3. How can young people be supported to exit homelessness permanently?

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.

 

How to complete this activity and save your work: Type your response to the question in the box below. When you are done answering the question navigate to the ‘Export’ page to download and save your response. If you prefer to work in a Word document offline you can skip right to the Export section and download a Word document with this question there.

 

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.

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

  1. Young people need financial support to successfully exit homelessness. This may include providing rent subsidies and raising the level of government supports to a living wage.
  2. Young people need social support, such as building community connections in places related to education, employment, and faith.
  3. Young people need identity-based supports, to foster a sense of purpose and control that they can draw upon. This is not about pulling themselves out of homelessness, but rather about fostering internal resources and tools.

 

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.

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

  1. In Canada, we need to expand housing for young people who are experiencing homelessness or at risk. The housing should be designed by and for youth to reflect the level of income they actually have access to.
    • Despite funding new affordable housing developments, we do not do enough to ensure what we mean by ‘affordable’ actually matches what young people in extreme poverty can afford to pay.
  2. Young people need wrap-around supports and services to help them with life skills needed in transitioning out of homelessness, such as money-management and cooking.
  3. Youth who exit homelessness need to be supported in learning about their tenant rights, to prevent illegal evictions and pressure from landlords.
    • We need to ensure there is legal infrastructure to protect young people’s right to housing.
  4. Programs that help young people re-establish relationships with family members in a way that is safe can help provide additional support as they transition into housing.

 

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.

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

  1. We need affordable housing for young people and their families.
  2. Once housing is secured young people need wrap-around supports to help, such as through Intensive Case Management, to navigate complicated structures.
    • Youth may need help to figure out sources of income, connect with government programs, obtain mental health supports, and learn how to register and apply for financial aid for school.
    • This work is being supported by non-profit organizations, which need to be better funded.
  3. Youth exiting homelessness need what all young persons need, which is help figuring out systems, deciding between different options, and people who care about them.

 

Housing First, as discussed in the chapter on Politics, Policy, & Housing in Canada, is an intervention that prioritizes getting people housed and then providing them with the kinds of supports they need, according to principles such as client choice and self-determination. For young people, Housing First may look different than it does for adults. As teenagers or young adults, transitional housing with peers and on-site support may be preferrable to independent housing where the young person is expected to manage on their own. Results from Without a Home, the first national youth homelessness survey, showed that we need to prioritize prevention-focused approaches, like Housing First that are adapted for the unique needs of youth (Gaetz, O’Grady, Kidd, & Schwan, 2016). 


What do you think?

human head with light bulb as brain graphic

Based on what you have learned about the reasons young people become homeless and the challenges they face, what unique needs do you think they might have related to housing? How might Housing First be different for a teenager or young adult than for someone who is older? 


 

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.

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

  1. There are different best-practice approaches to supporting youth exiting homelessness, but Housing First is a key one for providing a safe sanctuary as a basic first step.
  2. Some young people may wish to return home, if it is a safe place, and there are strategies that can be used in the home as prevention even before the young person becomes homeless.
  3. Housing is an important foundational step. Once the person is housed, we need to consider what type of wrap-around supports they need.
    • Youth may need support to feel included in the community, return to school, or enter the labour force in a way that will not overwhelm them.
    • Youth need circles of care to 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.
    • Different styles and methods of intervention have been successful with youth, including dialectical behaviour therapy, cognitive behavioural therapy, and narrative work.
  4. Research shows having one supportive person youth feel connected to, and who cares about them, is important in navigating the struggles of adolescence and the additional trauma of homelessness.

 

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.

