research on youth homelessness

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Prevalence and Correlates of Youth Homelessness in the United States

Matthew h. morton.

a Chapin Hall at the University of Chicago, Chicago, Illinois

Amy Dworsky

Jennifer l. matjasko.

b Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia

Susanna R. Curry

c School of Social Services Administration, University of Chicago, Chicago, Illinois

David Schlueter

d Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee

Raúl Chávez

e Department of Social Welfare, University of California, Berkeley, California

Anne F. Farrell

Unaccompanied youth homelessness is a serious concern. Response, however, has been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. We sought to address these gaps.

Using a nationally representative phone-based survey (N = 26,161), we solicited household and individual reports on different types of youth homelessness. We collected household reports on adolescents aged 13–17 and young adults aged 18–25, as well as self-reports from young adults aged 18–25. Follow-up interviews with a subsample (n = 150) provided additional information on youth experiences and enabled adjustment for inclusion errors.

Over a 12-month period, approximately 3.0% of households with 13- to 17-year-olds reported explicit youth homelessness (including running away or being asked to leave) and 1.3% reported experiences that solely involved couch surfing, resulting in an overall 4.3% household prevalence of any homelessness, broadly defined. For 18- to 25-year-olds, household prevalence estimates were 5.9% for explicitly reported homelessness, 6.6% for couch surfing only, and 12.5% overall. The 12-month population prevalence estimates, available only for 18- to 25-year-olds, were 5.2%, 4.5%, and 9.7%, respectively. Incidence rates were about half as high as prevalence rates. Prevalence rates were similar across rural and nonrural counties. Higher risk of homelessness was observed among young parents; black, Hispanic, and lesbian, gay, bisexual, or transgender (LGBT) youth; and those who did not complete high school.

Conclusions

The prevalence and incidence of youth homelessness reveal a significant need for prevention and youth-centric systems and services, as well as strategies to address disproportionate risks of certain subpopulations.

Youth homelessness is a serious concern. Evidence shows that youth who experience homelessness are at high risk of exposure to a range of physical [ 1 ] and mental [ 2 , 3 ] health problems, violence [ 4 ], early pregnancy [ 5 ], substance use [ 6 ], and early death [ 7 ]. However, efforts to solve the problem have been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. In response, this study was undertaken as part of Voices of Youth Count (VoYC), a national research initiative on youth homelessness led by Chapin Hall at the University of Chicago. The research was designed to address critical evidence gaps while also responding to the federal Runaway and Homeless Youth Act (RHYA; P.L. 110–378), which calls for replicable national prevalence and incidence estimates of youth homelessness and data concerning the population’s needs and characteristics.

Federal definitions encompass distinct aspects of youth homelessness. The Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009, for example, defines homelessness partly by individuals’ sleeping arrangements—mainly unsheltered (e.g., sleeping in public places) or sheltered (e.g., homeless shelter or transitional housing). Moreover, it includes youth staying with others (e.g., couch surfing or doubling up) if they are considered homeless under other Federal definitions and meet additional conditions, or if they are fleeing unsafe situations [ 8 ]. Conversely, the RHYA definition makes no reference to sleeping location. It defines youth homelessness exclusively by the circumstances of the experience: a person within the defined age range “for whom it is not possible to live in a safe environment with a relative, and who has no other safe alternative living arrangement” [ 8 ]. Similarly, studies have used a range of parameters and indicators to estimate youth homelessness in the absence of any “gold standard” measure [ 9 - 11 ].

Moreover, previous estimates of youth homelessness have involved varying age ranges. For example, the U.S. Department of Housing and Urban Development’s Annual Homeless Assessment Report [ 11 ] documents youth homelessness up to age 24; other national estimates focus on adolescent years [ 9 , 10 ]. The RHYA calls for estimates among 13- to 25-year-olds and drives the age parameters of this study.

