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Youth experiencing homelessness (YEH) face challenges that increase their susceptibility to HIV/STIs. Nurse case management is effective in managing the complex needs of populations experiencing homelessness and reducing HIV risk. A randomized wait-list control study conducted between September 2019 to May 2023 evaluated the CAYA Come As You Are intervention. This nurse-led HIV prevention for YEH aged 16-25 years focused on the uptake of HIV prevention methods: pre- and post-HIV exposure prophylaxis (PrEP, nPEP), HIV/STI testing and treatment, sober sex, and condom use. Secondarily, we examined intervention impact on housing stability. Descriptive statistics were calculated by study arm. Multiple imputation (m = 10) was used for missing values and intervention effects were estimated from Bayesian multilevel models with noninformative priors. Participants (N = 450) were 21.1 years old on average, 62% Black, 11% Hispanic, 11% White, and 10% other race and reported being homeless for an average of 3 years. An intervention effect was found for PrEP use, which showed a larger increase from baseline to first follow-up (OR = 3.27; 95% Cr.I.: 1.13 to 10.14). No intervention impact was found for nPEP use, HIV and STI cases, sober sex, or condom use. Sheltering arrangements improved from baseline to the first follow-up in both groups with increase in shelter stability (OR = 3.85; 95% Cr.I.: 1.61 to 10.30) and decreased shelter transiency (OR = 0.29; 95% Cr.I.: 0.14 to 0.60). This study demonstrates that a personalized, nurse-led HIV prevention approach increased uptake of some but not all HIV prevention strategies among YEH. CLINICAL TRIAL REGISTRATION NUMBER: NCT03910218.

Homelessness presents numerous challenges for youth, including physical health issues, mental health problems, substance use, victimization, legal issues, and dropping out of school. Despite these challenges, youth display significant resilience. Using data from a randomized controlled trial on Housing First for Youth, this study examines qualitative narratives delving into the process of resilience (i.e., stressors, coping, and positive adaptation) among 21 youth over one year. Stressors varied among participants, with childhood abuse and instability being the most prominent. Coping mechanisms included creating barriers with unhealthy relationships, rebuilding relationships, and reframing their circumstances. The findings provide an exploration of the resilience process for youth experiencing homelessness, emphasizing the importance of understanding how youth respond to stressors and adapt to their environment. Additionally, this study highlights the significance of community and relationship-based coping strategies alongside individual approaches, thus displaying the pivotal role of community support in fostering resilience among homeless youth. [ABSTRACT FROM AUTHOR]

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.

(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.

The preservation of a person’s ontological security plays a vital role in the cultural formation of social groups. Using ethnographic data, the following paper demonstrates how young people, who reside in homeless hostels deal with feelings of anxiety and ontological insecurity. The paper argues that within the institutional setting of a homeless youth hostel, norms and values from outside of the hostel are reproduced by residents, to repair their ontological security. Younger residents become confronted with new levels of independence and freedom, which can prompt anxiety, negatively impacting upon their ontological security. It is contended that, to repair ontological security, and counter anxiety, those from similar cultural backgrounds gravitate toward one another and replicate the cultural norms and values to which they are accustomed. [ABSTRACT FROM AUTHOR]

This paper presents a qualitative study of 22 youth workers' perceptions of their roles and practices in seven school-based settings in a large post-industrial city in regional Australia. Youth workers are often engaged in school-based settings working with vulnerable young people, yet knowledge of how workers perceive and conceptualize their role and practice in these settings remains limited. Through focus group interviews, youth workers were asked how they engage, and work with vulnerable students, how they conceptualize their roles and the bodies of knowledge to which those practices and roles pertain. We find that youth work in school-based settings requires the dynamic and non-linear application of the practices of youth accompaniment, family support and youth-centred advocacy, underpinned by respect for the dignity, autonomy and agency of the young person. We argue that the complex application of these practices positions youth workers as 'bridge-builders' and 'boundary-spanners'. Bridge-builders assist young people to connect and engage with support services. Boundary-spanners build relationships across service providers to network different organizations and professionals for better collaboration and support of young people. These findings have implications for youth policy and practice in the area of youth work with vulnerable young people in school-based settings. [ABSTRACT FROM AUTHOR]

Pathways to Success (Pathways) is a youth-driven intervention designed to prevent homelessness among youth with foster care experience as they approach early adulthood. This formative evaluation measures the feasibility of implementing this intervention and its potential for improving outcomes in several key areas. One hundred twenty-eight youth at risk of homelessness were provided Pathways, and outcomes were measured using pre- and post-survey data. Fidelity measures were established to ensure services were delivered as designed and rates of homelessness significantly decreased, from 37% at pretest to 10% following engagement with Pathways. This formative evaluation builds evidence for Pathways and lays the foundation for future research on homelessness prevention for youth with foster care experience. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

(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. [ABSTRACT FROM AUTHOR]

