With the federal government aiming to end youth homelessness by 2020, the Department of Housing and Urban Development's annual point-in-time counts have become a crucial tool for understanding just who is homeless in the first place, and where. And young people are taking an active role in that effort. If you'd dropped in on the Los Angeles County count in January, you'd have found about 50 formerly homeless youth taking to the streets to help count their peers.
LA is one of nine sites across the country participating in Youth Count!, a federally funded demonstration project aimed at discovering and sharing best practices for point-in-time counts of homeless youth. Every year since 2007, the Los Angeles Homeless Services Authority has employed a growing number of clients from youth-serving agencies throughout the county. Their 2013 count was the first in which youth counted their homeless peers in all eight of LA's "service planning areas," designated by the authority.
“[Youth] know where the hot spots are,” says Lisa Snyder, senior policy and housing analyst. “So they’re at an advantage over other potential counters.”
Thanks to the young counters, Snyder says, the authority now has a more accurate idea of the number of homeless young people in LA and the parts of the county they live in. And by working with young people being helped by local homeless service providers, the LA youth count has improved collaboration between the area’s many youth-serving organizations.
Here’s how Snyder and her team made their youth-led youth count happen:
Step 1: Engage Youth-Serving Organizations
As Los Angeles County’s foremost funder and coordinator of homeless-serving organizations, the authority asked its partner programs with youth clients to bring two or three on board as counters. While 50 young people were necessary in order to cover each of greater LA’s eight service planning areas, smaller communities could likely employ fewer. Each counter was given a $10 lunch voucher and a $50 gift card.
Step 2: Train the Counters
The count took place from 10 a.m. to 3:30 p.m. on January 22. Snyder and her colleagues held a 45-minute training for youth counters that morning at the authority’s offices.
“We began by getting them to understand the scope of [overall] homelessness in LA,” she says, “how the count helps us see if we’re making progress, or how to better tailor our programs.” Then youth learned how to use their tally sheets to count young people on the streets. They also got a rundown of the day’s schedule.
Step 3: Assign Youth to the Areas They Know Best
After the training, each youth-serving agency’s counters got in their own van with a supervisor from their program, who did the driving. Each team canvassed the neighborhoods their organization serves.
“Because LA is so big, one [area] to another is night and day,” Snyder says. “The situation in the Antelope Valley, an hour from downtown LA, is not the same as the situation for a youth on Hollywood Blvd.”
Step 4: Support the Effort
Throughout the day, Snyder and her colleagues stood by at the authority office. “We stayed by the phone, prepared to send someone from our emergency response team if a situation called for it,” she says. Luckily no incidents arose.
“We got a great group of kids,” she says. “They had great attitude, especially when you consider what some of them have been through.”
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“Brief report: Pregnant by Age 15 Years and Substance Use Initiation Among U.S. Adolescent Girls.” Journal of Adolescence, Vol. 35, No. 5 (October 2012).
What it’s about: Researchers at the Washington University School of Medicine in St. Louis wanted to know what types of substance use might put teenage girls at risk for becoming pregnant at a very young age (under 15 years old). To find out, they studied data from the National Youth Risk Behavior Survey, which is conducted every two years by the Centers for Disease Control and Prevention. The survey takes stock of the risky health behaviors of U.S. high school students.
Why read it: There’s a lot of research that shows an association between teen pregnancy and unhealthy consequences for the young moms and their babies. The consequences are worse when teens get pregnant at 15 or younger.
Biggest takeaways for youth workers: Only 3 percent of the teens in the researchers’ sample had ever been pregnant by age 15. But among those who had, marijuana use and smoking were common, even at very young ages. Thirty percent of girls who had been pregnant had also smoked marijuana by age 12. Half had smoked cigarettes by age 12. Only 8 percent of girls who had never been pregnant had smoked marijuana by that age, and one-fifth percent had used cigarettes.
Overall, the likelihood of getting pregnant by age 15 was highest for girls who had smoked marijuana when they were 10 or younger.
The researchers point out some limitations of their analysis. The Youth Risk Behavior Survey stopped asking about teen pregnancy after 2003. So the results of this study, which uses data from the 1999, 2001 and 2003 surveys, is somewhat dated. Also, because of the type of study this is, the researchers can’t say that substance use causes teen pregnancy. And the study doesn’t include responses from teens who had dropped out of school, who may have higher pregnancy rates than youth who stay in school. The researchers view their study as a starting point for future investigation of how substance use influences teen pregnancy, and how this knowledge may help us find better ways to prevent very young teens from getting pregnant.
