An Onsite Clinic Builds Healthy Connections for Homeless Youth and Their Kids
For formerly homeless youth living at the Valley Youth House apartment complex in Allentown, Pennsylvania, basic physical and mental health care is only a few feet away. In January 2015, the social services agency launched the Regional Integrated Collaborative for Healthy Youth, or RICHY, program, an onsite clinic offered to residents and their children eight hours a week.
Bringing the clinic to residents’ living space does more than reduce their travel time, says Samantha Goodrich, senior research and evaluation scientist at partner organization Lehigh Valley Health Network. The setup allows youth to seek help at their own pace, with many asking basic questions during their first visit or discussing their child’s symptoms rather than their own.
“When you’re dealing with a group of adolescents who experienced a lot of trauma in their past and a lot of trust issues in general, reaching out to the healthcare system is not something they’ve been taught or feel comfortable doing,” Goodrich says. “By going to where youth are, [clinic staff] can break down some of those walls between [youth] and the healthcare system and show that they are trustworthy and can provide good healthcare information.”
Making the Healthcare Connection
The nurse practitioner and nursing student who work at RICHY typically spend clinic hours answering medical questions and promoting healthy habits rather than treating youth or their kids for a specific illness, Goodrich says. A social work student is also on-hand to address behavioral health concerns and to help residents see how physical ailments can stem from traumatic experiences.
RICHY also helps young people schedule appointments at a nearby health center for cases requiring further medical attention. Bridging that relationship helps connect residents and their children to a primary care provider, Goodrich says, and gives them a medical option beyond the emergency room.
Indeed, data collected during the program’s first six months showed that RICHY helped residents avoid five emergency room visits for non-urgent cases. During that same time, clinic participants made 15 visits to the local health center.
Partnering for Progress
RICHY’s partners meet regularly with each other and with residential staff to strengthen the program and its services, says Valley Youth House Director of Independent Living Lisa Weingartner. The ongoing partnership has led to small changes that make a big difference in practice. Youth workers found that knocking on young people’s doors when they don’t show up to a clinic appointment, for example, has reduced the number of no-shows by creating a culture of accountability.
Similarly, the agency has positioned nursing and social work students’ limited time with the clinic—usually two or three semesters—into a practical lesson about change. “Even if you go to the same doctor’s office, you’re not always going to get the same people each time,” Weingartner says.
She also points to the benefits of bringing in an outside evaluator like Goodrich to help partners better understand what can and cannot be measured based on a program’s offerings. An initial goal to measure improvement in parenting skills, for example, was scrapped after stakeholders realized the clinic wasn’t providing a parenting curriculum. Instead, the group will begin to measure the strength of relationships between residents and their primary care provider, Goodrich says.
Beyond the evaluation process, Weingartner has another overarching goal for RICHY—helping young people with difficult pasts learn to speak up for themselves across their lifetimes.
“If you learn how to manage your own health care and the healthcare system by advocating for yourself, you can transfer that [skill set] to all kinds of other settings,” she says. “That, to me, is what positive youth development is really about—empowering youth to be the true leaders of their lives.”