Methods for identification and sampling have further implications for the reliability and inclusiveness of estimates [ 12 ]. Point-in-time counts, which are required of communities funded by the U.S. Department of Housing and Urban Development to deliver homelessness programs, enumerate the number of people experiencing homelessness on a specific night in January and rely largely on street- and shelter-based identification. This reliance means that youth experiencing homelessness on other nights or more hidden forms of homelessness on the night of the count—such as couch surfing, sleeping in discreet or remote locations, and youth who actively avoid services and being counted—are not reflected in the estimates [ 13 ]. School-based administrative and survey data, such as the U.S. Department of Education’s data on student homelessness and the Youth Risk Behavior Survey data based on optional homelessness modules, inherently exclude out-of-school youth and young adults [ 10 , 14 ]. Given such differences, previous national estimates of the size of the population experiencing youth homelessness have varied widely.

The present study addressed two primary research questions. First, what is the estimated 12-month prevalence of unaccompanied youth homelessness? Second, what youth and household characteristics are associated with increased risk of a homeless experience?

We both examine youth homelessness broadly and segment different forms of homelessness. The broad definition includes individuals, aged 13–25, living in places not meant for human habitation, in shelters or transitional housing (or other temporary housing arrangement), or staying with others while lacking a safe and stable alternative living arrangement. Couch surfing, which can reflect a common subset of youth homelessness experiences (“staying with others”), involves “mov[ing] from one temporary living arrangement to another without a secure ‘place to be’” [ 15 ]. However, because some classifications include staying with others under broader concepts of housing instability rather than homelessness [ 16 ], we report prevalence with and without youth that only had couch surfing experiences. Running away, also taken as a subset of youth homelessness experiences, is defined by RHYA as a minor “who absents himself or herself from home or a place of legal residence without the permission of a parent or legal guardian.” Unaccompanied, which is variably defined in the literature, refers in this case to the absence of a parent or legal guardian.

We surveyed a nationally representative sample of adults whose households included 13- to 25-year-olds over the preceding 12 months. During two rounds of data collection, each involving different random samples, from July to September 2016 (round 1) and May to July 2017 (round 2), a homelessness module was added to Gallup, Inc.’s U.S. Politics and Economics Daily Tracking Survey (DTS) [ 17 ]. Because we captured 12-month prevalence, we do not suspect that a lack of seasonal variation in the timing of data collection was consequential for estimates, although this would be worth exploring in future research. The DTS used a dual-frame (cellular and landline) random-digit dial telephone sample to interview a national quota of 500 adults per day. Daily samples included quotas of 60% cell phone respondents and 40% landline respondents. The DTS response rate averages 12%. Although prior research has found response rate to be an unreliable indicator of bias, this response rate is also typical of, or slightly higher than, other phone-based surveys [ 18 ].

The second round increased the overall sample size for greater precision and included follow-up interviews. Follow-up interviews were conducted during the second round with a random sample of respondents who reported any youth homelessness (explicitly) or couch surfing. Follow-up interviews were generally conducted within 2–3 days after the respondent’s completion of the DTS. We established quotas of 50 completed follow-up interviews for each of three groups: (1) respondents who reported that a household member aged 13–17 experienced homelessness or couch surfing, (2) respondents who reported that a household member aged 18–25 experienced homelessness or couch surfing, and (3) 18- to 25-year-olds who reported that they experienced homelessness or couch surfing. The follow-up interviews response rate was 32%. Although a relatively small subset of a larger sample, accumulating a substantially larger subsample would have required a much bigger time period and cost burden for running the module with the DTS, completing interviews, and transcription, and coding. Nonetheless, using the follow-up interviews for estimating inclusion errors and examining experiences allowed for markedly greater accuracy and understanding of the prevalence estimates. Data collection began after the University of Chicago’s Institutional Review Board approval. Respondents provided verbal informed consent.

This study involved three instruments: the DTS, a brief 19-item youth homelessness prevalence and incidence module, and a more detailed follow-up interview protocol. The DTS solicited demographic characteristics on respondents, including age, sex, race/ethnicity, household income, employment, education, county population density, sexual orientation and gender identity, and marital and parenting status.

