Let’s imagine it is a bright sunny day back in July 2005. The same author is volunteering at a drop-in centre for youth and takes a walk to pick up the muffins and donuts from the local news station. On this particular day, as she walks back, she encounters the same young man. Rather than walking back with her, he stops to say hello and tell her about the changes in his life. In the time since she last saw him, he has been enrolled in a program designed to help young people transition out of homelessness. A team of support workers has helped him find housing, provided subsidies to cover the cost of rent, and connected him with a harm reduction program within the community. He says he cannot stop to talk long because he is on his way to an adult education centre, where he is working on credits toward his high school equivalency.

This is not a storybook ending. The challenges he faced on the street – violence and trauma in his early years, mental health struggles, addictions, malnutrition, and the physical effects on his body – have not magically disappeared. The key difference is that he has received the support he needs to begin the difficult process of transitioning out of homelessness. This is not a linear path, and his support workers know that his risk of falling back into homelessness again is high. Their role is to help him maintain his housing and to help connect him with the supports he needs to be well. On the very best of days, this work remains two steps forward, one step back. Throughout this section we will take a closer look at the work young people undertake to exit homelessness, and what can be done to support them on their journey. Before you continue through the material, we invite you to pause now and record your thoughts about how we can best support young people throughout this process.

Becoming securely housed is not a linear event where young people exit the street and become permanently housed. Exiting youth homelessness does not happen immediately, but rather takes place as a series of stages that include a turning point, housing, acceptance, and achievement (Karabanow, Hughes, Kidd, & Frederick, 2018). Karabanow et al., (2018) note that in their study of young people exiting homelessness, what stood out was that even among the successes these youth achieved, they still struggled on a daily basis to maintain their stability while reconstructing their sense of self-identity. This identity-struggle is often characteristic of adults exiting homelessness as well, as they continue to face barriers related to poverty, social marginalization, inadequate and unaffordable housing, violence, and lack of access to services to meet their personal needs (Sylvestre et al., 2018).

For many young people who transition off the streets, the ability to formulate and realize long-term plans remains marked by their need to focus on day-to-day existence, which can be characterized as a precarious path marked by structural gaps (Thulien et al., 2018). Young people need rent subsidies and affordable housing, but it is also important to consider what social support and meaningful social integration looks like in their lives (Thulien et al., 2019b). As youth become more stable, they often want to distance themselves from their previous identity as a person experiencing homelessness, and need to cultivate new identity capital (Thulien, Gastaldo, McCay, & Hwang, 2019a). We begin this section by returning to our conversation with Dr. Naomi Thulien, who speaks about the importance of helping young people with their financial, support, and identity needs in order to help them successfully make the transition and find long-term stability.

Dr. Naomi Thulien: How can young people be supported to exit homelessness permanently?

In this video, Dr. Naomi Thulien identifies three key factors young people need to successfully exit homelessness. These include financial supports, such as rent subsidies and a living wage, social supports through community connections in education, employment, and faith-based places, and identity-based supports to foster a sense of purpose and control upon which these youth can draw. This video is 1:26 in length and has closed captions available in English.

Housing is the first step in supporting young people exiting homelessness – but it is not the last step. Even as young people become housed, they often still struggle with the effects of having been homeless, and the trauma and stress that goes along with that experience. Research shows that even amongst young adults residing in single room occupancy housing, there are still high mortality rates, multi-morbid illnesses, unmet mental health needs, and extreme poverty (Barbic et al., 2018). Young people may also have on-going sexual health considerations, such as whether to continue with a pregnancy and/or intimate relationships (Begun, 2019). In addition to on-going physical and mental health effects, young people may have acquired legal challenges that can complicate leaving the street and that need to be identified and addressed or risk being barriers to long-term housing security (Chan & Huys, 2017). As we examine more closely in the chapter on Sociology & Crimino-Legal Studies, ticketing the money-making activities of people experiencing homelessness (such as panhandling and squeegeeing) can create barriers to moving out of homelessness, as they often go unpaid and can count against a person’s credit score, which makes it difficult to qualify for housing.