Additional references: You can learn more about the Youth Risk Behavior Surveillance System on the CDC website. Curriculum-Based Support Group is an evidence-based program for children and preteens who are at high risk for using drugs and alcohol at an early age.
With springtime arriving, many high school seniors are finishing up their college applications or hearing back from schools. On average, higher education boosts people’s lifetime earnings compared to having a high school-level diploma or less. But many homeless youth living on their own apart from their families don't go to college--or even see higher education as an option.
FYSB's Acting Associate Commissioner, Debbie A. Powell, wrote about this problem this week in The Family Room, the official blog of the Administration for Children & Families. Here's what she says about the hurdles that keep homeless youth from going to college:
Those obstacles include not having the money for deposits and fees, lack of knowledge about their rights and the benefits they may be eligible for, daunting paperwork, and lack of support as they attempt to navigate the higher education system on their own. Many youth may not know that the Higher Education Opportunity Act of 2008 expanded the definition of “independent students” eligible to apply for financial aid without a parent or guardian’s approval or financial records. Now that category includes unaccompanied homeless youth and foster youth.
Powell goes on to talk about further steps states, educators and youth-serving agencies are taking to make sure homeless youth can access a higher education.
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NCFY offers tips for youth-serving organizations that want to help runaway and homeless youth make the leap to college
In our newest podcast, we talk to Nia, a one-time resident and current employee of a California transitional living program. She shares her methods for avoiding secondary trauma, which occurs when youth workers become traumatized or overstressed themselves from proximity to their clients' struggles.
NCFY Reads: 'The Boy Who Was Raised as a Dog and Other Stories From a Child Psychiatrist’s Notebook'
“The Boy Who Was Raised as a Dog and Other Stories From a Child Psychiatrist’s Notebook”
by Bruce D. Perry and Maia Szalavitz
A child psychiatrist shares his experiences with memorable young clients to explain how childhood trauma can impact brain development. Written with the help of a science and health journalist, this book compellingly shows how abuse and neglect can impact a child’s physical, emotional and social growth.
When Bruce D. Perry became a child psychiatrist in the 1980s, the field paid little attention to how psychological trauma shaped the brain. Many scientists and helping professionals of the era believed that children could simply bounce back from years of abuse and neglect.
In “The Boy Who Was Raised as a Dog and Other Stories From a Child Psychiatrist’s Notebook,” Perry chronicles his work with severely traumatized children and the lessons he learned from them about trauma’s lasting effects. His evolution as a psychologist in some ways mirrors the youth work field’s progression, over the past two or three decades, toward a trauma-informed model of care. Combining human drama and clear-eyed science writing, Perry gives readers a sense of just how important it is to understand the needs of traumatized children and youth, and to choose interventions that promote healing where their minds and bodies need it most.
Making the Brain-Body Connection
Each chapter in “The Boy Who Was Raised as a Dog” tells the story of a child whose brain has been ‘rewired’ by his or her traumatic experiences. A seven-year-old girl accused of lewd sexual behavior, for example, doesn’t know how to interact with male classmates after years of sexual abuse. A violent teenager accused of murder can’t relate to people around him because his mother ignored him daily for hours on end.
Aided by collaborator Maia Szalavitz, a science and health journalist, Perry weaves into his stories fascinating facts about brain science and how a child’s brain grows. The key to healthy physical, social and emotional development, he writes, is for children to get the right types of experiences at the right stages of childhood. He writes:
The fact that the brain develops sequentially—and also so rapidly in the first years of life—explains why extremely young children are at such great risk of suffering lasting effects of trauma: their brains are still developing. The same miraculous plasticity that allows young brains to quickly learn love and language, unfortunately, also makes them highly susceptible to negative experiences as well.
In other words, when normal experiences are replaced by stressful events, like the violence and neglect Perry’s clients experienced, the brain can put itself on high alert. Parts of the brain stop growing and, in effect, become frozen in time. Young people whose brains have undergone this type of stunting may act differently than other children and teens, bursting out suddenly, having trouble controlling their actions or finding it hard to concentrate.
One of the book’s key takeaways, and one of extreme interest to youth workers, is that the brain can be reshaped by services that stimulate the specific areas of the brain that have broken down. Perry writes of a young girl who, after being left for dead in a home invasion, reenacts her mother’s murder during therapy. Disturbing as they are, her reenactments satisfy her brain’s need to process the event in small, manageable doses, Perry contends. Similarly, a young boy raised in a cage surrounded by dogs takes music and speech therapy classes to learn basic communication skills most children pick up at home.
Perry doesn’t minimize the strength and patience it takes for young people and their care providers to roll back the effects of years of abuse. But he does offer hope that healing can happen.