Youth homelessness in Canada impacts a significant number of young people. More specific to our focus, populations of young people who are more likely to experience homelessness (e.g. youth with mental health issues, 2SLGBTQIA+ youth, youth from care, and Indigenous youth) face significant barriers to accessing safe, culturally appropriate, and supportive education, suggesting rights to housing and rights to education are intersecting equity issues. This article presents findings from a participatory research project led by members of Youth Action Research Revolution, carried out in Tio’tiá:ke/Montréal, Québec, Canada. Building from experiences young people shared, this article highlights aspects of the public education system that pose problems for youth who are precariously housed or homeless, namely, the application of one-size-fits-all approaches, barriers for students with mental health or learning disability diagnoses, and the lack of clear or actionable institutional mechanisms for students to access preventative support. Following this, we outline educational discourses, practices, and processes that constitute where something may have been done differently to prevent homelessness. We conclude with possible actions to support youth homelessness prevention in schools, including creating more flexible ways for children and families to access supports, resourcing “champion” teachers, and addressing the insidious biases and discrimination in the organization of school policies.

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.

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.

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.

Pathways into and the impact of homelessness on young people have been extensively explored. There is less emphasis on young people's perspectives of the interventions designed to assist them to avoid or exit homelessness. This study undertook a systematic review of the youth homelessness interventions literature that included the perspectives of young people experiencing these interventions. Our review identified five key approaches as useful in assisting young people to exit or avoid homelessness, namely (1) the centrality of relationships, (2) a youth‐centred approach, (3) integrated and multi‐disciplinary service provision, (4) a beyond housing approach and (5) strength‐based therapeutic models/interventions. The review enhances the capacity of practitioners to provide supportive and contextually situated services to young people experiencing or at risk of homelessness. However, further research is required to understand the bundles of interconnected practices within these approaches that are performed by workers and young people to address homelessness and risk. [ABSTRACT FROM AUTHOR]

Background: Youth with intellectual disabilities experiencing homelessness are invisible within multiple service sectors. We know little about their experiences of homelessness, or the impacts of such on the social and physical health and well‐being. Methods: We used quantitative and qualitative methods to measure prevalence and learn from key informants and homeless youth with intellectual disabilities about factors leading to and sustaining homelessness, and the implications of such on their social, physical, and mental health and well‐being. The project involved seven co‐researchers with intellectual disabilities and experience of youth homelessness in research design, data collection, analysis, and dissemination. We created Forum Theatre scenes that creatively represent the findings of the project. In this paper we share one of those scenes, as well as the recommendations three co‐researchers with intellectual disabilities have for improving support to homeless youth with intellectual disabilities. Findings: Lack of awareness of and about homeless youth with intellectual disabilities, combined with siloed ways of working by involved sectors, results in significant disadvantage and health inequities for youth. Also revealed was the likelihood this would continue given existing obstacles to accessing appropriate housing and supports to exit homelessness. Conclusion: Services providers, policy makers and representatives of the involved sectors need to recognize and acknowledge homeless youth with intellectual disabilities and take responsibility for learning and working together to develop integrated and responsive approaches to effectively supporting them. Accessible Summaries: Many youths with intellectual disabilities are homeless, but we do not know very much about them. We do not know how they became homeless, what their lives are like when they are homeless or how being homeless affects their health.The (name withheld) research project included academic researchers and co‐researchers with intellectual disabilities, who had experience of being homeless. They spoke to service providers and to homeless youth without intellectual disabilities about these things.They learned that most homeless youth with intellectual disabilities have had very difficult lives. They face many challenges every day. They don't have access to health care, mental health supports, food and nutrition or physical safety. Attending school or having a job is harder to do when you are homeless.Many different services are involved in the lives of people with intellectual disabilities who are homeless. However, these services don't know about each other or work together to support homeless youth with intellectual disabilities.Service providers, governments and policy makers need to take responsibility to learn about the lives of homeless youth with intellectual disabilities. They must work together, and with homeless youth with intellectual disabilities, to develop better supports for this group of youth. [ABSTRACT FROM AUTHOR]

Introduction: It is well-documented that sexual minority youth are at a higher risk of experiencing being thrown away and running away from their parental home, the two main pathways to youth homelessness. These challenges are often related to family rejection and strained child-parent relationships. However, little knowledge exists of how sexual minority status intersect with race/ethnicity in this context. Methods: The study utilized data from Wave III (2001–2002) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) (1994–2018) with a sample size of 14,181 survey participants to examine the effects of sexual minority status and race/ethnicity on the experience of youth being ordered to move out and running away from one's parental home. Results: A series of regression analyses revealed that sexual minority youth were more likely to experience being thrown away and running away from their parental home. Furthermore, the findings showed significant intersectional disparities from sexual minority status and Black race in experiences of being thrown away and running away even after controlling for various sociodemographic, family circumstances, and other risk factors. Black sexual minority youth faced heightened risks of parental home displacement, indicating increased vulnerability within sexual minority youth. Conclusions: The study provides the first large-scale, nationally representative population-based evidence for the unique risk that Black sexual minority youth are facing with respect to the two pathways to youth homelessness. Policy Implications: Families with sexual minority youth and youth experiencing homelessness may benefit from racially/ethnically specific and sexuality-specific interventions. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Experiences of family conflict are common in young people's accounts of homelessness, yet in‐depth explorations and conceptualisations of these experiences remain sparse. Drawing on focus group discussions with 29 participants, this article explores the accounts of young people and carers and parents about the dynamics, interactions and characteristics of family conflict. Findings highlight the primacy of verbal insults, criticisms or threats, as well as acts of aggression and violence in young people's and parent's understandings of family conflict. Feelings of mistrust, instability and a lack of safety also pervade family conflict and are considered its most impactful elements. We contend that these impacts are best understood via the concept of ontological (in)security, whereby young people's sense of self, belonging and stability are undermined by family conflict. This provides important insights for developing practice in this space, where working to remove long‐term patterns of family conflict, restoring young people's sense of self and belonging within their family, and supporting the stability and trust within a family may prove beneficial. [ABSTRACT FROM AUTHOR]