The brief youth homelessness module was administered to adult respondents whose households included members aged 13–17 or 18–25 and young adults aged 18–25. Reflecting different experiences of homelessness, we asked adults whose households included at least one person aged 13–17 if any of those individuals had (a) run away, (b) left home because of being asked to leave, (c) couch surfed, or (d) been homeless in the last 12 months. Adults whose households had at least one individual aged 18–25 were asked if any of those individuals had (a) couch surfed or (b) been homeless. Adults who themselves were aged 18–25 were asked if they had (a) couch surfed or (b) been homeless. The literature notes stigmatization and varied interpretations sometimes associated with the term “homeless,” hence the inclusion of additional indicators [ 3 ]. Before the study, interviewers field-tested the homelessness module (n = 20); modest changes were made based on this cognitive testing.

The follow-up interviews involved a mixed-methods approach, for example, questions with closed and open-ended response options. Closed queries addressed youth characteristics, sleeping arrangements, duration, frequencies, vulnerabilities, service utilization, and causes. Open-ended questions elicited additional detail about the young person’s homelessness or couch surfing experiences, causes, and occurrences in which the young person felt unsafe or in distress. These data also increased our ability to account for inclusion errors, which occurred if a person or experience was inappropriately captured in the initial prevalence estimates.

For our first research question, we estimated the prevalence of homelessness by calculating sample proportions along with associated uncertainty (95% confidence intervals [CIs]) in these estimates. Population or household weights were used for descriptive statistics to compensate for disproportionalities in selection probabilities and nonresponders. Based on the proportion of inclusion errors among the follow-up interviews, we made subsequent adjustments to prevalence estimates. We present segmented estimates of certain types of homelessness, namely, experiences that the respondent described explicitly as homelessness (“explicit homelessness”) 1 and experiences that were restricted to couch surfing and not referred to explicitly as “homelessness” (“couch surfing only”). Further, we include a broader estimate of any homelessness that combines the two. For 13- to 17-year-olds, the explicit homelessness category includes experiences of having been away from home for at least one night due to running away or being asked to leave.

We estimated two types of 12-month prevalence: (1) household prevalence, that is, the share of households with youth members in the specified age groups in which any of those members had experienced homelessness, and (2) population prevalence, that is, the share of the youth population of the specified age group that experienced homelessness. Because this survey was administered to adults (aged 18 and over), we could estimate only household prevalence for the 13–17 age group. For 18-to 25-year-olds, we estimated both household and population prevalence. Because divergent life stages, normative expectations, and legal statuses distinguish the subsets of adolescent minors (13–17) and young adults (18–25), we separated these groups in analyses.

We used NVivo 11 [ 19 ] to conduct qualitative analyses of responses to open-ended questions in the follow-up interviews. Based on the broad operational definition of unaccompanied youth homelessness, two researchers independently reviewed and compared decisions for including or excluding reported experiences of homelessness from the initial survey. Inter-rater reliability agreement was 92%, and remaining cases were discussed and conferenced with a third researcher until 100% consensus was achieved. We then calculated inclusion error rates and used these to adjust initial prevalence estimates.

To estimate the number of households with youth aged 13–17 and 18–25 who had experienced homelessness in the last 12 months, we applied the relevant household prevalence rates to the number of households in the U.S. with any occupants belonging to corresponding age groups, according to the U.S. Census Bureau’s 2015 American Community Survey (ACS) data [ 20 ]. To produce a population estimate for individuals aged 18–25, we applied the population prevalence rates to the number of 18- to 25-year-olds in the U.S. according to 2015 ACS data.

For our second research question, we used Stata 14.0 [ 21 ] for descriptive statistics and logistic regression, examining cross-sectional bivariate associations of homelessness with various demographic characteristics and producing unadjusted and adjusted risk ratios, reporting 95% CIs for each. To ease interpretation, we used the Stata command “oddsrisk” to convert odds ratios to risk ratios with associated CIs [ 22 ]. The logistic regression model was based on the self-reported data for respondents aged 18–25; these data contained the most information about the young people themselves because DTS questions referred to the respondents. Additionally, the dependent variable was limited to explicitly reported homelessness because these reports involved the fewest inclusion errors.

