker might respond to an angry person by saying, “I understand where you’re coming from. How can we help you?”

Take care of yourself, and encourage your partner to do the same. “We have to be mentally and physically healthy before we can help anybody else,” Solheim says. “It’s hard to see the same kids every day, not working toward change. You need to keep things in perspective.”

In the particular case of adolescent outreach workers, Barrieau says, “We identify things that are meaningful to the teens to help preserve their emotional state and avoid burning out, whether it’s take a walk, watch a movie, take five minute alone.” Barrieau encourages a young person who’s having a bad day to take the day off. “We encourage self care because they may make less risky decisions and focus on delivering the service.”

What's In Your Bag?

Effective street outreach is well-planned, thoughtful, and responsive to the diverse needs of young people living in precarious environments. Outreach workers must be well-equipped. This means having critical listening and communication skills and the ability to counsel or intervene when necessary. It also means having a lot of stuff. Here are some items street outreach workers carry with them to foster a street youth’s survival or comfort.

  • bus tokens
  • candy and healthy snacks
  • instant soup packets
  • individual cereal cartons
  • water and Gatorade
  • feminine hygiene products
  • toothbrushes, toothpaste
  • dental floss (also good for sewing shut holes in clothes)
  • sewing kits, iron-on seam repair kits, Velcro, and safety pins for repairing clothing
  • washcloths, hand sanitizer, wet wipes
  • first aid kits
  • cough drops
  • self-care kits for stomach ache, headache, PMS, sore throat, cuts and wounds, constipation, diarrhea, with instructions on how to know when you’re sick, how to treat yourself (for instance, how to treat diarrhea with Gatorade), and when to seek medical care
  • flashlights
  • single load packages of laundry detergent and quarters for Laundromat 
  • eyeglass repair kits
  • blankets
  • clothing like underwear, long johns, socks, boots, gloves, jackets, hats, hoodies, shoes
  • rain jackets
  • cosmetics
  • wallets
  • travel alarm clocks and day planners
  • school and art supplies
  • backpacks and duffel bags
  • dog food (for street youths’ pets)
  • $5 gift certificates to fast food restaurants
  • $5-$15 gift certificates to pharmacies for prescriptions
  • wallet-sized cards with agency phone numbers and the outreach worker’s names
  • resource lists (e.g., where to find hot meals, food pantries, shelters, or dental and medical care)
  • legal aid information card (explaining where to get legal help and describing legal rights of street youth)


In Outreach Work, No Substitute for Peers

As an adolescent, Nicole Bush lived on the streets of Denver, Colorado, for a time. She escaped, thanks to the staff and programs of youth service provider Urban Peak. When she became ready for employment, the agency hired her as a peer outreach worker, a youth who accompanies adult outreach staff on their shifts.

Bush found that having experienced homelessness made her job easier. She knew what youth were going through—she’d been there—and she knew how to conduct herself in the tough street environment. Now in her twenties, she works full time on Urban Peak’s street outreach team.

“It’s easy for me to talk to a lot of different kids,” she says. “They just feel comfortable with me, my language, my body language. I look approachable, appearance-wise. That’s the main thing.”

By hiring young people, agencies can overcome one of the biggest obstacles in reaching homeless adolescents: the difficulty of forming trusting relationships with youth who, time and again, have been hurt and victimized by adults in their lives. While most street outreach programs make an effort to hire staff members who reflect the youth population in cultural background and life experience, youth and adults agree that there’s really no substitute for peer-to-peer interaction.

Someone to relate to

Some agencies favor peer workers who have been homeless or on the brink of homelessness. “A number of our peer outreach workers have been on the street,” says Andy Peters, associate director for program development at the Long Island Crisis Center in New York. “Or they can relate to those living on the street because they might have been at risk themselves.They may have been couch surfing. Others are highly sensitive to it because they come from families who are struggling economically.”

Formerly homeless youth may have life experiences that are valuable to street youth. They can share advice on navigating services, trying to obtain identification, and dealing with loneliness and fear. But regardless of a potential peer worker’s personal, family, and economic background, street outreach programs look for peers who can relate to everyday problems.

“There are certain things that happen to everybody, or that everyone goes through, like trouble with parents or friends in school,” says Sarah Gunner, who served as a peer outreach worker at CAPTAIN Youth and Family Services in Clifton Park, New York.