The gender gap in adolescent mental health experiences is notable, with gender adding an additional layer to the already complex experience of being a young person who is experiencing homelessness. Yet, research in this area is limited. The purpose of this qualitative, interpretive description study was to understand how gender shapes the mental health of youth who are experiencing homelessness in the Niagara Region of Ontario, Canada. Eleven young people between the ages of 16 and 24 were recruited from a youth shelter and participated in individual semi-structured interviews. Thematic analysis and Gender-Based Analysis Plus was used to analyze the data, and findings revealed four contextual factors that appear to influence a young person's mental health while homeless but that is experienced differently depending on one's gender identity. These factors are: (1) housing acquisition is challenging, (2) physical presentation is meaningful, (3) cleanliness and hygiene are expected, and (4) utilizing mental health resources is complicated. Additionally, the many strengths that the youth identified and demonstrated in navigating their circumstances are highlighted in the results. These strengths involve (1) exhibiting resilience, (2) expressing the ability to survive, (3) imagining a world that is better, (4) articulating their needs, and (5) drawing on their social connections. The gendered lens that guides this study provides a challenge to the homogenous way that young people experiencing homelessness are often portrayed within the literature. Intersecting identities that include gender and age need to be considered within the mental healthrelated experiences of youth who live with homelessness. Ensuring that interventions are tailored to meet young people's specific gendered needs is both a matter of human rights and health equity. Practical implications for service providers are discussed. [ABSTRACT FROM AUTHOR]

Youth homelessness presents a complex and persistent challenge worldwide, particularly affecting young adults between 16 and 24 years of age in the US and Canada. This population faces elevated risks of exploitation, victimization, and various health issues upon detachment from familial support structures. Understanding the multi-faceted nature of youth homelessness requires the consideration of individual, structural, and systemic factors within the socio-ecological model. Historically, when examining youth homelessness, traditional methods have concentrated either on individual factors contributing to homelessness or on broader structural issues within society. The emergence of the new orthodoxy attempted to bridge the apparent gap between individual- and structural-level factors by considering both to be equally significant, but it faced skepticism for its theoretical framework. In response, the “pathways” approach gained traction, emphasizing the subjective experiences and agency of youth experiencing homelessness. Departing from conventional epidemiological models, the pathways approach views homelessness as a dynamic process intertwined with individual life contexts. This paper navigates the scholarly discourse on youth homelessness and examines the distinct characteristics of the pathways approach. By exploring its implications for research and policy, this study contributes to a nuanced understanding of youth homelessness and informs future prevention-focused interventions.

The gender gap in adolescent mental health experiences is notable, with gender adding an additional layer to the already complex experience of being a young person who is experiencing homelessness. Yet, research in this area is limited. The purpose of this qualitative, interpretive description study was to understand how gender shapes the mental health of youth who are experiencing homelessness in the Niagara Region of Ontario, Canada. Eleven young people between the ages of 16 and 24 were recruited from a youth shelter and participated in individual semi-structured interviews. Thematic analysis and Gender-Based Analysis Plus was used to analyze the data, and findings revealed four contextual factors that appear to influence a young person’s mental health while homeless but that is experienced differently depending on one’s gender identity. These factors are: (1) housing acquisition is challenging, (2) physical presentation is meaningful, (3) cleanliness and hygiene are expected, and (4) utilizing mental health resources is complicated. Additionally, the many strengths that the youth identified and demonstrated in navigating their circumstances are highlighted in the results. These strengths involve (1) exhibiting resilience, (2) expressing the ability to survive, (3) imagining a world that is better, (4) articulating their needs, and (5) drawing on their social connections. The gendered lens that guides this study provides a challenge to the homogenous way that young people experiencing homelessness are often portrayed within the literature. Intersecting identities that include gender and age need to be considered within the mental health-related experiences of youth who live with homelessness. Ensuring that interventions are tailored to meet young people’s specific gendered needs is both a matter of human rights and health equity. Practical implications for service providers are discussed.