Sample characteristics

The homelessness module was administered to 26,161 of 68,539 DTS respondents (38.2%) who met the eligibility criteria. The sample was broadly representative of the U.S. population with respect to sex, race/ethnicity, income, and employment (see Table 1 ). Prevalence estimates were drawn from three subsamples of respondents: (1) 13,560 with at least one member aged 13–17, (2) 16,975 with at least one other household member aged 18–25, and (3) 6,295 who were themselves 18- to 25-years-old (some respondents belonged to more than one subsample). The sample size for the follow-up interviews was 150. We tested for differences on a range of variables including education, employment, income, and other demographics between the follow-up interview subsample and the overall sample and found no significant differences apart from the modestly younger mean age of follow-up interview respondents (due to quotas).

National survey sample characteristics compared with U.S. Census Bureau data

Notes: The Daily Tracking Survey (DTS) N = 68,539. U.S. Census statistics are all for 2015 and extracted from: https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=PEP_2016_PEPASR5H&prodType=table , accessed on August 1, 2017. The unemployment reference statistic was extracted from U.S. Bureau of Labor Statistics data for July–September 2016, available at: https://data.bls.gov/timeseries/LNS14000000 , accessed on August 1, 2017. The median annual income is presented as a range because the DTS queried on income as a categorical variable; respondents were asked to describe annual income in relationship to ranges rather than to give an actual value.

Based on initial household prevalence estimates, over a 12-month period, approximately 3.4% of households with 13- to 17-year-olds explicitly reported homelessness experiences (including running away or being asked to leave) among them, and 2.8% reported experiences that solely involved couch surfing, resulting in an overall 5.3% household prevalence. For ages 18–25, household prevalence estimates were 6.7% for explicitly reported homelessness, 14.3% for couch surfing only, and 21.0% overall. The initial 12-month population prevalence estimates, available only for ages 18–25, were 5.9%, 9.7%, and 15.6%, respectively. Additionally, among those reporting explicit homelessness, we found substantial overlap of couch surfing. Specifically, 64.7% of 18- to 25-year-old respondents self-reporting homelessness also reported couch surfing.

The combined incidence rates (shares of respondents reporting first-time youth homelessness and/or couch surfing cases in the last 12 months) were 3.0% for respondents reporting experiences of anyone aged 13–17 in their households, 11.3% for respondents reporting experiences of anyone aged 18–25 in their households, and 8.3% for respondents aged 18–25 self-reporting experiences. These were about half as high as the corresponding prevalence rates.

Follow-up interview results showing different types of identified inclusion errors for different reporting groups are presented in Table 2 . Inclusion errors comprised reports of experiences while accompanied by a parent or guardian (for minors only), misreporting (or misunderstanding) regarding the age or time frame of interest, or, most commonly, reporting apparently safe and normative experiences that did not involve a lack of access to stable housing as couch surfing. The inclusion error rates were substantially lower among respondents reporting explicit homelessness (12%) than they were for respondents who reported couch surfing only (54%). Many couch surfing-only experiences involved normative situations with access to safe and stable housing and needed to be deducted. Inclusion error rates between the three quota groups were fairly similar, although we found a somewhat higher error rate among respondents reporting explicit homelessness for 13- to 17-year-olds than with respondents reporting on 18- to 25-year-olds. Given the small subsamples and general consistency, we applied the inclusion error rates of the overall follow-up interview sample to the final prevalence calculations, reducing the estimates for explicitly reported homelessness by 12% and the estimates for couch surfing only by 54%.

Summary of identified inclusion errors in the follow-up interview sample

Note: This table is based on the full follow-up interview sample (n = 150).

H = homelessness, which includes respondents who responded “yes” to the questions explicitly asking about any youth homelessness, including those who reported both homelessness and couch surfing; C-o = couch surfing only, which includes respondents who responded “yes” to youth couch surfing and “no” to youth homelessness. Safe/normative/stably housed experiences that were interpreted as couch surfing included situations such as staying with friends or relatives recreationally or traveling for recreation or work while having access to a safe and stable living arrangement.