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

  1. The first step in helping young people exit homelessness is improving their access to affordable housing.
  2. Addressing the permanency of housing is more difficult, as many youth struggle to remain housed over the long-term, for several reasons.
    • The quality of housing they can afford may not be suitable for habitation, such as containing mold or flooding issues, or may have exploitative landlords.
    • Young people may find housing with friends they have met through shelters or while they were experiencing homelessness, and conflicts may arise over substance use issues, a roommate’s inability to pay rent, or other transitional challenges.
  3. Young people exiting homelessness may lack a safety net to help navigate issues, such as having a first apartment, fighting with a roommate, troubleshooting issues with a landlord, and filling out paperwork.
    • Youth need at least one supportive person they can turn to, whether that is a more established friend or a case manager who can step in and help them achieve longer-term stability.
  4. Once young people are housed they often need help bridging into the next part of their lives, so they do not get stuck.
    • Youth often benefit from programs that help transition them back into high school or post-secondary education, find suitable employment, and develop life skills needed to live independently.
  5. As they transition out of homelessness, young people need to establish a sense of belonging within a community. They may seek to distance themselves from relationships they formed on the street and making new friends can be challenging.
  6. Key to any transition is to support young people’s mental health and wellness so they have the energy to undertake major changes in their life and manage the stressors that might accompany them.

 

Karabanow, Hughes, Kidd, and Frederick (2018) have published a book entitled, “Homeless youth and the search for stability” detailing the outcomes of a multi-year study on supporting youth exiting homelessness. In the book they write, “… the majority of these young people remain in a fragile state throughout their transitions to non-street life. This fragility has much to do with their in-between status. Not certain they have indeed been removed from street life, and by no means comfortable or accepted within mainstream civil society, these young people struggle with their sense of self – of who they are, what they desire, where they are going, and what they need. Given that for most youth living on the street, their memories of home were filled with trauma and upheaval, it is not surprising that while they would dream of leaving the streets and living in a stable environment, they were not sure how to do it” (Karabanow et al., 2018, pg.16). 

 

aqua icon for website linkAs part of this project a group of young people, Layla Sunshine, Baby T, Orlando Foster, and Sarafin, worked together to create a truly remarkable comic-style book about the challenges of exiting homelessness.

We encourage you to take a moment and learn more.


 

Dr. Sean Kidd was a lead researcher on this project as well and has studied young people’s transitions out of homelessness for many years. In the next video, he reflects on this extensive research, identifying several programmatic interventions and the need for tailored mental health and addictions support for young people. Here he explains further. 

 

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.

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

  1. Family Reconnect is a program that focuses on identifying young people through shelters or other services, quickly assessing whether there are any positive familial relationships that can be salvaged, and re-establishing the young person with housing, education, and supports through that relationship.
    • Some situations may be irredeemable and unsafe, such as severe abuse, neglect, or dysfunction within the family, but there may be good relations with an extended family member who could care for the young person.
    • This program is impactful because it is an early intervention to prevent young people from living in predacious and violent environments.
  2. We know many young people flow into homelessness from institutions, such as child welfare and the criminal justice system. We know where they are, who they are, and what is happening. We need to provide these young people rapid housing and supports.
  3. Housing First is an important strategy, recognizing young people need housing in place rapidly and without strings attached, but also that what youth need will be different than the adult model.
    • Young people need a higher support environment and congregate living in a way that makes them feel included rather than isolated. Peers can be an important source of support for young people exiting homelessness.
    • Young people may need to be taught independent living skills, such as grocery shopping, cooking, paying bills, looking for work, and managing relationships with important people like landlords.
    • Young people need customized supports, such as shared housing that has harm reduction policies or housing that is abstinence-based, depending on their needs.
    • On-going assessments are important, to determine what young people need at different points and how those needs might change as they become more stable.
  4. For many youth exiting homelessness, tailored mental health and addiction help is key.
    • Young people who experience homelessness often have a profound lack of choice in many areas, so they must have choice in the treatments they receive. The treatment approach needs to be flexible, to find what works best for an individual.
  5. Just as important as the interventions are the common factors, which means people who can help cultivate hope, speak in a way you understand, come together on shared goals, make you feel cared for, and with whom you can build a trusting relationship.
    • A range of people can be skillful engagers who work with young people in ways that connect them to foundational supports.
  6. We need reasonable funding so that we are not scrambling for money and constantly functioning in crisis response mode.
  7. We need evidence to inform what works best, for which clients, and when so that we can better understand how to target and focus our efforts without unnecessary duplication of approaches that are not helpful.