Considerations and accommodations

For all the benefits that peer outreach can bring, programs must also recognize the amount of time, energy, and commitment required to assure that young people have the necessary training and opportunities to become successful outreach workers. Similarly, youth should know what the job entails and understand what’s expected.

Most programs require that peer outreach workers are clean and sober and have stable living arrangements. Programs also develop specific on-the-job guidelines, such as no shifts past 9 p.m.—even with parents’ permission.

Outreach coordinators should be prepared to make accommodations for young outreach workers when necessary. This may mean taking school schedules into consideration, providing extra feedback on a young person’s job performance, and not sending youth to parts of town in which they feel uncomfortable working. Adult staff also need to properly train and supervise youth.

“I can’t emphasize enough how important training and ongoing supervision are, and regularly checking in with young people doing outreach work,” says Dennis Lundberg, program supervisor for outreach programs at Janus Youth Programs in Portland, Oregon. Lundberg’s staff supervisors closely monitor peers and train them regularly on topics including personal boundaries and neutrality.

Setting boundaries

Learning to separate the personal from their work can be especially tricky for adolescent outreach workers stepping into an emotionally draining job that may be their first. They need to know how to establish professional distance between themselves and others.

“Setting boundaries might mean not working with people that you know from outside of work, or not getting involved in, or even hearing about, cases involving someone you know,” says Rosemary Fister, 22, who has conducted street outreach for Lutheran Social Services in St. Paul, Minnesota, for over 2 years. It might also mean not associating socially with people who live on the street.

Taking on the role of neutral observer can pose particular challenges for peers who have been homeless. Often, they confront issues of saving face or maintaining their street credibility. Former friends might ask, “What’s the matter? Now you’re doing this, you can’t hang out with us anymore?” Peer outreach workers should explain what they’re doing and why they’re doing it.

“You have to have boundaries when it comes to old friends,” Bush says. “It’s hard seeing people that you know out there. You just hope to inspire them or give them hope to do better.” She says peer workers should process their experiences by talking to a supervisor who can help them deal with peer pressure.

Lundberg believes it’s best for peer outreach workers to be several years removed from living on the street before doing outreach work. In thattime, they can make new friends and develop a new support system.

If not enough time has elapsed or the young person hasn’t had thorough training, things can go wrong. “You’ve got to make sure that the person you hire is in a good place and won’t relapse because it could really hurt a lot of clients if a peer outreach worker messes up,” Bush says. “These kids put a lot of faith in peer outreach workers.”

One important lesson peers must learn, according to Jasmine Pettet, a peer outreach worker in Portland, Oregon, is not to share information about their personal lives. Another: “We don’t hug the clients we’re working with,” she says. “It can be taken the wrong way, especially for kids who have been sexually abused.”

Even with the proper training, outreach work can be difficult. “Sometimes it’s hard for me to grasp what kids have really gone through,” Gunner says. “Sometimes you have to try hard not to act shocked.”

Something to offer

When peer outreach really works, it’s not just the street youth who benefit, peers and adult supervisors say. Adolescent outreach workers, often at risk themselves, receive training, learn new skills, gain positive relationships with adult staff, and develop school and career goals.

The position teaches youth who have never before held a job how to act in a work environment. Youth have the freedom to make both decisions and mistakes, outreach coordinators say, while being held accountable by their agencies. This means they must demonstrate a strong work ethic, reliability, and commitment.

Peer workers say they also gain something more important than skills. By doing relevant work that produces meaningful outcomes for their communities, many young people discover they have a lot to offer the world.

“Young people see they can have an impact on people,” Lundberg says. “It’s very empowering to be in that role, to be in a position to be a role model. It can help build self esteem. It can help a young person envision something for themselves that they could not imagine before—power over their own lives.”

Bush, of Urban Peak, is a case in point. “It’s awesome to give these kids tools and see them flourish into healthy adults,” she says. “Now I couldn’t picture myself doing any other kind of work.”

Trafficking and Runaway Youth

When Tina was 14, she was forced to work the streets by an older “boyfriend.” In testimony to a congressional subcommittee, Tina, now a street outreach coordinator for an anti-human-trafficking organization, detailed the beatings and emotional trauma she suffered at the hands of the man who initially won her over with love and attention before humiliating her and forcing her and three other girls onto the streets of Cleveland, Ohio. During that terrifying time, Tina said, she felt that she had nowhere to turn for help. She knew of no one who could provide her with the specific services she needed to regain control of her life.