Adjusting for inclusion errors, we estimate that approximately 4.3% of households with 13- to 17-year-olds, and 12.5% of households with 18- to 25-year-olds, had people in those age groups that experienced some form of explicit homelessness and/or couch surfing without safe and stable housing in the last 12 months. Additionally, 9.7% of 18- to 25-year-olds self-reported homelessness and/or couch surfing in the last 12 months. Converted to counts based on ACS data, these estimates translate to approximately 660,000 households with 13- to 17-year-olds, 2.4 million households with 18- to 25-year-olds, and 3.5 million youth aged 18–25. Table 3 provides these results and segmented estimates for explicit homelessness and couch surfing only.

Twelve-month national prevalence estimates adjusting for inclusion errors

Notes: For ages 13–17, the “explicit homelessness” estimates include experiences of having ran away and been asked to leave; for both ages 13–17 and 18–25 it includes “yes” responses to the explicit question on homelessness experiences. The revised estimates for “explicit” use a smaller deduction (12%) because this was the inclusion error rate calculated for this subgroup of experiences based on follow-up interviews. The revised estimates for “couch surfing only” use a larger deduction (54%) because this was the inclusion error rate calculated for this subgroup of experiences, which included a high proportion of experiences that were not couch surfing as a form of homelessness—that is, the young people did not lack a safe and stable place to stay.

For the second research question, we examined whether prevalence rates for rural counties differed from those of nonrural counties, and we investigated the correlations between other covariates and homelessness. Figure 1 displays the explicitly reported homelessness and couch surfing-only household prevalence rates (adjusting for inclusion errors) in rural and nonrural counties for ages 13–17 and 18–25 and the population prevalence rates for 18- to 25-year-olds. In all reporting categories, the percentage of respondents in mostly rural counties reporting youth homelessness was nearly equal to mostly urban counties. In every case, chi-square goodness of fit tests revealed no significant between-group differences ( p > .05).

Prevalence rates in rural versus nonrural counties. Notes: The presented prevalence rates include adjustments for inclusion errors. Rural versus non-rural distinctions are based on U.S. Census data providing the number and percentage of people in each county living in rural and urban areas. Mostly rural means that at least 50% of the county’s population lives in rural areas as classified by the U.S. Census Bureau.

Results of logistic regression indicated that the unadjusted relative risk of experiencing homelessness (denoted here as RR, with 95% CI) was significantly greater for young people who reported the following characteristics: unmarried with children of their own (RR = 3.00; 2.37–3.76); lesbian, gay, bisexual, or transgender (LGBT; RR = 2.20; 1.67–2.89); black or African-American (RR = 1.83; 1.42–2.35); had not completed high school or a general education diploma (RR = 4.46; 3.54–5.57); and annual household income of less than $24,000 (RR = 2.62; 2.10–3.24). Young people of Hispanic origin also had higher risk of experiencing homelessness (RR = 1.32; 1.04–1.67), but the relationship was no longer statistically significant once the model controlled for education and parenthood. Figure 2 includes forest plots depicting relative risk (unadjusted and adjusted RRs) for specific demographic groups.

Logistic regressions for youth homelessness (aged 18–25, self-report). Note: The dependent variable is explicitly reported homelessness (excluding couch surfing only). Unadjusted relative risks (RRs) express associations between homelessness and one other variable only (e.g., female). Adjusted RRs present variable-wise RRs having controlled for all other variables in the model. Diamonds represent the RR while the extending lines on either side of the diamonds represent corresponding 95% CIs. A filled diamond indicates that the RR is statistically significant ( p < .05). An RR of 1.0 means that risk is even between two groups. Each RR represents the difference in risk of having experienced homelessness between the group described by the variable (e.g., females) and its opposite reference group (e.g., males). The reference group for the “younger age group (18–21)” is respondents aged 22–25. Race variables compare to all others, of which the majority are White non-Hispanic (e.g., for Black or African-American, the reference group is all youth who were not Black or African-American). For the unemployed variable, the reference group is all youth who were not unemployed, including those who were employed or who were not in the labor force. Parent (unmarried) = the youth was an unmarried parent; Ann. hh income = annual household income.