 

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.


Featured Reading:

open book graphicVitopoulos, N., Cerswell Kielburger, L., Frederick, T., & Kidd, S. (2018). Developing a trauma-informed mental health group intervention for youth transitioning out of homelessness. In S. Kidd, N. Slesnick, T. Frederick, J. Karabanow, & S. Gaetz (eds.), Mental health & addiction interventions for youth experiencing homelessness: Practical strategies for front-line providers. Toronto, ON: Canadian Observatory on Homelessness. 


 

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.

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

  1. Early intervention and prevention are the best places to start so that young people do not become homeless.
    • Programs like Upstream and Family Reconnect can be implemented in schools because nearly every young person has been in the education system at some point prior to homelessness.
  2. Thinking about exiting comes back to considerations of the damage that experiencing homelessness causes.
    • When young people leave the streets they generally are not doing well. They are often malnourished, living in extreme poverty, fearful of losing their housing again, not re-engaging with education or employment, and socially excluded.
  3. There are different evidence-based support models, but Housing First for Youth is a ‘made in Canada’ one that adapts the standard approach to the needs of developing adolescents and young adults.
    • For young people returning home with family supports may be an option if it is safe to do so.
    • There are youth-specific transitional housing models, like the international Foyer approach, that help youth to achieve the goal of living independently.
    • There are good examples of Indigenous focused Housing First for Youth programs that have Indigenous led supports and cultural reconnection.
  4. In addition to housing stabilization, support models have to focus on well-being, such as engagement in education and employment, trauma-informed care, and promoting social inclusion.

 

Quote Source

 

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.

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

  1. Until recently in Canada, most of our focus has been on understanding young people’s experiences of homelessness, such as how they make money, where they sleep, and the peer groups they form. It is only now that we are beginning to consider how to help young people exit homelessness permanently.
  2. School-based interventions are important because teachers often have a good sense of which students are at risk, but do not have the existing resources to help.
    • School boards and governments need to collaboratively support and invest in these early intervention programs.
  3. Young people are often in contact with some members of their family. Programs like Family Reconnect can help them re-establish relationships and work through problems that contributed to their homelessness episode.
  4. Institutional supports are needed to help young people gradually exit public systems, such as child welfare, rather than abruptly moving from care into homelessness.
  5. Young people who identify as LGBTQ2S+ may need additional specialized supports. Recent attention has been paid to the discrimination these youth face, and the need for separate shelters and programs that address their needs.
  6. Completing their education is important for youth to transition out of homelessness, as many of these youth have not finished high school.
    • They often have to choose between going to school or surviving while homeless, because they cannot do both.
    • Beyond basic resume writing, young people also need training and education, which they are entitled to as a basic human right.
  7. Housing First for Youth is a key strategy that prioritizes housing and addresses people’s needs, in a way that is designed to work for young people.

 

 

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.

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

  1. LGBTQ2S+ youth experience homelessness at younger ages compared to heterosexual and cisgender youth. This generally results in longer episodes of homelessness, with greater accumulation of traumas, making it more difficult to exit homelessness.
  2. Early intervention and prevention are critically important for LGBTQ2S+ youth. This may take the form of building support networks within schools to help young people and their families as they come out about their gender identity and/or sexual orientation.
  3. Focusing on protective factors is key, which for LGBTQ2S+ youth often involve peer groups and identifying supportive people in their lives.
    • Within LGBTQ2S+ communities, people may redefine the meaning of family. This is important to consider in relation to Family Reconnect programs, in order to respect and continue to build upon these supportive relationships.
  4. LGBTQ2S+ youth experiencing homelessness benefit from population-based programs that have supportive case managers who allow them to be themselves and connect with others who identify in similar ways.