Street outreach workers are often the first to come into contact with young victims of human trafficking like Tina. They may be runaway or homeless youth, or they may appear to be. And they often have needs similar to those of runaway and homeless youth clients, including shelter, health care, counseling, and other support services. But recognizing and helping human trafficking victims, who are often scared, manipulated, and abused, can be complicated. As the Federal government increases awareness of and services for domestic trafficking victims, street outreach workers may be called on more and more to recognize and refer young people like Tina to the services they need to reclaim their lives.

Indeed, in 2005, the Administration on Children & Families began awarding a small number of grants to street outreach providers to help identify victims of trafficking among the populations they already work with, including at-risk and homeless youth and girls exploited through commercial sex. The grants supported direct, person- to-person contact, information sharing, and counseling.

In fall 2006, ACF awarded an additional $3.4 million in grants to organizations across the country to fight human trafficking and provide assistance to victims.

“These grants will strengthen our effort to rescue and restore victims of human trafficking,” said Wade Horn, HHS assistant secretary for children and families. “They will enable groups to expand their outreach to identify and help more victims of this modern-day form of slavery.”

Who is a trafficking victim?

Trafficking victims can be boys or girls of all races and ethnicities. They can come from wealthy families or poor ones in cities, suburbs, or rural areas. Under the Trafficking Victims Protection Reauthorization Act, anyone under the age of 18 who is used for a commercial sex act is automatically a victim of  “severe forms of trafficking in persons,” regardless of whether he or she is a “willing” participant. Trafficking victims 18 and older must have been subject to force, fraud, or coercion.

How do I stay safe when approaching potential trafficking victims?

According to Karen Countryman-Roswurm, a street outreach expert at Wichita Children’s Home, safety measures should include:

  • Do some geographic analysis. Where is sexual exploitation happening in your area? Be realistic about whether that place is safely accessible. If it is, park your van in the area for a while and just watch for hints of the particular street culture of the neighborhood.
  • Before you jump out of your van to approach a potential victim, assess the situation. Is someone trying to pick them up? Is the trafficker watching? If you approach, is that going to get them beat up?
  • Always respect gender roles. Street outreach teams should consist of a man and a woman. The female team member should approach a suspected female victim, with the male team member standing within a safe distance. The male team member should address a male trafficker, should it be necessary to do so.
  • Be careful how much you badmouth the person who’s exploiting the victim – it’s often her “boyfriend” or “caregiver.” Victims may not consider themselves exploited.
  • Set protocols and build relationships with the local police and the regional FBI. Conduct trainings to help them understand how to treat youth who are involved in sexual exploitation so that you feel comfortable calling them in to situations where you may need help.
  • What do I need to think about when providing services to these young people?
  • Victims will often deny the abuse because they or their families have been threatened or they are embarrassed. Being persistent and asking the right questions may help you determine if someone is a victim of human trafficking.
  • Enlist the help of a staff member who speaks the potential victim’s language and understands his or her culture.
  • Victims need safe housing away from traffickers or their associates.
  • Because victims have been so isolated from their families and friends, they often feel that going back to their exploiter is the only option.
  • Reestablishing social connections is crucial. Be aware, however, that exploiters often use victims to recruit other youth.
  • Victims often have no identification and need help getting new, untraceable replacements.
  • Victims need services, such as transportation, vocational training, and life skills, similar to all runaway and homeless youth.
  • Victims need mental health services from professionals trained to deal with extreme forms of post-traumatic stress disorder.
  • Victims often need extreme medical and dental care.

Where do I go for more information?

The Administration for Children & Families’ anti-human trafficking campaign helps identify and assist victims of human trafficking in the United States. You’ll find campaign materials you can use to raise awareness and other resources to help you serve victims.

The National Human Trafficking Resource Center is a national, toll-free hotline open 24 hours a day, 7 days a week, every day of the year. It is operated by Polaris, a nonprofit anti-trafficking organization, through a grant from ACF. The resource center offers assistance to victims, concerned individuals and social service providers in more than 200 languages. Call 1-888-373-7888 or text HELP or INFO to BeFree (233733).