This study produced the first national estimates of 12-month prevalence of youth homelessness in the U.S. for ages 13–25. Although they encompass a spectrum of experiences, our prevalence estimates imply a much broader national challenge than do point-in-time counts or public schools data by themselves. If the 2016 Annual Homeless Assessment Report numbers of 3,916 unaccompanied minors and 41,662 youth aged 18–24 [ 23 ], based on nationally aggregated point-in-time counts of youth (including parenting youth), were to be converted to national prevalence rates, these would reflect percentages of less than .02% of 13- to 17-year-olds and .14% of 18- to 24-year-olds on a specific night. Apart from the focus that point-in-time counts have on certain types of homelessness (unsheltered and in shelters or transitional housing), substantial differences are likely due to the facts that our survey captures 12-month prevalence and uses a population-based sampling approach to study a largely hidden and dynamic phenomenon. Our estimates for adolescents also significantly exceed the national public schools count of unaccompanied students (95,032 in the 2014–15 school year [ 14 ]), conceivably because a representative survey approach does not depend on formal reports or school identification of homelessness.

Looking to other representative surveys—only available for adolescents—our estimates are more similar. For example, Ringwalt et al. found a 5.0% 12-month prevalence rate of homelessness among 12- to 17-year-olds in 1992–1993, although this included self-reports (population prevalence) and both accompanied and unaccompanied homelessness [ 9 ]. More recently, local and state estimates of prevalence of unaccompanied homelessness among high school students from representative school-based surveys have ranged from 2.2% to 2.9%, although these were based on a stricter measure of unaccompanied homelessness: typically sleeping somewhere other than home without a parent or guardian over the last month [ 10 ].

Nearly two thirds of youth who reported explicit homelessness also reported couch surfing over the last 12 months. This underscores the fluidity of young people’s arrangements over time. Many youth do not fit squarely into any single type of homelessness experience. Still, a sizable share of the overall prevalence rates also involved couch surfing only without a safe and stable living arrangement. These experiences likely include a wide range of degrees of vulnerability (from lower-risk experiences of leveraging social networks during periods of housing instability to high-risk or exploitative arrangements) [ 15 , 24 ]. Additionally, some couch surfing could function as a precursor to more entrenched homelessness [ 25 ]. Given these complexities, assessments of youths’ circumstances beyond their sleeping arrangement at a given time are important to determining their levels of risk and service needs.

Prior to this study, little was known about how the prevalence of youth homelessness in rural areas compared with nonrural areas. Our results indicate that youth homelessness is equally prevalent in both areas. Tailored policies and programs to address the unique circumstances of youth homelessness in rural communities—such as a lack of service infrastructure and lower visibility due to absence of urban magnet spots that attract youth—may be needed.

Our findings reinforce growing evidence on the heightened risk of experiencing homelessness among LGBT youth [ 26 , 27 ]. Disproportionality of homelessness experiences among black youth mirrors racial disparities documented elsewhere, for example, school suspensions, juvenile justice involvement and sentencing, and foster care placements [ 28 , 29 ]. Furthermore, although Hispanic youth were at higher risk than non-Hispanic youth of experiencing homelessness (and comprised 34% of 18-to 25-year-olds reporting homelessness), only 19% of youth served by federally funded runaway and homeless youth programs in FY 2014 were Hispanic [ 30 ].

One of the strongest risk correlates for homelessness was a lack of a high school diploma or GED. Although we cannot make causal inferences, this finding reinforces the extent to which education, and underlying factors that support educational attainment, might protect youth from becoming homeless. Young parents were also at high risk for homelessness relative to their nonparenting peers, suggesting that more attention should be paid to the relationship between early parenthood and homelessness. The findings also indicate a marked need for coordination among youth and family homelessness service providers, as well as interventions designed with the unique needs of young parents and their children in mind.

Both the scale of youth homelessness experiences (represented by our 12-month prevalence estimates) and the extent of new cases over a 12-month period (represented by our incidence estimates), reinforce the extent to which prevention and early intervention are needed. Downstream interventions to help currently homeless youth gain stable housing and positive transitions to adulthood are vital but insufficient to ending youth homelessness. The extant literature has identified key entry points for advancing prevention, such as with family interventions, school dropout prevention, public systems including child welfare and justice systems, and affordable and subsidized housing [ 31 , 32 ].

