Search Results (56)

Background/Objectives: The homeless population (HP) is a heterogeneous group characterized by the absence of stable and conventional housing, often relying on public spaces and deteriorated environments for shelter and survival, either temporarily or permanently. This group is exposed to multiple health vulnerabilities, with substance use disorder (SUD) identified as a significant risk factor for suicidal behavior. The aim of this study was to conduct a scoping review of the relationship between PAS use and suicide among homeless individuals. Methods: A comprehensive literature search was performed using five databases: PubMed, Scopus, SciELO, LILACS, and Google Scholar. Studies were selected based on their relevance to the topic, and data were extracted regarding substance use, suicide-related outcomes, and associated sociodemographic and clinical factors. Results: The findings indicated a strong association between PAS use and increased suicidal ideation and behavior among homeless individuals, particularly among youth, men, and women. Opioids and alcohol were the most frequently reported substances in this context. Additional factors such as unemployment, exposure to violence, social inequalities, and mental health disorders further exacerbated the risk of suicide in this population Conclusions: The reviewed literature underscores the urgent need for integrated, context-sensitive interventions addressing both substance use and mental health among the homeless. Tailored public health strategies focused on prevention, harm reduction, and psychosocial support are essential to reducing suicide risk and promoting overall well-being in this highly vulnerable group. Full article

(1) Background: Housing instability is a public health issue in both developed and developing countries. This exploratory pilot study examines executive functioning (EF) and the history of acquired brain injury (ABI) in youth and young adults experiencing homelessness (YYEH). (2) Methods: Twenty-three YYEH (ages 18–25; 48% male) were recruited from a drop-in center in Central Ohio. The Ohio State University TBI Identification Method (OSU TBI-ID+ABI) was used to screen for exposure to ABI. Outcomes were measured using the Behavior Rating Inventory of Executive Function for Adults (BRIEF-A) and the NIH Toolbox Cognitive Battery. (3) Results: Eighty-seven percent of participants reported a lifetime history of ABI, including traumatic brain injury or hypoxic-anoxic brain injury. Overall, participants did not present with elevated EF scores on outcome measures. Those with multiple lifetime ABIs (n = 16) had significantly higher scores than those with a single ABI (n = 4), representing poorer EF, on shift, self-monitor, task monitor, and the Global Executive Composite of the BRIEF-A. There was no evidence of significant differences between participants on outcome measures based on injury mechanism. (4) Conclusions: In this pilot sample, those with multiple reported ABIs demonstrated decreased EF performance, and these differences were noted in specific areas of EF. To ensure YYEH have access to services, resource support and intervention providers should consider the cognitive profiles of the youth they serve. Full article

Marginalized populations face significant barriers to mental health care, such as stigma, poverty, and limited access to adapted services, with conventional psychiatric approaches often falling short. This study aimed to explore how psychiatric care can be adapted to better meet the needs of vulnerable populations. Data were collected from psychiatry residents, psychiatrists, and community organization staff during a course on vulnerable populations, using semi-structured discussions and analyzed through grounded theory with iterative coding. Seven main themes emerged: (1) barriers and needs of vulnerable populations, highlighting challenges like homelessness and stigma; (2) psychiatric interventions and flexible approaches, emphasizing tailored care; (3) collaboration with community organizations, focusing on partnerships to improve care access; (4) ethical approach and respect for rights, ensuring dignity in treatment; (5) specific populations and associated challenges, addressing the needs of groups like LGBTQ+ youth and migrants; (6) intervention and support models, such as proximity-based care and post-hospitalization follow-up; (7) innovation and evolution of practices, focusing on research and institutional adaptations. This study emphasizes the need for personalized, intersectoral care, recommending improved collaboration, flexible models, and greater clinical exposure, with future research exploring how psychiatric education can better prepare clinicians to work with marginalized groups. Full article

Youth-led action research has significantly influenced local and statewide policies aimed at supporting students experiencing homelessness in California. This study employs a Youth Participatory Action Research (YPAR) methodology, summarizing five years of research conducted by high school student cohorts and UC Berkeley graduate students to examine effective strategies for preventing and addressing student homelessness. The research engaged over 260 high school students, nine graduate research fellows, 31 university student mentors, and eight civic and community organizations through data collection, policy analysis, and stakeholder collaboration. Findings indicate that youth-led research strengthens alignment mechanisms, enhances cross-sector collaboration, and improves policy coordination, leading to more effective services and positive educational experiences for students experiencing homelessness. These results underscore the transformative role of youth-driven inquiry in shaping inclusive, evidence-based policies, and demonstrate the need for sustained youth engagement in policymaking to create long-term, systemic change. Full article

