National Runaway Prevention Month 2015: 10 Questions to Screen Runaway Youth for Sexual Abuse

It's National Runaway Prevention Month! In the spirit of raising awareness of runaway and homeless youth this November, we're re-posting several articles that highlight this group's unique needs and experiences. In this article first published in 2012, a nurse practitioner shares how police in St. Paul, Minnesota, ask 10 questions to screen runaway youth for sexual abuse.

Until recently, police in St. Paul, Minnesota, had only one question when they released a runaway youth from custody: Did the young person get home?

Today, police ask ten questions of every runaway teen they come into contact with. The questions were chosen specifically to help police identify sexually abused teens and get them treatment. Researchers from the Midwest Children’s Resource Center at Children’s Hospital and Clinics of Minnesota teamed up with the police, put together the questions, and tested them out on more than 250 runaway youth.

When police officers asked, most teens answered. One in 10 revealed that they’d been sexually touched or assaulted while away from home.

We spoke with Laurel Edinburgh, a nurse practitioner and researcher from the resource center, about how the 10-Question Tool can be used to identify sexually abused teens and help them get treatment.

NCFY: How is the St. Paul Police Department using the 10 questions?

Edinburgh: For each youth that runs away, when they return home someone from the missing persons department interviews the youth. Or when the youth returns to school, the youth is interviewed by a school resource officer.

Then we have pathways for what is supposed to happen next in terms of connecting kids to services. “Are you afraid at home?” Well, if the kid says yes, then our police have a lot of critical thinking skills that they use all the time. “Why are you afraid at home?” And if then the kid also says, “I’m being abused at home,” well that would be an opportunity for a teen to go to shelter and then have further follow up at the child advocacy center in our community.

NCFY: So it’s not just about asking the questions. You also have to have those connections between the police and service providers set up.

Edinburgh: You do, and I think our community was wise and said you can’t ask a question or pick a scab and then not offer anything afterward. That didn’t feel fair or ethical to us as this was being implemented.

NCFY: What do you recommend for runaway and homeless programs that want to get police in their community to use this tool?

Edinburgh: I think you start with a broad spectrum of people in your community that would see that this is a way to do screening and to help the police link kids to services.

We have found that the police were very open and motivated to do this because they want fewer kids running away. And if you’re not identifying the problems that are leading the kid to run away, then the kid’s going to keep running away.

More Information

“Runaway Youth Helped Using 10-Question Tool”

"Assessment and Screening Tools for Measuring Mental Health, Substance Abuse, and Independent Living Skills in Adolescents"

"Does Running Away Increase a Girl's Risk of Sexual Assault After She Returns Home?"

Q&A: Making Anti-Violence Programs More Welcoming for Transgender Survivors

As we shared last month, anti-violence programs face a new charge to provide services to survivors who identify as lesbian, gay, bisexual, transgender, or questioning (LGBTQ). The legislative change marks progress for survivors who identify as transgender or gender non-conforming, but may pose additional challenges for shelters and programs that typically separate services for men and women.

Kristie Seelman, an assistant professor at Georgia State University in Atlanta, has researched the experiences of transgender survivors who feel they receive unequal services or treatment when accessing domestic violence and rape crisis programs. Seelman’s recently published study is the first to explore the ways that race/ethnicity, disability, and other personal factors may impact these experiences. We spoke to Seelman about the findings from that study and steps programs can take to offer more inclusive services.

NCFY: What motivated you to take a closer look at the experiences of transgender individuals who try to access rape crisis centers and domestic violence programs?

Seelman: I was studying social work at the University of Denver, and was interested in ways of improving different settings for the transgender population. The domestic violence shelter movement in general was so informed by feminism, and that’s affected the way we go about offering services. For example, so many shelters are targeted to female survivors, but this was one of the risks in the literature I saw around being transgender.

The transgender population brings forth areas where we can do better serving people related to gender. This is an important critique to grapple with, that addressing gender inequality means transgender inequality as well.

[Discover tips for serving transgender and gender non-conforming youth.]

NCFY: What do you consider the most important findings for staff members who may serve transgender survivors at family violence shelters and programs?

Seelman: People at highest risk for [feeling that they received unequal treatment or services due to being transgender] were non-citizens, people with low income, those with a history of trying to commit suicide or engaging in sex work, and those disconnected from family. Those most in need of help are facing a closed door keeping them from services that they need.

Another important finding is differences by gender identity. There are some patterns where transgender women [male-to-female] are reporting more unequal treatment. A lot of the domestic violence and sexual assault shelter history is based on gender equality, yet transgender women are reporting the greatest discrimination. It’s a call to action for people in these settings to ask, “How can we better serve this population?”