A particular strength of this study lies in its methodology, which is replicable and cost-efficient, given that it builds on existing sampling and survey infrastructure and does not require on-the-ground data collection. This enables the option of repeated national estimates over time to track progress toward the Federal Government’s goal of ending youth homelessness [ 33 ]. However, some limitations of the study should be kept in mind when interpreting the results and considering enhancements of future national estimates.

First, because Gallup’s DTS surveys adults, we relied on third-party household reports of experiences of individuals aged 13–17, which could have been influenced by social desirability and recall biases. Second, only household prevalence estimates could be generated for ages 13–17 because the survey module asked about the experiences of any youth in the household, not each 13- to 17-year-old who lived there. To the extent that more than one 13- to 17-year-old in some households had experienced homelessness, this might have resulted in a more conservative estimate of the population size. Conversely, reporting households could have functioned as either “sending” households (from which youth left into homelessness) or “receiving” households (where youth stayed during or after homelessness), and this could contribute to a degree of inflation. Third, we found and corrected for a large inclusion error rate of 54% for respondents reporting couch surfing only, and a much smaller inclusion error rate of 12% for explicitly reported homelessness. A more detailed homelessness and housing module would allow for improved precision of initial prevalence estimates (i.e., fewer inclusion errors), particularly in terms of capturing forms of couch surfing that reflect homelessness. This would be preferable to post hoc deductions based on estimated inclusion errors from a smaller subsample. Finally, sampling biases were possible if youth experiencing homelessness were less likely to have phones or respond to a phone-based survey than their stably housed peers. Yet, this approach is likely preferable to sampling based on mailing or visiting homes for reaching unstably housed youth, and research suggests that many homeless youth are technology-connected [ 34 ]. Nonetheless, this survey likely yields underestimates of homelessness to the extent that it misses young people who lack working cell phones and have been totally disconnected from households that could report on their experiences.

Although individual experiences vary, homelessness and housing instability clearly have adverse consequences for young people and their futures. This effort demonstrates the feasibility of estimating national prevalence and incidence of youth homelessness using a cost-efficient methodology with potential for enhancement and replication to track progress and target solutions to preventing and ending this hidden problem. Our findings reveal that the challenge involves a scale that necessitates greater coordination and resourcing of multiple systems and programs—behavioral and physical health, child welfare, education, employment, housing, justice, and outreach—at local, state, and federal levels to drive these numbers toward zero.

IMPLICATIONS AND CONTRIBUTION

This paper reports U.S. prevalence estimates of unaccompanied youth homelessness for ages 13–25 based on a nationally representative survey. Results suggest that youth homelessness is a significant national challenge and reveal subpopulations at particular risk.

Acknowledgments

This report is the result of a collaboration involving the Voices of Youth Count (VoYC) Policy and Research Team from Chapin Hall and many partners. Certain team members made particularly important contributions to the analysis, including Jenelle Birchmeier. Substantive comments and inputs were kindly provided by Matthew Aronson, Colette (Coco) Auerswald, Brian Chor, Dennis Culhane, Chris Ringwalt, and Bryan Samuels. Jennifer Vidis served as project director and Sonali Patel provided policy insights. External partners who provided methodological advice to this research included the VoYC Technical Advisors and Gallup, Inc., which fielded the survey and contributed additional technical expertise.

The VoYC initiative is made possible through a grant from U.S. Department of Housing and Urban Development Office of Policy Development and Research (PD&R, grant no. RP-16_IL-001) and generous support from Chapin Hall, Arcus Foundation (grant no. G-PGM-1511-1561), Ballmer Group Philanthropy, Campion Foundation, Casey Family Programs (grant no. FY14-1060), Dr. Inger Davis, Elton John AIDS Foundation (grant no. 5202-00-00), Melville Charitable Trust (grant no. 2015-015), and Raikes Foundation (grant no. 281).

1 We use the term “explicit homelessness” rather than the term “literal homelessness” because the latter is generally used to refer specifically to sleeping in places not meant for human habitation, in a homelessness shelter, or in transitional housing. Respondents may or may not have referred to these types of sleeping arrangements when responding “yes” to the question on homelessness experiences.