A new video series from the Justice Department’s Office for Victims of Crime educates viewers about childhood trauma and emerging practices that help address the problem. The series is part of a federal effort to unite neighbors and professionals in identifying, protecting and treating children exposed to violence.
"Through Our Eyes: Children, Violence, and Trauma" includes four videos of around seven minutes each:
- The introduction features adults who experienced violence while they were young, as well as trauma experts who explain the changes that occur in the brain when young people experience extreme fear or stress.
- "Treatments That Work" discusses two evidence-based practices that help victims of childhood violence: trauma-focused cognitive behavioral therapy and child-parent psychotherapy.
- "The Child Advocacy Center Model" demonstrates a multidisciplinary approach that brings together police, mental health and medical professionals, victim advocates and others to treat traumatized young people.
- "Community-Based Approaches" highlights three programs that support children and families in their communities. The video also emphasizes the benefits of individually tailored programs.
The Justice Department also offers online publications about children’s exposure to violence, as well as resource guides for professionals serving child and youth victims.
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"NCFY Recommends: Lessons Learned About Working With Teens and Children Exposed to Violence"
"Q&A: Elena Cohen from the Safe Start Center on Trauma-Informed Approaches to Helping Young People"
"Bright Idea: A Virtual Treatment Helps Youth Heal from Trauma"
In January, communities across the nation counted the number of people experiencing homelessness on a particular night. Called point-in-time counts, these efforts are required by the U.S. Department of Housing and Urban Development in communities that have continuum of care grants to provide comprehensive services to the homeless.
In an effort to share the results of the local point-in-time counts, the National Alliance to End Homelessness recently released the “2013 Homeless Counts Map.” The interactive tool shows communities that have made their results public, either in formal online reports or in local media coverage.
Red pins represent an increased number of homeless people, while green pins show a decline. Clicking a pin brings up the total count for that community and links to the corresponding report or news article.
The alliance's Homelessness Research Institute will update the map as new information is released. If you would like your community to be included, please email a completed report or relevant news story to email@example.com.
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For youth worker Matt Tennant, opening a nonprofit bike shop seemed like an ideal way to combine two passions. After years of doing street outreach in Minneapolis, Tennant opened Full Cycle in 2008 to connect homeless young people to the many benefits of owning and fixing bikes.
Today, Full Cycle repairs and sells bicycles, parts and accessories to the public. The organization also offers a number of initiatives for homeless youth ages 23 and under, including street outreach, an internship program and the Free Bike Program, which enables youth to build their own bikes from donated parts while also getting to know staff members.
“For us, the bike has always been a tool to do good youth work and to make connections,” he says.
Two Wheels, Many Benefits
Since opening Full Cycle, Tennant has seen and heard how bikes can help young people in many ways. Youth often tell him about jobs they’ve been able to keep, he says, or how they show up on time for appointments with their case workers.
Occasionally, the shop receives bike trailers, which young homeless parents use to take their children to the doctor and to plan healthy outdoor activities.
“When you’ve got three little kids and no transportation and you’re staying in the shelter, it really gets to be pretty smothering,” Tennant says. “So if you can get out on a bike, it can really change your frame of mind.”
He adds that for some young people, the most useful part of visiting Full Cycle takes place before they leave the shop. Tennant hires experienced outreach workers and mechanics, who get to know homeless youth while they make repairs. An hour-long appointment to build a bike may begin with replacing a tire, for example, and end with an offer to take the young person on a tour of a local shelter.
“Anytime you’re doing a project and you’re using your hands, you’re just connecting on a different level,” he says. “I think it makes it easier [for youth] to open up and have conversations that just come more naturally.”
Giving Bike Programs a ‘Test Ride’
Last year, Full Cycle loaned a small fleet of bikes to four local youth shelters to use however they saw fit. Shelters borrowed the bikes for six months before returning them to Full Cycle for maintenance over the winter. Tennant hopes to expand the initiative this summer to meet local demand, and he thinks other bike stores and agencies could easily replicate the program across the country.
He says youth workers can reach out to bikes stores in their communities, especially nonprofit shops with a youth focus. Nonprofit bike stores often have more bikes than they can sell, he says, and may be open to starting a borrowing program if one doesn’t already exist.
Agencies could also request bike donations or look for cheap bikes at yard sales and through online services like Craigslist. The most important step, Tennant says, is finding local mechanics willing to volunteer their know-how to keep bikes in working order.
“There are so many bikes sitting around unused out in the world,” he says. “It just takes people to find and redistribute them to people who will actually use them but can’t afford them.”
