NCFY Reports

Answering Questions, Building Trust: The Role of Health Services in Promoting Well-being

YouthLink, a youth-serving organization in Minneapolis, last year opened a one-stop-shop health clinic for runaway and homeless youth. Here, Clinical Supervisor Lisa Borneman explains how the facility works and why physical health is essential to young people’s well-being.

Our clinic is open Tuesdays and Thursdays, noon to 8 p.m. That overlaps with our drop-in period, which is 3 to 8 p.m. During these hours, youth can talk to a nurse practitioner and a clinic nurse from Health Care for the Homeless. A visiting nurse also comes every Wednesday during drop-in, and we provide dental services once a month where young people can get a cleaning or a tooth pulled.

Our goal is to get them connected to a clinic, because having a primary care doctor who can follow them is the best thing for their health. So many of our youth use the hospital for their primary care, which means there aren’t necessarily records following them. But at a clinic, doctors can check their records and notice, “Hey, you’ve been in here for upper respiratory things a lot, maybe you have asthma.” The hospital won’t necessarily know that pattern.

A lot of the girls come through for pregnancy testing. But a lot of them have colds, rolled ankles, just general stuff. We do a lot of STD testing, too. But sometimes it’s enough for these young people just to have a medical person to talk to. Whether it’s trouble with their menstrual cycles or a recurring pain, a lot of our youth don’t really understand how their bodies work. As far as mental health, our youth often come to us for anger management. They’ve been exploited, abused, they’ve witnessed abuse. They’re having a normal reaction to an abnormal situation, but it confuses them and makes them angry.

Much of the visiting nurse’s job is education, just so youth are more aware of the available services. If they need help that goes beyond what our clinic can do, the nurses connect the youth to another clinic with more services. Or if youth come in during off-hours, we can call our nurse practitioner. She can help them find a clinic rather than having to use a hospital.

This relates to well-being because it’s relationship-based: We have a regular medical staff now that is so youth-focused. They’re always here on the same days, always consistent, so the youth count on that and know they can get these services. Having a familiar face at the drop-in gives youth a sense of trust and security. Because of the nature of homelessness, they have a lot of mistrust of agencies, services, people in general. We used to have doctors once a week, very short hours. It wasn’t great for relationship-building with youth or staff. We have to build relationships first to help them feel ready for services.

Youth walk in to our health center with really varied issues. They say, “My stomach hurts” or “I have asthma.” The youth don’t always know what they need, so it’s our job to explain what’s available. And so whoever has the relationship with that youth, the case worker or another staff member will say, “Let me introduce you to this woman in the clinic.” Since they trust the services we have here, we can get them to sign up to be seen.

They often come in for one thing, but end up talking about their past. They’ve been forced to take meds or do counseling when they weren’t ready. Our goal is to give them choices and present health services in a positive way. We do groups on healthy relationships, to get them to realize that mental health involves more than sitting around in an office spilling your guts.

Having these services onsite is great because we don’t have to refer youth to places that we may not know, or places it might be difficult for them to get to. Often youth won’t attend to things because, without good transportation options, it’s simply a lot of work.  It’s nice for them to have it all in one place so they don’t have to balance it all themselves.

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