Background: Adolescents in foster care endure frequent disruptive transitions, often culminating in discharge to independent living rather than reunification or adoption. Former foster youth fare poorly once on their own, with high rates of homelessness and social disconnection. This study explored the use of the Bridges Transitions Framework near the end of placement to help youth cope with the transition to adulthood. Methods: In this exploratory study, the framework was integrated into a foster agency’s programming; then, we assessed outcomes using administrative data and youth interviews. Thirty-five youth participated. Status of employment, education, and social support was collected 18 months after exposure to the framework. Results: The participants reported moderate to high levels of social support, which is often limited or absent among foster care leavers. Relative to rates reported in state-level foster care data, participants had substantially higher rates of school enrollment after discharge. With very few empirically assessed models available for this population that specifically address internal coping with such substantial life changes, the Transitions Framework offers a tool that may help foster youth navigate aging out of care. Securing lasting and meaningful social support and employment and completing education remain elusive for former foster youth. Conclusions: To confirm the utility of the Transitions Framework, it is recommended to assess it with a large sample and matched comparison group over time. Full article

Youth experiencing homelessness (YEH) face elevated risks of HIV and STIs compared to their housed counterparts. HIV and STI testing services are pivotal for prevention and early detection. Investigating utilization rates and associated factors among YEH provides critical insights for intervention efforts in major U.S. regions. This study analyzed secondary data from the Homeless Youth Risk and Resilience Survey (HYRRS) conducted between 2016 and 2017. Participants were recruited in seven major cities: Los Angeles, San Jose, Phoenix, St. Louis, Denver, Houston, and New York City (n = 1426). Notably, YEH in Denver, Houston, Phoenix, San Jose, and St. Louis were significantly less likely to use HIV testing services than those in Los Angeles. YEH reporting early sexual activity were less likely to undergo HIV testing, while having online sex partners increased the likelihood of HIV testing. Moreover, YEH in New York City were more likely to receive STI testing, while Phoenix and San Jose had lower testing rates. Disparities in testing rates highlight questions about equitable resource allocation, accentuating the need for enhanced educational and community outreach efforts to address barriers across diverse urban settings. Full article

Historically, the prevention of youth homelessness has not been a priority in Canada or the United States. In recent years, this has begun to change. While there is growing recognition that a shift by preventing homelessness is required to bring a substantive end to homelessness, a common and shared understanding of what prevention is and what it involves has remained largely absent or obscured in both policy and practice. In this paper, we focus specifically on the prevention of youth homelessness and set out to provide conceptual clarity through presenting a clear definition of what prevention is and what it is not. Accompanying the definition is a five-point typology that includes (1) structural prevention; (2) systems prevention; (3) early intervention; (4) crisis intervention, and (5) housing stabilization. Each of the five elements of the typology is defined, identifying who is responsible for implementation. In addition, the typology is populated with examples of different approaches to the prevention of youth homelessness. We conclude with some key considerations to guide the implementation of preventive interventions and present core principles designed to support the development of effective and quality prevention interventions. Full article

In recent years, researchers and policymakers have called attention to the importance of child and adolescent trauma for understanding adult health status. The primary aim of this study is to describe the adverse childhood events reported in a sample of runaway and homeless youths and examine their impact on these youths’ current health status. We utilize survey data collected from a community sample of runaway and homeless youths gathered in metro Atlanta. Using the Adverse Childhood Experiences Scale (ACEs scale), we examined the relationship between ACEs and several health status measures using OLS and logistic regression. We found that runaway and homeless youths endorsed experiencing many ACEs, especially sexual minority youths, youths who had prior involvement with child-serving social service systems, and youths who were homeless for more than a year. Black/African American youths were slightly less likely to report many adverse childhood experiences. Runaway and homeless youths who reported more ACEs had increased odds of experiencing significant current mental health and/or substance abuse problems. Our study suggests ACEs are an important factor shaping these youths’ health and underscores the potential value of trauma-informed care for youths experiencing homelessness. Full article

(1) Background: Youths with multiple risks and severe disadvantages experience poorer health and educational outcomes than less disadvantaged peers. To address problems with coping and self-regulation in this group, mental skills training (MST) approaches more commonly used in sport are an emerging intervention approach. (2) Methods and results: this narrative review synthesizes literature to explain the need for MST, how it works, and evidence to support it works by focusing on two well evaluated programs: LifeMatters and My Strengths Training for Life™. (3) Conclusions: To support positive youth development, MST is a strengths-based, flexible, and adaptable approach to help fill the shortage of available evidence-based programs for those youths facing multiple disadvantages. The findings of this review may facilitate policy makers, commissioners, program planners, and researchers in the uptake of MST or similar psychoeducational approaches in future. Full article

Native Hawaiian and Pacific Islanders (NHPIs) are overrepresented in Hawai‘i’s houseless population. Indigenous populations, such as NHPIs, may encounter experiences of historical trauma that impact their well-being. This original research project examines how NHPI identity and houselessness compound to affect the perceived stress and historical trauma of transition-aged youth. Fifty-one participants aged 18 to 24 (M = 21.37, SD = 1.93) completed a survey that included the historical traumatic events scale, historical loss scale, perceived stress scale, and a demographic questionnaire. Over half (n = 26, 51.0%) of the participants identified as NHPI. A two-way ANOVA indicated a non-significant effect of NHPI identity and housing status on perceived stress. However, housed participants scored significantly higher than participants experiencing houselessness on the historical traumatic events scale (p = 0.006). Our findings elucidate the role of knowledge in the experience of historical trauma. Further results, limitations, and future directions are offered. Full article