 

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.

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

  1. For a permanent solution, we need policy change, because exiting youth homelessness is impacted by factors such as long waitlists for affordable housing which can have developmental impacts on young people.
  2. We need structural changes, like investments in a range of different publicly funded housing options for young people, including supports if needed.
    • There is a lack of available housing stock that makes it difficult to offer young people choice. We need more options so that young people do not need to check themselves into a hospital or rehab for services they do not need, just to have somewhere to live.
  3. We need to narrow the gap between people’s wages and the cost of housing. We have created a situation where people are paid minimum wage in communities where housing prices are increasing rapidly.
  4. We need better non-paternalistic systems for listening to young people, understanding their role as autonomous decision-makers, and working with them to define the most appropriate interventions.
    • Young people should be recognized as legal rights holders who are capable of contributing to their care plans, with acknowledgement that their needs may change as they continue to grow and develop.

 

aqua icon for website linkWant to learn more about how to support young people exiting homelessness? Check out the Homelessness Learning Hub links below!


 

Young people become homeless for very complex reasons, and experience considerable trauma while on the streets. Throughout this section, we looked at some of the ways to help support these youth as they transition out of homelessness and into secure housing. We saw that this is not something that happens overnight, but rather is a process marked by both progress forward and steps backward. What matters in this process, is that they be given the support they need to achieve financial security, social inclusion, and a redefined sense of identity that highlights their self-worth. We heard from multiple researchers that while housing is an important place to start, it must be accompanied by wrap-around supports such as through Housing First for youth. Which supports a young person receives will vary depending on their self-identified needs, but commonly include interventions aimed at improving mental health and/or issues with addictions. Here we learned about coordinated efforts that are being implemented in different cities to help young people address these issues as they transition out of homelessness.

 

There were three programmatic interventions that were routinely identified throughout this section. Upstream Canada is a preventive measure that is used to identify young people at risk of homelessness through school settings. However, while this program has shown promising outcomes, it is not yet widely implemented across the country. Family Reconnect is an early intervention program that is used to help repair family discord, where safe and possible, or rehouse a young person with extended family. We saw that while this intervention is effective, it may need to be broadened in scope, particularly for young people who identify as LGBTQ2S+. Finally, we have considered Housing First as a tailored intervention for helping young people become housed and have wrap-around supports based on choice and self-determination.

 

The foundation of success for all of these programs and interventions is that they consider young people to be rights-holders who are capable of making their own autonomous decisions. The best way we can support young people is to design our society in a way that prevents homelessness from occurring. When prevention fails, we must shift towards early intervention to get young people returned to family where safe to do so. As a very last resort, we should move young people into Housing First programs where they have wrap-around supports to meet their needs. Our current approach – of allowing young people to become homeless, experience trauma after trauma, and then wait to get them housed until after they are in crisis – is the worst possible scenario.

 

We began each section of this chapter with a story about a young man sleeping outside, using intravenous drugs, and living a difficult life in the summer of 2005. Unfortunately, we do not know what happened to him, but we like to believe the narrative that he got support, secured housing, and returned to school with the help of community agencies. While he may be out there today – living in a house, married with children, working a full-time job – he would still carry with him the scars of having been homeless as a young man. Let’s imagine instead that Upstream interventions were in place in his school, he was identified early, given support, and never was on the street to meet the author carrying the donuts. That would be the happy ending he deserves.

 

Podcast: How can young people be supported to exit homelessness permanently? (52:57)

Click the link below to listen to all of the researchers answer the question “How can young people be supported to exit homelessness permanently?” in audio format on our podcast!


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Understanding Homelessness in Canada Copyright © 2022 by Kristy Buccieri, James Davy, Cyndi Gilmer, and Nicole Whitmore is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, except where otherwise noted.

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