Youth homelessness presents a complex and persistent challenge worldwide, particularly affecting young adults between 16 and 24 years of age in the US and Canada. This population faces elevated risks of exploitation, victimization, and various health issues upon detachment from familial support structures. Understanding the multi-faceted nature of youth homelessness requires the consideration of individual, structural, and systemic factors within the socio-ecological model. Historically, when examining youth homelessness, traditional methods have concentrated either on individual factors contributing to homelessness or on broader structural issues within society. The emergence of the new orthodoxy attempted to bridge the apparent gap between individual- and structural-level factors by considering both to be equally significant, but it faced skepticism for its theoretical framework. In response, the "pathways" approach gained traction, emphasizing the subjective experiences and agency of youth experiencing homelessness. Departing from conventional epidemiological models, the pathways approach views homelessness as a dynamic process intertwined with individual life contexts. This paper navigates the scholarly discourse on youth homelessness and examines the distinct characteristics of the pathways approach. By exploring its implications for research and policy, this study contributes to a nuanced understanding of youth homelessness and informs future prevention-focused interventions. [ABSTRACT FROM AUTHOR]

This exploratory study aimed to understand how the COVID-19 pandemic has affected a medium-sized community's frontline workers in the Canadian youth homelessness services sector. This study phenomenological case study elicited practitioner knowledge and experience in servicing homeless youth in a medium-sized community – Kelowna, British Columbia, Canada. Two in-depth focus groups were conducted with a convenience sample of participants (N = 9). Thematic analysis revealed five overarching themes: a) Community Connection, b) COVID-19 Challenges and Services, c) Provider Well-being, d) Successes, and e) Youth Services and Housing. The results illustrate the early impact of COVID-19 on service providers and provision for youth experiencing homelessness, and the adaptations needed to provide them with services during this time. Replication of this research into other regions and social services is recommended. Future research that provides a retrospective account would offer a valuable point of comparison of providing social services to homeless youth during and after COVID-19 public restrictions. [ABSTRACT FROM AUTHOR]

Abstract Background While research on substance using youth experiencing homelessness (YEH) is increasing, there is a dearth of information regarding effective prevention interventions for these youth. Suicide is the leading cause of death among YEH and most youth do not access services that may be available to them. Therefore, this study seeks to address this gap in the research literature with the goal to identify an effective suicide prevention intervention that can be readily adopted by communities that serve these youth. Methods Three hundred (N = 300) YEH with recent substance use and suicidal ideation or a recent suicide attempt will be recruited from the streets as well as a drop-in center serving YEH. After the baseline assessment, all youth will be randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Services as Usual (SAU) (N = 150) or to SAU alone (N = 150). SAU includes outreach, advocacy, and service linkage whereas YEH who receive CTSP will also receive ten CTSP sessions and an optional nine booster sessions. Follow-up assessments will be conducted at 3, 6, 9, and 12 months post-baseline. Theoretically derived mediators (e.g., cognitive distortions) will be tested to shed light on mechanisms associated with change, and the moderating effects of sex, race, sexual orientation, and baseline service connection will be examined. In order to ease future dissemination of the intervention to agencies serving YEH, we will rigorously assess acceptability, feasibility, fidelity, and cost associated with the delivery of our intervention approach using a mixed-methods approach. Discussion This study adds to a very small number of clinical trials seeking to prevent lethal suicide among a very high-risk group by addressing suicidal ideation directly rather than underlying conditions. It is hypothesized that youth receiving CTSP + SAU will show greater reductions in suicidal ideation (primary outcome), substance use, and depressive symptoms (secondary outcomes) over time compared to SAU alone, as well as improved risk and protective factors. Trial registration NCT05994612. Date of Registration: August 16, 2023.

Being homeless is broadly understood to be traumagenic. Thus, support services for individuals experiencing homelessness (such as youth refuge) are encouraged to use trauma-informed models of care. However, there is a dearth of research that (1) focuses on youth refuge specifically, despite refuges being the most common response for youth homelessness worldwide, and (2) explains trauma-informed care models in detail so that they may be evaluated in practice. This paper outlines a trauma-aware framework used for nearly a decade within a youth refuge located in Melbourne, Australia: a psychologically informed environment (PIE). The paper provides: (1) an overview of trauma-informed care before describing what a PIE entails; (2) the how of a PIE, including core principles, their theoretical underpinnings, and how these principles are practically applied; and (3) the why of a PIE, focusing on implications for practice. A PIE is underpinned by key theoretical approaches such as attachment theory, the core emotional needs model, psychodynamic theory and formulation, social cognitive theory, and the transtheoretical model of change. A PIE encompasses five core principles of (1) relationships, rules, responsiveness, and roles; (2) physical and social spaces; (3) learning and enquiry; (4) staff support and training; and (5) psychological awareness. Overall, PIEs have been found to increase consumer engagement and decrease evictions, instill confidence and improve empathy within the staff, and decrease the risk for organizations, as seen by low incident rates. It is hoped that by providing this detailed outline of a PIE, more research can be undertaken into youth refuge care models, and more psychologically informed frameworks that address the multi-directional relationship between trauma and homelessness can be employed.