At the same time, some researchers have suggested that transgender men [female-to-male] may be less likely to seek out formal support in situations of violence. One of the things [to consider] when it comes to best practices is communicating openness to identities that include trans men so they seek help when they need it.

[Explore common challenges faced by transgender individuals seeking out community services.]

NCFY: How can service providers make their programs more inclusive of transgender survivors?

Seelman: When I have students introduce themselves, I have them state their preferred pronouns and tell them that this is a best practice. One of the turn-offs for a trans person is assuming a gender identity and using that pronoun rather than asking them. But if someone expresses to staff that they are trans, don’t share the information widely, outing them, unless they ask you to.

Place people in shelters based on how they identify their gender. In some ways [the practice of serving people based on biological sex rather than gender identity] is to protect non-trans women and make a safe space, but a best practice is having services that match how individuals define their identity, as well as keeping everyone safe across the board.

One of the challenges trans people face is how they can find a bathroom they can use safely. If possible, it’s really helpful to have at least one bathroom on site that’s a single-stall bathroom with a locking door, where gender is not a requirement to get in the door.

Be aware that this is a diverse world, and reaching different communities takes practice. It’s a constant educational process in oneself, to see the potential for growth over time.

[Read an abstract of Seelman's study.]

Annual Disparities Report Says Access to Health Care Improving

Insurance rates improved substantially after individuals were able to obtain coverage through provisions of the Affordable Care Act, according to the 2014 National Quality and Disparities Report released last week by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality. The gains in access to care were greater among African American and Hispanic adults than whites.

The research and quality agency's annual report on the nation's health care includes a section on measures of access to care that, for the first time, cover a period after implementation of the Affordable Care Act's Health Insurance Marketplaces. Data covering January to June 2014 show that the overall rate of "uninsurance"—a measure of access to care—decreased substantially to 15.6 percent in the second quarter of 2014 among 18- to 64-year-olds (from a high of 22.3 percent in 2010). Because the data run through June 2014, they capture enrollment gains only from the first open enrollment period in the Health Insurance Marketplaces. The second open enrollment period began on November 15, 2014, and is not captured in the report.

The decline in uninsurance was greater among African Americans and Hispanics, who historically have had higher uninsurance rates compared to whites. For African Americans, the uninsurance rate decreased from 24.6 percent in the last quarter of 2013 to 15.9 percent in the first half of 2014. During the same period, the uninsurance rate dropped from 40.3 percent to 33.2 percent for Hispanics, and the rate declined from 14.0 percent to 11.1 percent for whites.

Read the press release.

Read the report (PDF, 1.4MB)

More on the Affordable Care Act

"Resource Roundup: Helping Youth and Families Get Affordable Care Act Health Coverage"

"Five Key Ways the Affordable Care Act Affects Young People"

"Ask NCFY: What Does the Affordable Care Act Mean for Runaway and Homeless Youth?"

"Q&A: Amy Lin of Young Invincibles on Helping Young People Find Health Insurance"

#WhatIWouldMiss Enables Youth to Use Social Media to End Trafficking

The #WhatIWouldMiss campaign is a public-private partnership to raise awareness about human trafficking among high school students through a peer-to-peer social media competition, organized by President Lincoln’s Cottage, the U.S. Department of Health and Human Services, and the U.S. Department of Education. The campaign encourages 9th- through 12th-graders to think about aspects of their daily lives that they would miss if they were victims of human trafficking and share a post on social media about those things, along with a fact about human trafficking.

All posts to #WhatIWouldMiss shared by February 27, 2015, will be reviewed by a panel of judges and one winner, between the ages of 14 and 19, will be invited to attend the third annual Students Opposing Slavery International Summit in Washington, DC.

The campaign aims to increase youth engagement in preventing and ending human trafficking, generate youth-informed and youth-friendly prevention and intervention messages, share effective prevention messages on a broad scale, and raise public awareness about human trafficking.  It is one of the action items in the Federal Strategic Action Plan on Services to Victims of Human Trafficking in the United States.

Learn more about the #WhatIWouldMiss campaign.

Shining a Spotlight on Ending Youth Homelessness

By Jesus Garcia, Special Assistant, Office of Public Affairs, Administration for Children and Families

(This article first appeared on the Family Room blog on Oct. 23, 2014.)

LGBT youth advocate Cyndi Lauper traveled to Washington, D.C., on Oct. 22 to commemorate the 40th Anniversary of the Runaway and Homeless Youth Act, but the three formerly homeless youth joining her on the National Press Club stage soon took the spotlight with their stories of tragedy and hope.