We can see even from this brief discussion, that it is not a simple task for young people to become housed. Gaetz, Ward, and Kimura (2019) argue that when considering what it means to successfully exit homelessness, we must take a holistic approach that recognizes a range of positive outcomes related to housing, but also to safety and security, health and well-being, social connections and integration, and the pursuit of goals that are meaningful to the individual. Having housing is an important place to begin, but to assist young in permanently exiting homelessness, we also must ensure they have access to a range of wrap-around supports that are tailored to their self-identified needs. In the next two videos, Dr. Kaitlin Schwan and Dr. Jacqueline Kennelly respectively discuss the need for affordable housing with wrap-around supports. If you would like to learn more about these kinds of supports, we encourage you to read the chapters on Mental Health and Social Work, where we examine case management and different support styles in more detail.

Dr. Kaitlin Schwan: How can young people be supported to exit homelessness permanently?

In this video, Dr. Kaitlin Schwan argues that in Canada we need to expand housing for young people who are experiencing homelessness or at risk, by enforcing the development of affordable housing that reflects the actual level of income these young people have access to. She notes that these youth need wrap-around supports and services to help them with life skills, such as money-management and cooking, and that these youth need to be supported in learning about their tenant rights. Dr. Schwan states that we need to ensure there is legal infrastructure in place to protect young people’s right to housing. She concludes by explaining that many young people experiencing homelessness wish to reconnect with family members, and that programs that help them do so in a safe way can provide an additional layer of support as they transition into secure housing. This video is 4:45 in length and has closed captions available in English.

Dr. Jacqueline Kennelly: How can young people be supported to exit homelessness permanently?

In this video, Dr. Jacqueline Kennelly argues that we need affordable housing for young people and their families. She notes that once housing is secured, young people need wrap-around supports, including Intensive Case Managers, to help them navigate complex structures, such as signing up for government financial assistance, obtaining mental health supports, and learning how to register for and finance schooling. Dr. Kennelly explains that youth exiting homelessness need help, guidance, and people who care about them, the same as all young people need. She concludes that since this important work is often undertaken by non-profit organizations, they need to receive increased funding. This video is 3:24 in length and has closed captions available in English.

A critical component of Housing First initiatives for young people is helping ensure they feel a sense of social inclusion. When a young person becomes homeless, they often lose their connection to family, friends, and the general community. As we have seen, this can have a detrimental impact on their sense of identity and well-being. Young people need to engage in meaningful pursuits as they progress towards greater stability, and a key part of this is connecting them with supportive and reliable adults they can turn to. Social service providers can play an important role in helping young people to feel connected, by reassuring them that they are supported and will not be abandoned (Kozloff, Bergmans, Snider, Langley, & Stergiopoulos, 2018).

Young people’s own subjective sense of their stability is one of the key indicators of long-term housing stability (Frederick, Vitopoulos, Leon, & Kidd, 2021) and the more these young people access services, the less likely they are to return to homelessness (Barker, Shoveller, Grant, Kerr, & DeBeck, 2020). These findings suggest that connecting youth with services, and helping them feel stable in their housing, is critically important for increasing the chances they permanently exit homelessness. In the next two videos, Dr. Jeff Karabanow and Dr. Tyler Frederick speak about the importance of Housing First and having supportive people in the lives of young people transitioning out of homelessness.

Dr. Jeff Karabanow: How can young people be supported to exit homelessness permanently?

In this video, Dr. Jeff Karabanow explains that there are different best-practice approaches for supporting youth exiting homelessness but that Housing First is critical for providing a safe sanctuary as a basic initial step. He notes that some young people may wish to return home, if it is safe, and that there are programs that can assist with this. Dr. Karabanow expresses that housing is an important step but that once the youth is housed we need to consider the types of wrap-around supports they might need, including feeling part of the community, returning to school, and/or finding employment. He notes that youth need circles of care that help them deal with trauma, and issues such as addiction and/or mental illness using harm reduction approaches and philosophies of compassion, choice, and gradual change. Dr. Karabanow identifies different intervention approaches that have shown positive results for youth, but also notes that what is most critical is that the young person has at least one person in their life they feel connected to, and who will support them. This video is 4:50 in length and has closed captions available in English.