Abstract Objectives Youth experiencing homelessness (YEH) face challenges that impact their physical, mental, and social wellbeing, emotion regulation, and coping. Mindfulness reduces stress and improves resilience, emotion regulation, and executive functioning. Mindfulness-based interventions (MBI) teach the practice of mindfulness to foster present-moment attention without judgement and enhance self-observation and self-regulation, resulting in greater awareness of thoughts and emotions and improved interpersonal relationships. One such intervention, .b, has been shown to lower stress among youth. While a pilot study of .b among sheltered youth found the intervention to be feasible, the need for modifications was identified to improve its relevance, accessibility, and incorporate a trauma-informed approach. Methods We used the ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical experts, Integration, Training staff, and Testing) framework to adapt the .b mindfulness intervention to YEH living in an emergency shelter. Nine focus group discussions (n = 56), key informant interviews (n = 8), and beta testing with five youth working group sessions (n = 10) identified needed modifications. Results Adaptations to the curriculum and delivery modality were made to approximate the average length of stay in the shelter; integrate trauma-informed care approaches; increase diversity of images by race, ethnicity, age, sexual orientation, and gender identity; and increase the relevance of the audio-visual components. Conclusions Youth and the health and social services providers who care for youth generally liked the core concepts and presentation of the curriculum. Using the ADAPT-ITT framework, minor, yet important, changes were made to increase the relevance, acceptability, and feasibility of the intervention. Next steps are to conduct a randomized attention control pilot study to assess feasibility and acceptability.

Background: While research on substance using youth experiencing homelessness (YEH) is increasing, there is a dearth of information regarding effective prevention interventions for these youth. Suicide is the leading cause of death among YEH and most youth do not access services that may be available to them. Therefore, this study seeks to address this gap in the research literature with the goal to identify an effective suicide prevention intervention that can be readily adopted by communities that serve these youth. Methods: Three hundred (N = 300) YEH with recent substance use and suicidal ideation or a recent suicide attempt will be recruited from the streets as well as a drop-in center serving YEH. After the baseline assessment, all youth will be randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Services as Usual (SAU) (N = 150) or to SAU alone (N = 150). SAU includes outreach, advocacy, and service linkage whereas YEH who receive CTSP will also receive ten CTSP sessions and an optional nine booster sessions. Follow-up assessments will be conducted at 3, 6, 9, and 12 months post-baseline. Theoretically derived mediators (e.g., cognitive distortions) will be tested to shed light on mechanisms associated with change, and the moderating effects of sex, race, sexual orientation, and baseline service connection will be examined. In order to ease future dissemination of the intervention to agencies serving YEH, we will rigorously assess acceptability, feasibility, fidelity, and cost associated with the delivery of our intervention approach using a mixed-methods approach. Discussion: This study adds to a very small number of clinical trials seeking to prevent lethal suicide among a very high-risk group by addressing suicidal ideation directly rather than underlying conditions. It is hypothesized that youth receiving CTSP + SAU will show greater reductions in suicidal ideation (primary outcome), substance use, and depressive symptoms (secondary outcomes) over time compared to SAU alone, as well as improved risk and protective factors. Trial registration: NCT05994612. Date of Registration: August 16, 2023. [ABSTRACT FROM AUTHOR]

About 900 youth experiencing homelessness (YEH) reside at an emergency youth shelter (EYS) in Toronto on any given night. Several EYSs offer access to healthcare based on youths' needs, including access to primary care, and mental health and addictions support. However, youth also require healthcare from the broader health system, which is often challenging to navigate and access. Currently, little is known about healthcare coordination efforts between the EYS and health systems for YEH. Using grounded theory methodology, we interviewed 24 stakeholders and concurrently analyzed and compared data to explore pathways to healthcare coordinated for youth who reside at an EYS in Toronto. We also investigated fundamental parts (i.e., norms, resources, regulations, and operations) within the EYS and health systems that influence these pathways to healthcare using thematic analysis. A significant healthcare coordination gap was found between these two systems, typically when youth experience crises, often resulting in a recurring loop of transition and discharge between EYSs and hospitals. Several parts within each system act interdependently in hindering adequate healthcare coordination between the EYS and health systems. Incorporating training for system staff on how to effectively coordinate healthcare and work with homeless populations who have complex health needs, and rethinking information-sharing policies within circles of care are examples of how system parts can be targeted to improve healthcare coordination for YEH. Establishing multidisciplinary healthcare teams specialized to serve the complex needs of YEH may also improve healthcare coordination between systems, and access and quality of healthcare for this population. [ABSTRACT FROM AUTHOR]

Access to adequate housing is a fundamental right and considered decisive for the social inclusion of persons in homelessness. This article offers a socio-legal analysis of access to rights in the context of the Danish welfare state for young persons in homelessness. Statistics indicate that the number of persons aged 18 to 29 living in homelessness in Denmark almost doubled from 2009 to 2019. Drawing on analyses of law and on interviews with young persons in homelessness, the article examines legal opportunity structures for accessing rights and the young persons' experiences of mobilizing law. Danish social law outlines opportunities for support in cases of homelessness, and this article's findings suggest that professionals play a pivotal role for young persons' access to rights as they can use their expertise and knowledge of both the systemic institutional welfare set-up and a person's social situation to translate that person's situation into a social law context, which is decisive for the mobilization of social rights. Without this expertise to draw on, young persons may find themselves lost in a complex welfare state system which has the potential to leave them in an increasingly marginalized situation. [ABSTRACT FROM AUTHOR]