There is a growing movement in Canada towards youth homelessness prevention. One such response, called shelter diversion aims to move young people into safe and supportive housing as quickly as possible. The objective of this project is to assess how, and in what ways, shelter diversion operates and whether this intervention permanently or temporarily diverts youth from homelessness. Our project is grounded in principles of community-based participatory research including community/university partnerships and an advisory committee of lived-experience experts. Our team is utilizing mixed methods to capture the outcomes of diversion programs. Data collection began in September 2022 and ended in May 2024. Quantitative and qualitative data analysis is underway. Preliminary results show differences in how diversion is defined and implemented across organizations. There are also differences in staffing models and program budgets. The findings from this study will contribute to a recommendation for a national definition and adaptable program model for shelter diversion, easily accessible to support the expansion of diversion programs into youth-serving organizations across Canada. This study is the first in Canada to examine the effectiveness of shelter diversion as an early intervention strategy to prevent youth homelessness on a national scale. Full article

Prevention and early intervention have become part of the Australian policy discourse; however, the prevention and early intervention of youth homelessness remain significantly underdeveloped and underfunded in practice. Consequently, too many young people experience homelessness. This article presents the ‘Community of Schools and Services’ (COSS) Model as an innovative approach to the prevention of youth homelessness. The COSS Model is an Australian place-based collective impact approach that uses data gathered via population screening in secondary schools to identify and then support adolescents at risk of homelessness and also reorganizes the local support system available to vulnerable young people and their families. This paper is not the result of a research project. Rather, this paper presents the findings of the Embedded Development and Outcomes Measurement (EDOM) report, which is a feature of the COSS Model. This paper is limited to findings from the COSS Model implementation in Albury, NSW, known as the Albury Project, from 2019 to 2023. The Albury Project has demonstrated significant reductions in the risk of homelessness and entry into the local homelessness service system. Findings reveal that: (1) when COSS Model support is delivered to identified at-risk students, 40–50% of individuals are no longer at such high risk of homelessness 12-months later; (2) only 3–5% of students identified as at risk of homelessness and supported through the COSS Model sought assistance from local homelessness services in the following two years; and (3) the flow of adolescents (12–18 years) into the local homelessness services was reduced by 40% from 2019 to 2023. As an evidence-based, complex innovation, there are major policy, funding, and implementation challenges in scaling the model to multiple community sites. Full article

Young adults experiencing homelessness face multiple challenges and are often confronted with additional barriers stemming from adverse past experiences. Whereas youth homelessness rates appear to increase across Europe, our knowledge on its nature in Belgium remains limited. Based on recent local point-in-time counts on homelessness in Belgium (2020–2022) and a focus group (2022) to interpret these results, we examine the profiles of more than 2000 homeless young adults and distinguish between three distinct groups (youth care leavers, Belgians with no care history, and newcomers). Alongside the need for universal prevention, tailored interventions are crucial for each subgroup to address their unique needs. Full article

Transphobic and homophobic violence and discrimination within homes and housing programs lead many 2-Spirit, lesbian, gay, bisexual, transgender, and queer (2SLGBTQ+) youth to find alternative, temporary, and insecure housing. These types of living situations are considered “hidden homelessness”. This study interviewed 2SLGBTQ+ youth (n = 6) and key informants (n = 12) who have experienced and/or who support hidden homelessness across three sites in Ontario (Toronto, York Region, and London). The results suggest experiences of hidden homelessness for 2SLGBTQ+ youth are nonlinear, with pathways driven by family conflict combined with the high cost of living and lack of employment, making independent living unaffordable. Additionally, youth avoid services where they experience discrimination and often experience social isolation. In rural and suburban areas, youth have fewer options for safe and inclusive services. When services are accessible, wrap-around supports that address the complexity of their situations help youth exit hidden homelessness. Prevention strategies should focus on addressing family conflict and supporting reunification when it is safe to do so. For those who are unable to return home, there is a need for increased financial support and more affordable housing. Building comprehensive population-based support services is recommended to address the overrepresentation of 2SLGBTQ+ youth experiencing homelessness. Full article

In this study, we identified differences in characteristics and circumstances, main presenting problems, and types of referrals received among young people who were in crisis, at imminent risk of homelessness, or currently homeless. This study draws on data from 11,566 young people who contacted the National Runaway Safeline (NRS) through the National Communication System (NCS), a federal program for young people at risk or experiencing homelessness in the U.S. and those who care for them. Frontline staff collect information directly from young people during crisis intervention engagement through the NRS. We used multinomial logistic regression analyses to predict membership in each of the homelessness risk categories and logistic regression analyses to predict the type of service referrals young people received. Results revealed that young people’s circumstances and presenting problems were associated with homelessness risk category membership, which in turn was linked with the types of service referrals young people received. This study illuminates valuable opportunities for targeting prevention opportunities to the specific needs of young people with varying levels of homelessness risk. Full article