This page was updated in January 2015. Learn about the Family & Youth Services Bureau’s current anti-trafficking initiatives.

The Numbers

  • Every day, approximately 1.3 million runaway, thrownaway, and homeless youth live on the streets of America.
  • Children, both boys and girls, are solicited for sex, on average, within 72 hours of being on the street.
  • Approximately 55 percent of street girls engage in formal prostitution; 75 percent of those work for a pimp. About one in five of these children becomes entangled in nationally organized crime networks and is forced to travel far from home and isolated from friends and family.
  • A girl will first become a victim of prostitution between the ages of 12 and 14, on average.

What are Some Signs that a Young Person May Be a Victim of Trafficking?

(Note: This list is not exhaustive.)

  • No identification or fake identification
  • Bruises and other physical signs of abuse (or covering up abuse with too much clothing)
  • Evidence that time or schedule is being controlled
  • Evidence that movement is being controlled or restricted
  • Living on or near job location
  • No money or control over spending
  • Cut off from family
  • Isolated from friends or other social network
  • Gaps in life story
  • Paranoia or hypervigilance
  • Mistrustful, particularly of law enforcement
  • Aggressive, destructive behavior
  • Malnourished
  • Untreated health and dental problems


A Day in the Life of a Mobile Health Clinic

Harvard Square in Boston, Massachusetts, is a renowned tourist area, known around the world for its shopping, dining, entertainment venues, bookstores, architectural landmarks, and cultural destinations. It is also a place where a large number of runaway and homeless youth sleep every night—some suffering from medical illnesses, others just hungry and alone.

A mobile health clinic run by Bridge Over Troubled Waters, a FYSB grantee in Boston, Massachusetts, parks in front of Harvard Square every night for one hour, from 8:30 to 9:30 p.m.

The van runs from 6 p.m. to 10 p.m.—the hours that they can reach the most homeless teens—and stops at shelters, parks, and subway stops. The street outreach team accompanies the van, passing out sandwiches on Tuesdays along with “survival guides”—brochures that highlight food banks, transitional living programs, and shelters that serve homeless youth.

For some street youth, the majority of whom are uninsured and ineligible for Medicaid, this is the only health care that they will receive. Many young people on the streets do not have money for public transportation to get to a local hospital or clinic. The mobile health clinics meet the needs of runaway and homeless youth by bringing the services to them.

“We have an open access policy,” says Dr. Rhonique Shields-Harris, medical director of the mobile health programs at the Children’s Health Project in Washington, D.C. “You come in, we don’t ask questions. We would rather they use us as a resource than go to the emergency room, where the wait time will be longer.”

This policy appeals to street youth who are often wary of going to hospitals or clinics for fear of being turned in to police or social services.

“People are more trusting of the medical van,” says Peter Ducharme who runs the medical van for Bridge Over Troubled Waters. He adds that many homeless youth have escaped abusive situations and are scared of being returned to their homes.

When street youth are looking for additional support, however, the mobile health clinic can refer them to drop-in, basic center, and transitional living programs. Mobile clinics address the needs of runaway and homeless youth, who have a high risk of getting infectious diseases from being out on the street.

Many youth from Covenant House—a FYSB grantee and runaway and homeless youth program located onsite with the Children’s Health Project—come to the agency because they are referred by doctors with the mobile health clinic. For example, when a pregnancy test reveals that a young woman is expecting, a mobile health clinic will often refer her to a transitional living program.

In fact, Bridge Over Troubled Waters began in 1970 as a mobile health clinic and grew into a human service organization which includes a street outreach program, a transitional living program, and residential housing. Of the 4,000 youth the agency comes in contact with each year, 2,000 are seen on the medical van and 2,000 are serviced by onsite facilities. About 1,300 are referrals from street outreach workers.

“We run into a lot of people who will come to the van and ask questions, and it might not be an absolute emergency or a crisis, but we will get them answered at the van, rather than risk going to a hospital,” says Ducharme. When youth go to the hospital, he says, the van program misses the opportunity to refer youth to additional services like drop-in programs.

Treating the Whole Person

It’s a clear morning and two large blue vans—a mobile health clinic and a mobile dental clinic—pull away from the Children’s Health Project on Mississippi Avenue in Southeast Washington, D.C.