Dr. Tyler Frederick: How can young people be supported to exit homelessness permanently?

In this video, Dr. Tyler Frederick explains that the first step in helping young people exit homelessness is improving their access to affordable housing, but that addressing permanency is more difficult. He notes that many young people struggle to remain housed due to a range of complex issues, such as only being able to afford poor quality housing, difficulties with landlords, and challenges with roommates. Dr. Frederick argues that young people exiting homelessness may lack a critical safety net to help them navigate these issues and that having at least one person they can count on, whether a friend or case manager, is essential for achieving longer-term stability. He cautions that young people may become stuck after getting housed and that they often benefit from bridging support to help them return to school, find employment, and learn independent living skills. Dr. Frederick concludes that as youth transition out of homelessness, it is critical they feel a sense of belonging in the community and have mental health and wellness supports to help them navigate the stress that these life changes may bring. This video is 8:29 in length and has closed captions available in English.

Dr. Sean Kidd: How can young people be supported to exit homelessness permanently?

In this video, Dr. Sean Kidd promotes Family Reconnect as a programmatic intervention that can be used to identify young people experiencing homelessness, quickly assess whether there are any positive familial relationships that exist, and re-establish housing and supports through that relationship. He notes that these programs are helpful in identifying extended family member supports and serving as early intervention to keep young people from living in predacious and violent street environments. Dr. Kidd explains that we need to improve our ability to rapidly house young people leaving institutions, such as child welfare and the criminal justice system. He sites Housing First as an important strategy but notes that youth may require different models than adults, including a focus on congregate living with shared common spaces, life skills training, peer-support, harm reduction or abstinence programming, and ongoing assessment of their changing needs. Dr. Kidd observes that for many young people exiting homelessness, tailored mental health and addiction help is key and that young people must have choice and flexibility in their treatment. They must also have skillful engagers who can help with common factors such as making them feel understood, hopeful, cared for, and like they have someone they can trust. Dr. Kidd concludes by arguing that as part of our efforts to support young people exiting homelessness, it is essential to have reasonable funding and evidence to inform what programs and supports work best for whom. This video is 9:39 in length and has closed captions available in English.

In the preceding video, Dr. Kidd explains that programs and interventions should be evidence-informed through the most recent evaluations. In much the same way, Malla et al., (2019) have also argued that youth mental health services are most effective when they involve detailed and carefully orchestrated processes guided by a set of values and principles, clear objectives, training, and evaluation. The research shows that there are innovative programs to help young people cope with mental illness and/or addictions as part of their pathway out of homelessness.

For instance, in Montreal, a team of service providers offers intensive outreach intervention for youth experiencing homelessness and suffering from first episode psychosis and addiction (Doré-Gauthier, Côté, Jutras-Aswad, Ouellet-Plamondon, & Abdel-Baki, 2019). Analysis of this program shows that when the team first meets with youth, they often have poor prognostic factors, such as one of the Cluster B personality disorders, substance use disorders, legal problems, childhood trauma, and lower educational attainment, but that after a period of 6 months the majority have been able to achieve housing stability and improved functionality (Doré-Gauthier et al., 2019). Providers can work together to support the mental health needs of youth experiencing homelessness, as evidenced by the development and growth of the Montreal Homeless Youth Network (Morisseau-Guillot et al., 2020). As an outcome of this collaborative work, a clinic was created for youth to ensure they had timely access to appropriate services, using an approach that engaged young people in service planning and design (Abdel-Baki et al., 2019).

In the preceding video, Dr. Kidd spoke about the need for mental health and addictions support for young people transitioning out of homelessness. He and his team have led a multi-agency and interdisciplinary collaboration, known as the Housing Outreach Program – Collaboration [HOP-C], which is comprised of transitional outreach-based case management, individual and group mental health supports, and peer support (Kidd et al., 2019a, 2019b). These wrap-around supports, built on collaboration, mental health support, and peer support, have been linked to positive outcomes for young people (Vitopoulos et al., 2018b). Ongoing analysis of the HOP-C initiative demonstrates that there is potential benefit in fostering city-level, multi-disciplinary teams that work together across organizations to support young people who are transitioning out of homelessness (Kidd et al., 2020). We invite you now to learn more about the HOP-C project in this section’s featured reading entitled, “Developing a trauma-informed mental health group intervention for youth transitioning out of homelessness” presented below.