It is well documented that marginalized youth, including Black and Brown youth and LGBTQ+ youth, experience much higher incidence of homelessness and running away. National studies frequently discuss the incentruence of systemic racism and heterosexism on family resources and dynamics. However, in these discussions about systems of oppression and their relationship to runaway incidence and youth homelessness, there is rarely, if ever, mention of the words "disability" and "ableism." This research seeks to address that gap. Using 150 posts from the National Runaway Safeline's public crisis forums, I analyze young people's experiences with disability and ableism as they consider running away or do run away from home. My findings indicate the pervasive nature of ableism and disability in the lives of runaway youth and youth considering running away from home, despite the lack of attention to ableism and disability in national data. [ABSTRACT FROM AUTHOR]

This qualitative study documents incidents of discrimination and violence among LGBTQ + youth experiencing homelessness along with their adaptation strategies. Using intersectionality theory, this analysis is based on individual interviews conducted with 17 LGBTQ + youth experiencing homelessness aged 17 to 25. According to their stories, LGBTQ + youth experienced various types of discrimination and violence in the context of homelessness. Youth report anticipating and experiencing physical and psychological violence from passersby in public spaces, causing them to hide from the gaze of others. They also report that police profiling of racialized youth and young women sex workers leads these youth to avoid confrontational interactions with the police. Some youth mention that landlords and employers discriminate against them based on their ethnicity and gender expression, requiring them to have contingency plans for housing and employment. Lastly, many LGBTQ + youths report hiding information about being bisexual, being trans or doing sex work to avoid prejudice and rejection from their intimate partners. The results show that heterosexist, cisgenderism, sexist and racist discrimination and violence amplify the social exclusion of LGBTQ + youth who are already marginalized due to their homelessness. [ABSTRACT FROM AUTHOR]

Preparing for the future is a major developmental task during adolescence and early adulthood. However, youth experiencing homelessness face additional challenges relating to economic instability, housing insecurity, and a lack of social support. Semi-structured interviews were conducted with 38 youth, from Ottawa and Toronto, who were experiencing homelessness and participating in a randomized controlled trial of Housing First for Youth (HF4Y). This qualitative study explores youths' visions for the future, including their goals, aspirations, plans, and barriers to achieving them. Overall, findings demonstrated that youth had positive visions of the future and strove to reach developmentally appropriate goals and responsibilities. Compared to youth receiving HF4Y, the future expectations of those receiving treatment as usual (TAU) were characterized by uncertainty and lacked clear direction. Additionally, they emphasized self-reliance and autonomy, while HF4Y prioritized forming relationships and reconnection. Findings highlight the importance of stable housing intervention, and social, community, and financial support in planning for the future and transitioning out of homelessness. Implications for intervention, directions for future research, and limitations are provided. [ABSTRACT FROM AUTHOR]

Building Resilience through Intervention, Direct Guidance, and Empowerment (BRIDGE) is an innovative program designed to prevent homelessness and other negative outcomes among youth aging out of foster care. BRIDGE was pilot-tested on youth aging out of two orphanages in a city in southern Poland in 2009–2012. Youth were recruited at age 17, before aging out at age 18. Quasi-experimental methods were used to evaluate program outcomes among nine BRIDGE clients compared to two matched groups (n = 9 and n = 18) of youth who had recently aged out of orphanages in the same Polish region. Consistent with Hypothesis 1, results of chi-square tests showed that, over an 18-month follow-up period, BRIDGE clients experienced superior housing outcomes relative to both matched groups. Consistent with Hypothesis 2, the results of a between-subjects ANOVA showed that BRIDGE clients received significantly greater income relative to the matched groups. Within-subjects effects of BRIDGE from baseline across 6-, 12-, and 18-month follow-ups were examined with repeated-measures ANOVAs. Consistent with Hypotheses 3–5, results showed that across time BRIDGE clients experienced a general increase in income and decrease in psychological distress (i.e., total distress, obsessive-compulsiveness, interpersonal sensitivity, and paranoia). The study's findings support the further development of BRIDGE and similar programs. [ABSTRACT FROM AUTHOR]

In LA County, service providers rely on government funding to assist youth experiencing homelessness. Existing literature acknowledges the unique problems that the youth subpopulation confronts. Moreover, research notes that the most effective services for youth are youth-focused, and the availability of services is directly correlated with the supply of funding. We question whether youth funding allocations in LA County meet the reality of the youth homeless crisis. To perform an analysis, this research pursues a community engaged analysis of funding allocations from three sources—HEAP, HHAP round 1, and Measure H funded contracts—to form a representative view of the LA funding ecosystem. Further analysis occurs at the LA City Council District, County Supervisorial District, and County Service Planning Area scales. We find trends that implicate inequitable funding allocations and a concerning lack of accessible and accurate data.