The vans rumble along turning down streets in the Parkland neighborhood before arriving at the Atlantic Terrace Apartments, alow-income housing project where they will park for the day.

Inside the mobile clinic at the Children’s Health Project, Dr. Terry Gray Brown sits in a swivel chair waiting for her next patient. She comes out from time to time, maneuvering her 8-month pregnant belly past her colleagues and patients in the narrow 2-foot hallway. She works in the mobile clinic 5 days a week, from 10 a.m. to 4 p.m. each day, in four lowincome D.C. neighborhoods.

The medical team collaborates with the mobile dental unit, a clinical social worker, a family services associate, a patient liaison, and legal aid services, and provides help with taxi transportation with specialist appointments and inhome counseling.

“Not only do they have medical needs, but they have social needs that we try to fulfill because that impacts their health a great deal,” says Brown. “We try to make sure the whole person is taken care of. Substance abuse, mental illness, all of that affects their medical needs.”

Snapshot: What's Next--Building a Recovery Culture

The youngest of seven children raised by a single mother, Bobby* had no positive role models. His siblings bounced in and out of juvenile detention facilities on drug charges. None of them finished high school. Bobby followed their lead. Police arrested him on drug charges—for both using and selling. After a short stint in a juvenile detention center, he ended up back on the streets. Street outreach workers and recovery transition advocates from Outside In, a FYSB grantee in Portland, Oregon, approached him, talked with him casually on a daily basis, gave him socks and other essentials, and let him know that food and a shower were available at the drop-in center.

Bobby came in to the drop-in program from time to time and became close to Mark. Both of them knew the intricacies of baseball and enjoyed playing the sport. And both of them liked fixing cars.

Bobby later learned that Mark was also an alcohol and drug addiction counselor, or a recovery transition advocate for Outside In. By this time, they had formed a strong relationship, and Mark understood Bobby’s needs and readiness for treatment.

“It’s not that they don’t know who is an alcohol and drug counselor, but we don’t approach it like, ‘Hey I think you should talk to the alcohol and drug counselor.’ It’s more like, ‘Hey, why don’t you talk to Mark?’ So it’s more relationship based. It is about building a positive connection,” says Heather Brown, Youth Department Director for Outside In.

Like Bobby, many street youth suffer from mental health problems or abuse drugs and alcohol. Often they cannot reconcile with their families because doing so might hurt their recovery. They may have an arrest record or other barriers to gaining employment. And they are often the least likely to reach out for help. These young people, outreach workers and other youth service professionals say, need a wide network of support. All staff members, including street outreach teams, counselors, and health professionals, need to work together and communicate about the young person’s needs.

Outside In builds a culture where the process of recovery is integrated into a variety of services offered to youth. Staff members build strong relationships with youth before beginning treatment and offer peer role models and an alcohol and drug treatment recreation group. In this group, youth may go to the arcade, play Frisbee, or go hiking with drug counselors. They even operate a doggy day care business staffed by homeless youth, which teaches street youth skills and helps them transition to the structure required by a job.

Brown says this sort of familiarity and relaxed atmosphere makes it, “cool when somebody is clean and sober, which is the opposite of what they are used to—having peers engaging in more drug using behavior.”

Staff members at Outside In conduct regular training sessions with community partners to ensure that drug treatment counselors and street outreach workers share a common language. For example, drug treatment counselors should understand terms like “positive youth development” and street outreach workers should understand terms like “pre-contemplation” that relate to a young person’s readiness for treatment.

“Now, with all of the stuff we do before treatment, they are building relationships and are more ready for treatment,” says Brown.

Brown says the system has worked much better than sending youth to specialty clinics because many young people create strong relationships with staff and are reluctant to build new ones at a new facility.

“We would send them out for treatment and they would feel the approach was so different that they would just bolt,” says Brown.

Brown says using this approach has doubled the number of Outside In youth seeking treatment for mental health and substance abuse problems.

What’s more, Brown says, they stay in treatment and complete the program.

“Before we had a really hard time getting people into inpatient treatment or even to follow up with outpatient treatment—they might not stay very long. Not very many people finished treatment,” says Brown. “Now, people try it out. People may make multiple attempts. Our treatment beds tend to stay pretty full and they finish treatment. We see the difference.”

*Names have been changed.