While young people demonstrate remarkable personal strength in exiting homelessness, they require support as they make these transitions. We have seen that the reasons young people become homeless are complicated, and that while on the street they experience a range of challenges including exposure to violence and trauma, stress, poor mental and physical health, addictions issues, and malnutrition. It is unrealistic to expect young people to recover from these experiences without sustained support and assistance. There is a recurring theme that runs throughout this chapter (and throughout the book as a whole) that argues for prevention and early intervention. If we can stop young people from becoming homeless, they will not have to go through the hardships and recovery period.

In the past, Canada has looked to the United States for solutions on how to address homelessness, such as through Housing First, but Gaetz (2018) notes that we are increasingly seeing international solutions arise. Upstream Canada is one such example, that is adapted from an Australian program and is put in place to identify youth who are at risk of homelessness and school disengagement by implementing a universal screening tool known as the Student Needs Assessment (Sohn & Gaetz, 2020). The values of Upstream Canada are to be collaborative, equitable, integrative, and longitudinal in identifying youth at risk, validating the findings with a trained Upstream Social Worker, and then connecting the youth to coordinated services and supports (Sohn & Gaetz, 2020). In the next video, Dr. Stephen Gaetz speaks about the importance of preventive programs, like Upstream Canada, in identifying young people before they become homeless and intervening to keep them connected and engaged with social supports, such as education.

Dr. Stephen Gaetz: How can young people be supported to exit homelessness permanently?

In this video, Dr. Stephen Gaetz argues that early intervention and prevention programs like Upstream and Family Reconnect are the best place to start supporting young people, so they do not experience homelessness. He notes that thinking about exiting homelessness draws our attention to the damage it causes, and that young people often continue to struggle with malnutrition, poverty, a lack of education and employment, and social exclusion even after they are housed. Dr. Gaetz explains that evidence-based approaches, like Housing First for Youth, are key in supporting the changing needs of developing adolescents and young adults. He states that there are different approaches, such as reconnecting with families if they are safe, obtaining youth-specific transitional housing, and including Indigenous-led housing programs that focus on cultural reconnection. Dr. Gaetz concludes that in addition to housing stabilization, support models must address elements of young people’s well-being using trauma-informed care. This video is 4:35 in length and has closed captions available in English.

The Upstream model is an important approach for addressing the gap that currently exists in mental health awareness training among pre-service teacher candidates (Brown et al., 2019). Rogers and Shafer (2018) have argued that when teachers are empowered with knowledge to reject the deficit model commonly attached to marginalized youth, they can become advocates for these young people. Teachers are well-situated to identify young people who are at risk of homelessness and help connect them with services and supports. However, it is essential that teachers themselves be educated in trauma and violence-informed care practices (Rodger et al., 2020).

While implementing prevention programs such as Upstream Canada are best-practice approaches, it is still possible that some young people will not be identified through these measures. In these instances, programs such as Family Reconnect can be implemented as early-interventions. Throughout this section, several researchers have identified three core interventions used to help young people, which come into effect at different stages. Upstream Canada has not yet been widely adopted but could help to identify young people in schools, before they become homeless. Family Reconnect is used once a young person has recently become homeless and may have the chance to return to their home (if safe for them to do so) or to live with another family member, such as a grandparent or aunt / uncle. Housing First is the most commonly used of the three programs, and it comes into effect after a young person has been homeless for a period of time and needs help securing housing arrangements and wrap-around supports.

In the next set of videos, Dr. Bill O’Grady and Dr. Alex Abramovich speak about the importance of these programs for young people. However, they also remind us of another common theme throughout this book, which is that there is no one-size-fits-all solution to homelessness. While having contact with supportive family members can help buffer risks on the street (Kidd et al., 2021) and there are therapies that can help families reconcile (Cully, Wu, & Slesnick, 2018), approaches like Family Reconnect might look very different for some youth. In particular, young people who left home or were thrown out over LGBTQ2S+ identity conflicts might not be welcome back home. In these instances, we may need to redefine who counts as family. Here Dr. O’Grady and Dr. Abramovich each respectively explain further.