Abstract Background Youth, 18 to 24 years, experiencing homelessness (YEH) are recognized as having developmental challenges dissimilar to older adults. Yet, research on efforts to end homelessness and prevent or intervene in drug use and mental health problems among youth have lagged behind that of adults. The Housing First (HF) Model which underlies Permanent Supportive Housing (PSH) and Rapid Re-Housing (RRH) has become preferred over treatment-first models. Methods and results We provide an overview of PSH and RRH studies to date and summarize our current understanding of their utility for use with YEH. Finally, we review our team’s current and past randomized trials testing RRH with YEH, providing lessons learned and recommendations. Conclusion Current research efforts to guide best practices are hampered by a lack of fidelity to HF principles, lack of randomized design, and lack of focus on youth. Lessons learned and recommendations from our work are offered to facilitate the future work of those who seek to end homelessness and address drug use and mental health problems among youth.

Youth homelessness remains a major public health issue in the USA, and youth experiencing homelessness (YEH) are still one of the more understudied and underserved groups. Comprehensive sexual and reproductive health (SRH) programs for YEH are rare. Yet, such programs are potentially effective settings through which to link YEH with housing services. Wahine ("woman") Talk is one such comprehensive program for YEH, and is a multilevel intervention delivered out of a youth drop-in center in Honolulu, Hawai 'i. One of Wahine Talk's core components is addressing basic needs, including providing linkages to housing services. Little research exists on SRH programs' opportunities and challenges to providing linkage to housing for YEH. The current study is an exploratory study asking, "What are opportunities and challenges to linking young women experiencing homelessness to housing services through a comprehensive sexual and reproductive health program?" The study team collected in-depth qualitative data through seven focus groups and 25 individual interviews with Wahine Talk staff and youth participants aged 14–22 years. Multiple team members analyzed the data using template analysis. The analysis revealed that while comprehensive SRH programs may have some opportunities and challenges to linking YEH to housing services that are consistent with traditional housing assistance programs, there are also factors specific to SRH programs. In particular, opportunities would be SRH programs employing a housing staff person and bolstering staff-youth meetings and communication. A challenge specific to SRH programs would be prioritizing youth's reproductive justice (i.e., choice) in lieu of solely prioritizing pregnancy reductions and delays; thus, it is recommended to train staff to prioritize youth's reproductive justice. The findings highlight the importance of SRH programs having staff focused on housing, sufficient opportunities for youth and staff to communicate with each other, and staff trained to prioritize youth's reproductive justice. [ABSTRACT FROM AUTHOR]

Objective: Given the high prevalence of Black youth experiencing homelessness, this study sought to understand if race impacts service use and whether other marginalized identities (e.g., gender, sexual orientation) are associated with unique service patterns among youth experiencing homelessness. Method: We used data collected from 1,046 homeless youth (ages 13–24) in Los Angeles County, CA, between October 2011 and June 2013. We used classification tree analyses to rank predictors of service use in order of importance and to test linear and nonlinear relationships among selected variables. Results: Across service type (i.e., shelter, therapy, employment, or health services), the classification tree analyses highlighted race as a primary predictor of service use. Conclusions: Critical race theory may be a useful framework for future explorations of service use among Black youth experiencing homelessness. Furthermore, as race consistently emerges as a feature of importance, providers should consider how race impacts service use. [ABSTRACT FROM AUTHOR]

Couch hopping is a significant feature of youth homelessness in the United States. Every year, half of youth ages 18 to 25 who experience housing instability report couch hopping—also known as couch surfing or doubling up. Emerging work suggests that in some intergenerational informal hosting arrangements, youth and their adult hosts can form meaningful and supportive relationships. However, hosts also navigate material challenges that could threaten the stability of these arrangements. Based on in-depth interviews with nine youth ages 17 to 23 in informal hosting arrangements and 10 informal hosts, we describe how increased household costs and lease and benefits restrictions can impact stability, and the strategies hosts and youth mobilized to address them. We place hosts' instability in the context of intergenerational poverty and structural racism, reframing material challenges as opportunities to strengthen the village of support youth need to make sustained exits from homelessness. [ABSTRACT FROM AUTHOR]

Objectives: Youth experiencing homelessness (YEH) face challenges that impact their physical, mental, and social wellbeing, emotion regulation, and coping. Mindfulness reduces stress and improves resilience, emotion regulation, and executive functioning. Mindfulness-based interventions (MBI) teach the practice of mindfulness to foster present-moment attention without judgement and enhance self-observation and self-regulation, resulting in greater awareness of thoughts and emotions and improved interpersonal relationships. One such intervention,.b, has been shown to lower stress among youth. While a pilot study of.b among sheltered youth found the intervention to be feasible, the need for modifications was identified to improve its relevance, accessibility, and incorporate a trauma-informed approach. Methods: We used the ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical experts, Integration, Training staff, and Testing) framework to adapt the.b mindfulness intervention to YEH living in an emergency shelter. Nine focus group discussions (n = 56), key informant interviews (n = 8), and beta testing with five youth working group sessions (n = 10) identified needed modifications. Results: Adaptations to the curriculum and delivery modality were made to approximate the average length of stay in the shelter; integrate trauma-informed care approaches; increase diversity of images by race, ethnicity, age, sexual orientation, and gender identity; and increase the relevance of the audio-visual components. Conclusions: Youth and the health and social services providers who care for youth generally liked the core concepts and presentation of the curriculum. Using the ADAPT-ITT framework, minor, yet important, changes were made to increase the relevance, acceptability, and feasibility of the intervention. Next steps are to conduct a randomized attention control pilot study to assess feasibility and acceptability. [ABSTRACT FROM AUTHOR]