  • Anthony Ross and his sisters scrambled around the house to escape their drug addicted mother, who was once again on a rampage. But this time, her rage included a meat cleaver in hand. The children never saw their home again. The sibling group was separated, and 13-year-old Ross, who never knew his father, ended up on Washington, D.C.’s streets. He was helped by Sasha Bruce Youthwork and today he’s preparing for law school after graduating college with Magna Cum Laude honors.
  • Syncere St. Jamyz had a normal life before his world came crashing down the day his mother died of cancer. His only foundation was gone and now he slept inside abandoned buildings and shelters of Chicago, where he often feared being victimized by homeless adults. Throughout this ordeal, St. Jamyz came out, which brought on the anxiety of who would accept and help a gay homeless teen. Today, St. Jamyz works with homeless youth at The Night Ministry, the very same organization that helped him get off the streets and take back his life.
  • Jessica McCormick became homeless right before her senior year. She left a violent home and bounced among the houses of friends and extended family in Grand Rapids, Michigan. McCormick couldn’t stay with other aunts or uncles, several who were homeless themselves or fighting addiction. Her refuge was her own education that she kept on pursuing with the help of Arbor Circle. Social workers at the agency worked with college administrators to get McCormick financial aid and housing even before school started. Today, she advocates for other students who face homelessness.

These three young adults were given a second chance at life thanks to a network of runaway and homeless youth shelters and caring adults that didn’t give up on them. They, along with government officials and advocates, sat on a panel to discuss the runaway and homeless youth issue with reporters.

Lauper, a long-time advocate for lesbian, gay, bisexual, transgender and questioning youth, pointed out a glaring statistic from recent studies on homeless youth. 

“I think it’s alarming that up to 40 percent of all runaways and homeless youth are LGBT, when they only make up seven percent of the general population,” said Lauper. “These kids are being thrown away because of who they are. We need these kids. You don’t know who they’re going to be.”

ACF’s Acting Assistant Secretary Mark Greenberg told audience members that we’ve come a long way since the Runaway and Homeless Youth Act was signed in 1974. “Before the Act, young people who had run away or been found on the streets were routinely viewed as delinquents and put in detention centers or jails,” he said. “Today, the Act enables youth-serving organizations across the country to move young people into stable housing and provide vital services such as family and individual counseling, education support and career training.”

This past fiscal year, ACF’s Family and Youth Services Bureau provided funding for:

  • Emergency shelters that served more than 30,000 young people 
  • Transitional living programs that served 3,322 young people 
  • Street Outreach Programs in more than 100 communities, which made contact with youth more than 600,000 times
  • A national hotline that answers 200 calls daily

Recently, FYSB funded a first-of-its-kind study that focused on more than 600 14- to 21-year-olds in 11 cities. Respondents included street youth served by FYSB’s Street Outreach Program grantees and street youth who were not using services. The study found the following:

  • On average, the youth became homeless for the first time at age 15
  • The average youth spent nearly two years living on the streets
  • More than 60 percent were raped, beaten up, robbed or otherwise assaulted
  • Nearly 30 percent of participants identified as gay, lesbian or bisexual, and nearly 7 percent identified as transgender

Panelist Laura Green Zeilinger, the executive director of the United States Interagency Council on Homelessness, welcomed the new study.

“Because of the very nature of youth homelessness, what we know about it is limited and improving the data is vital. That is why the release of this new study is so important,” Zeilinger said. “This effort adds to the understanding we have. What gets measured gets done, which is why getting to a confident estimate of the size of the population is critical.”

Resa Matthew, director of FYSB’s Division of Adolescent Development and Support, shared study findings that dispel myths surrounding runaway and homeless youth.

After the event, the biggest champion in the room, Lauper, reminded the audience that even though she is a small gal, she has a very big voice and big mouth. She met with every single advocate, posed for pictures and encouraged organizations and federal offices at the function to hire the impressive youth on the panel as either staff members or interns.

When a reporter asked Lauper how she felt about her recent Songwriters Hall of Fame nomination, she quickly brought back the conversation to homeless youth.

Lauper took time to thank representatives from Senators’ Susan Collins (R-ME) and Patrick Leahy (D-VT) offices for coming to the event and for the sponsoring of Runaway and Homeless Youth and Trafficking Prevention Act, a Senate bill reauthorizing aid programs. Lauper underscored the need to support this bill to increase funding for programs that help runaway and homeless youth and to add language that makes sure every young person — no matter their sexual orientation or gender identity — gets the same services and respect they deserve.

#BecauseofRHYA, Two Midwest Youth Shelters Have Long Histories

What has the Runaway and Homeless Youth Act enabled you or your organization to do? Throughout September, share your accomplishments and connections to the act on Twitter and Facebook using the hashtag #BecauseofRHYA. Don’t have a social media account? Email your thoughts to us and we’ll share on your behalf!