Dr. Bill O’Grady: How can young people be supported to exit homelessness permanently?

In this video, Dr. William [Bill] O’Grady explains that in recent years we have expanded our understanding to consider ways of supporting youth exiting homelessness. He notes that school-based early interventions are important because teachers often have a keen sense of which students are at risk, but often do not have the resources to help. Dr. O’Grady advocates for the use of programs like Family Reconnect to help youth re-establish positive relationships, where possible, with members of their family. He argues that targeted approaches are needed, such as for LGBTQ2S+ individuals and youth aging out of state care. Dr. O’Grady notes that since many young people experiencing homelessness have had to prioritize survival over school, it is important to support them in returning to education as a basic human right. He concludes by discussing Housing First for Youth as a key strategy that prioritizes housing and addresses young people’s unique and changing needs. This video is 5:14 in length and has closed captions available in English.

Dr. Alex Abramovich: How can young people be supported to exit homelessness permanently?

In this video, Dr. Alex Abramovich explains that LGBTQ2S+ youth experience homelessness at younger ages than heterosexual and cisgender youth, resulting in longer episodes, higher accumulation of traumas, and making it more difficult to exit. For this reason, he notes, it is critically important to focus on prevention and early intervention efforts, such as through school-based programs. Dr. Abramovich argues that focusing on protective factors is key and that for LGBTQ2S+ youth this often involves peer groups and other supportive people in their lives. He explains that within LGBTQ2S+ communities, the meaning of family may be redefined and this needs to be respected in programs like Family Reconnect to ensure young people’s relationships with supportive people are respected. Dr. Abramovich concludes that these young people benefit from population-based programs that have supportive case managers, and that allow them to be themselves and connect with others who identify in similar ways. This video is 3:10 in length and has closed captions available in English.

Family reconciliation work may be more difficult within families where rejection of a young person’s LGBTQ2S+ status is an issue, but there are models of this work that have shown some promising outcomes, such as the Ruth Ellis Centre in Michigan (Jones & Ellis, 2017). As Dr. Abramovich noted in the preceding video, it may be that we need to expand our definition of what family means. If Family Reconnect programs are to be effective with LGBTQ2S+ youth, who constitute a particularly high-risk and marginalized group, then we must first ask whom the young people consider to be their family. Relationships that are supportive, stable, and empowering should be cultivated if in the best interest of the young person involved.

At the heart of this issue, is a young person’s right to make decisions and to choose what is best for them. As young people exit the streets, they are expected to address the challenges of emerging adulthood, independence, and overcoming the trauma that often contributed to their homelessness in the first place (Karabanow et al., 2018). One key way to help support young people permanently exit homelessness is to listen to them and respect that they understand what they need. We must also consider what the research tells us about the pathways into youth homelessness, the immense traumas young people experience as a result, and how to best support them to become safely and securely rehoused as quickly as possible.

Gaetz, O’Grady, Kidd, and Schwan (2016) have written that society’s failure to implement more effective strategies to address youth homelessness undermines these young people’s basic human rights. We need to work from an evidence-based framework that prioritizes human rights and equity while making changes to the way our social systems and institutions function (Nichols et al., 2017). Making this kind of change does not simply happen, but rather requires on-going and active commitment from people working in roles across society (Nichols, Schwan, Gaetz, & Redman, 2021). We conclude this section with a video of Dr. Naomi Nichols advocating for the rights of young people, as knowledgeable and autonomous decision makers.

Dr. Naomi Nichols: How can young people be supported to exit homelessness?

In this video, Dr. Naomi Nichols argues that for a permanent solution to help youth exit homelessness we need policy and structural changes. She explains that factors such as long waitlists, a lack of affordable housing, and housing that does not match young people’s income levels all serve as barriers to successfully transitioning out of homelessness. Dr. Nichols concludes that we need better non-paternalistic systems for listening to young people, understanding their role as autonomous decision-makers who have rights, and working with them to define the most appropriate interventions. This video is 5:35 in length and has closed captions available in English.