Homeless youth are more likely than the general teen and young adult population to get pregnant or contract an STD. But most STD and pregnancy prevention programs are designed for youth who live at home and go to school regularly. A group of researchers in the Los Angeles area, mostly at the RAND Corporation in Santa Monica, have been studying the attitudes and behaviors that may make homeless youth more likely to have risky sex. Their work, recently published in a trio of papers, sheds light on some of things public health workers and health educators might be able to do to tailor prevention programs to this vulnerable population.
Using a combination of interviews and surveys with homeless youth in and around Los Angeles, the researchers examined the effects of young people’s drug use and drinking, their relationships with family, friends and sex partners, and their feelings about pregnancy and parenthood on their likelihood of having protected or unprotected sex.
Influences on Condom Use
The researchers found that young people were less likely to use condoms if
- they or their partner had used hard drugs before they had sex
- they were with someone who was their boyfriend or girlfriend or to whom they felt strongly committed
- they had discussed “pulling out” as a contraceptive strategy before they had sex
- they were in situations where there was no privacy
Youth were more likely to use condoms when
- at least one of the partners regularly attended school
- they had positive feelings about using condoms
- they expressed high motivation to avoid pregnancy
The researchers also found that young people’s romantic partners had a strong influence on whether or not they used protection during sex, more so than friends or parents. In the study looking at attitudes toward pregnancy, youth in long-term relationships were more likely to have positive attitudes toward pregnancy and to not use contraception. In that paper the researchers write that “three-quarters of the youth thought it was very important to avoid pregnancy, but far fewer reported using effective contraceptives.”
Reducing the Risk
Based on the three papers, here are some things youth workers might consider when they create programs to reduce teen pregnancy and STDs among homeless youth:
- Work to reduce drug use among homeless youth, and educate them on the potential impact of drugs on their ability to practice safe sex.
- Encourage positive attitudes about condoms, which may lead to more condom use.
- Help youth develop communication skills so they can negotiate the use of condoms with their partners.
- Recognize the influence romantic partners have on young people’s contraceptive decisions.
- Think of stable housing as part of the strategy for reducing young people’s likelihood of having risky sex.
- Acknowledge and counteract the advantages homeless youth might see in getting pregnant and having children.
- Consider using comprehensive pregnancy prevention approaches that may be able to address young people’s needs for stable housing, education and employment while also reducing pregnancy.
Read the Studies
“Substance Use and Other Risk Factors for Unprotected Sex: Results from an Event-Based Study of Homeless Youth” (abstract). AIDS and Behavior, Vol. 16, No. 6 (August 2012).
“Understanding Pregnancy-Related Attitudes and Behaviors: A Mixed-Methods Study of Homeless Youth.” Perspectives on Sexual and Reproductive Health, Vol. 44, No. 4 (December 2012).
“Unprotected Sex of Homeless Youth: Results from a Multilevel Dyadic Analysis of Individual, Social Network, and Relationship Factors” (abstract). AIDS and Behavior, Vol. 16, No. 7 (October 2012).
Q: What are the implications of the Affordable Care Act for runaway and homeless youth?
A: If young people are still in touch with their families and their families have health insurance, the health care law makes it possible for them to be covered by their parents’ plan until age 26.
For those runaway and homeless youth who are on their own and unsupported by their families, you’ll still want to help them find out if they are eligible for Medicaid. Only their own income and not their families’ income should be counted when figuring out whether they are eligible.
For children and teens ages 6 to 18, the health care law requires all states to have a Medicaid eligibility level that is at least 133 percent of the federal poverty level. (Some states had already established higher levels for that age group, while others had not.)
Young adults age 19 and older will have to check their state’s Medicaid eligibility rules. Starting next year, because of the health care law, some states will be expanding Medicaid to cover individuals, including single adults, with incomes up to 133 percent of the federal poverty level, but others will not.
That means even a young person working fulltime at the federal minimum wage may become eligible for Medicaid, if the eligibility level in their state and for their age group is 133 percent of the federal poverty level.
Unaccompanied young people who don’t qualify for Medicaid or have health insurance through an employer will be able to purchase coverage directly on the government’s new Health Insurance Marketplace. Open enrollment will start this fall, and coverage begins next year.
The law also has a provision, sometimes referred to as the “individual mandate,” through which the IRS will be able to collect a fee from people who don’t get health insurance. The IRS payment will not apply to people whose income is too low for them to file taxes ($9,500 this year for an individual) nor to people for whom insurance is unaffordable.
“Virtually any unaccompanied homeless youth would probably be exempt from the individual mandate,” says Abigail English, director of the Center for Adolescent Health & the Law in Chapel Hill, NC, “because their income would be too low for them to be required to file a tax return.”
The IRS regulations regarding the payments are open for public comment until May 2, 2013.