Here's what we heard from Shirley Caylor, executive director of Crisis Center, Inc., in Gary, IN:

The Crisis Center’s Alternative House opened in January, 1976. It is one of the first funded federal programs. In the 1970s, calls had come in to our volunteer-run crisis line from kids who were on the streets. Armed with a belief that if it needed to be done, we could do it, we opened our emergency shelter with no money and a volunteer-run raffle to pay the utilities. Timing is everything. The Juvenile Justice Act [which included the Runaway Youth Act] had passed in 1974. We applied and were funded.

In the almost 39 years of Alternative House, we estimate that 10,000-plus boys and girls have passed through our doors. Kids like the young girl who wrote to us years later to tell us how the counseling helped her deal with her abuse and made her a better parent to her own kids. Or the young boy whose entry to Alternative House allowed him to finish high school and go on to college.

Small changes have large effects. Changing the lives of youth changes everyone with whom they are connected far into the future. The passage and continuation of the Runaway and Homeless Youth Act helped us change and save the lives of boys and girls. The Act is a life changer for them but also for everyone with whom they will connect.

And from George Belitsos, chief executive and founder of Youth and Shelter Services in Ames, IA:

Youth and Shelter Services was just getting started 40 years ago. We opened Iowa’s first emergency youth shelter known as Rosedale Shelter. The Runaway and Homeless Youth Act provides funding to this day, and just over 7,500 youth have been housed and served by Rosedale.

The agency has expanded to 25 locations, and our branch in Des Moines, known as Iowa Homeless Youth Center, is now in the process of remodeling a new 20,000 square foot runaway and homeless youth center in the heart of downtown. Every step of our growth has been aided by the resources of the Act, and Youth and Shelter Services, our youth and the state of Iowa are grateful.

Q&A: Helping Families Protect Themselves From Recurring Trauma

Imagine losing a friend to street violence, learning you need major surgery or facing eviction because you can't pay the rent. Now imagine going through all those things in a short span of time.

You can probably picture it easily if you work in family and youth services. So many families face huge obstacles that pile up one after another, laying waste to any foundation of security and predictability they could turn to in times of need.

In Baltimore, researcher Laurel Kiser and her colleagues at the University of Maryland’s Family-Informed Trauma Treatment Center are finding ways to help families that live in what she calls a “traumatic context.” The center offers two versions of Strengthening Family Coping Resources, a multi-week program that helps families deal with recurring stressors and protect themselves from future threats to their emotional and mental health.

We talked to Kiser about the cumulative effects of traumatic events that happen over and over, and how routines can help families communicate and cope.

NCFY: Earlier in your career, you looked at how anticipating traumatic events can hurt kids and teens. How does that research apply to families that seem to face one challenge after another?

Kiser: Anticipatory stress really looks at what happens when people anticipate on an ongoing basis that bad things are going to happen to them. So if you’re living in an unpredictable, uncontrollable kind of situation, and you’ve experienced multiple types of trauma throughout your life, then it’s easy to be on guard for and always looking for new threats.

It gets extremely tiring. People either become very vigilant and highly reactive or they just become numb to it because they have no further energy left for coping with those kinds of things.

The research that I did pretty clearly showed that the anticipation of a bad thing happening – even in the absence of that event – a person can still have symptoms similar to those they would have with post-traumatic stress disorder. Looking at it from the family level, we [at the center] feel that families develop patterns around anticipatory trauma, that it actually impacts the way they interact with each other.

NCFY: Strengthening Family Coping Resources helps families build protective factors through a variety of tools, including routine-building. Why are routines important?

Kiser: We build a lot of skills around routines in the family, helping the family build on daily routines that are functional and predictable. For some families, nighttime can become a really highly anxious time. It’s also a time when people are tired and more irritable, so a lot of families living under these circumstances just have stopped doing nighttime routines. Whenever anybody falls asleep, wherever they are, that is where they sleep for the night.

We try and get families to build some nighttime routines that will help encourage a better nights’ sleep and fewer sleep disturbances and sleep problems. So just helping them think through how to have some quiet time and then build to a nighttime routine that’s practiced the same way every night.

We also encourage them to think about what could happen on any given night that would throw that routine off. How are they going to deliberately practice that routine and make sure it happens over and over again? That sets up a sense of knowing and predictability that for kids—and even for adults—translates into a sense of safety.

NCFY: What about family and youth workers who don’t always interact with families as a whole?

Kiser: I definitely think that residential settings can improve their practice of ritual and routine in much the same way that families do. I also think preparing kids to return home to families that have learned some new skills is a really important aspect. If they’re going to return back to a family setting, we really need to work with that caregiving system and that child to develop some new ways of functioning so they can understand each other better, communicate with each other better and have a better sense of belonging.

Read NCFY's special feature on trauma-informed care, "Asking: 'What's Happened to You?'"

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