The purpose of this study was to understand the organizational and structural barriers young people face in seeking housing and to interpret those barriers through the lens of white supremacy culture. Data were collected through semistructured interviews with 31 young people (ages 18–26) accessing a variety of homeless services, including a drop-in center, emergency shelter, and transitional housing apartments. White supremacy culture was used as an organizing framework for interpreting thematic findings. Participants described bureaucratic and systemic barriers to accessing and maintaining stable housing; lacking resources necessary to securing and maintaining housing; and rigid rules in community and living environments that created difficult in maintaining safe housing. Five tenets of white supremacy culture emerged as we applied the organizing framework to our findings: power hoarding, paternalism, worship of the written word, fear of open conflict, and right to comfort. Our findings reflect that organizations employing bureaucratic processes hold power to determine who can access housing, what is required of those young people, and how housing can be maintained. Yet, those holding the power at these decision points often do not reflect the identities of those benefiting from the services. Future research and critical analysis using a white supremacy framework or Critical Race Theory may allow for better understanding of barriers for young people experiencing homelessness. [ABSTRACT FROM AUTHOR]

Couchsurfing, or temporarily staying with friends, extended family, acquaintances, or strangers, is a growing form of homelessness within Australia, and particularly concentrated among youth. System involvement with child welfare and its link to youth homelessness has previously been well-established, but not within the context of couchsurfing. In interviews with 19 young people with both couchsurfing and a history of system-involvement, we identify and describe six different pathways into couchsurfing. These pathways extended from the beginning to the end of their child safety involvement, and demonstrate how fear of reprisal for reporting, fear of out-of-home-care, and lack of transition planning pushed-or-pulled young people into couchsurfing. These findings indicate the link between couchsurfing and child safety involvement began very early in the investigative process, suggesting multidisciplinary service teams that include housing support should be involved in initial contact. We also echo the recommendations of other researchers to prioritise Housing First programming and risk assessment for evaluating young people’s living spaces.

Background: Youth, 18 to 24 years, experiencing homelessness (YEH) are recognized as having developmental challenges dissimilar to older adults. Yet, research on efforts to end homelessness and prevent or intervene in drug use and mental health problems among youth have lagged behind that of adults. The Housing First (HF) Model which underlies Permanent Supportive Housing (PSH) and Rapid Re-Housing (RRH) has become preferred over treatment-first models. Methods and results: We provide an overview of PSH and RRH studies to date and summarize our current understanding of their utility for use with YEH. Finally, we review our team's current and past randomized trials testing RRH with YEH, providing lessons learned and recommendations. Conclusion: Current research efforts to guide best practices are hampered by a lack of fidelity to HF principles, lack of randomized design, and lack of focus on youth. Lessons learned and recommendations from our work are offered to facilitate the future work of those who seek to end homelessness and address drug use and mental health problems among youth. [ABSTRACT FROM AUTHOR]

There were about a 4.1million homeless people in the European Union [1]. In the European Union, 20-30 per cent of homeless people are young people between the ages of 18-29 years [2]. Homelessness is a concern for policymakers and society as a whole. Recent literature on social workers’ experiences with homeless people has mainly focused on working with the general homeless population and not specifically on social work with homeless youth. A qualitative research method was used to analyze the cause and consequences of youth homelessness, and identify skills needed for social work with young homeless people and inspiration of social workers motivation to help young homeless people. Five social workers working with young homeless people from a city in Finland participated in research. The semi-structured interview data were analysed using the content analysis method. The study revealed – causes and consequences of youth homelessness; skills needed for social work with young homeless people and social workers driving force working with homeless youths.

Youth homelessness is a significant problem in most United States communities. Health problems are both a contributor to and a consequence of homelessness. Responses to youth homelessness are typically fragmentary. Different agencies deal with various causes and consequences of the problem. Stakeholders in Connecticut sought a more coherent approach. This article describes the development and use of a system dynamics simulation model as a decision-support tool that: (1) brings stakeholders together from diverse service sectors and allows them to see the system as a whole, (2) enables them to explore how delivery systems interact to affect homeless and unstably housed youth, (3) lets them test the impact of different intervention alternatives on reducing the problem, and (4) helps develop insights about coherent approaches to youth homelessness. The model's development is described as a phased process including stakeholder engagement, causal mapping, and creation of the quantitative simulation model. The resulting model is presented along with an interface that enables stakeholders to use the model in a Learning Lab setting. Results of an initial set of Learning Labs are presented, including types of insights gained by participants from using the simulation model. Conclusions include limitations of the model and plans for its future use. [ABSTRACT FROM AUTHOR]