Conflicts of Interest: The authors have no conflicts of interest to disclose.

Disclaimer: The substance and findings of the work are dedicated to the public. Chapin Hall is solely responsible for the accuracy of the opinions, statements, and interpretations contained in this publication, and these do not necessarily reflect the views of the government or any of Chapin Hall’s partners.

The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

• Research article
• Open access
• Published: 14 November 2019

The impact of interventions for youth experiencing homelessness on housing, mental health, substance use, and family cohesion: a systematic review

• Jean Zhuo Wang 1 ,
• Sebastian Mott 2 ,
• Olivia Magwood 3 ,
• Christine Mathew 4 ,
• Andrew Mclellan 5 , 6 ,
• Victoire Kpade 2 ,
• Priya Gaba 6 ,
• Nicole Kozloff 7 ,
• Kevin Pottie 8 &
• Anne Andermann 9  

BMC Public Health volume  19 , Article number:  1528 ( 2019 ) Cite this article

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Youth often experience unique pathways into homelessness, such as family conflict, child abuse and neglect. Most research has focused on adult homeless populations, yet youth have specific needs that require adapted interventions. This review aims to synthesize evidence on interventions for youth and assess their impacts on health, social, and equity outcomes.

We systematically searched Medline, Embase, PsycINFO, and other databases from inception until February 9, 2018 for systematic reviews and randomized controlled trials on youth interventions conducted in high income countries. We screened title and abstract and full text for inclusion, and data extraction were completed in duplicate, following the PRISMA-E (equity) review approach.

Our search identified 11,936 records. Four systematic reviews and 18 articles on randomized controlled trials met the inclusion criteria. Many studies reported on interventions including individual and family therapies, skill-building, case management, and structural interventions. Cognitive behavioural therapy led to improvements in depression and substance use, and studies of three family-based therapies reported decreases in substance use. Housing first, a structural intervention, led to improvements in housing stability. Many interventions showed inconsistent results compared to services as usual or other interventions, but often led to improvements over time in both the intervention and comparison group. The equity analysis showed that equity variables were inconsistently measured, but there was data to suggest differential outcomes based upon gender and ethnicity.

Conclusions

This review identified a variety of interventions for youth experiencing homelessness. Promising interventions include cognitive behavioural therapy for addressing depression, family-based therapy for substance use outcomes, and housing programs for housing stability. Youth pathways are often unique and thus prevention and treatment may benefit from a tailored and flexible approach.

Peer Review reports

Youth homelessness is a major public health challenge worldwide, even in high income countries [ 1 ]. Youth experiencing homelessness are defined as, “youth between the ages of 13 to 24 who live independently of their parents or guardians, but do not have the means to acquire stable, safe or consistent residence, or the immediate prospect of it [ 2 ].” Youth pathways into homelessness are anomalous and seldom experienced as a single isolated event. Compared to the adult homeless population, youth experiencing homelessness are more likely to report leaving home due to parental conflicts, including: being “kicked out” of the home, abuse (physical, verbal, sexual and other), parental neglect due to mental health problems, or parental substance use [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. The broader context of family dysfunction can lead to youth circumstances that further reinforce situations of homelessness, including desire for separation from unsupportive environments, financial independence, mental health challenges, substance use, and/or run-ins with the justice system [ 1 ].

Not only are youth’s pathways into homelessness different from the adult homeless population, but their experiences on the street are distinct as well. Once homeless, youth are exposed to many dangers and are at a high risk of further trauma [ 12 ]. Youth experiencing homelessness may face a number of daily stressors and have limited coping strategies and resources to deal with these stressors [ 13 ]. Youth homelessness is often invisible and includes vulnerable housing situations such as couchsurfing or staying with relatives [ 14 ]. Furthermore, youth experiencing homelessness are vulnerable to social and health inequities, which describe the fairness in the distribution of health opportunities and outcomes across populations [ 15 ]. Health inequities are differences in health status that are unfair and/or avoidable [ 16 ]. Often, the compounding effect of various stratifying characteristics can result in increased disparities between individuals.

Current research has largely focused on adult populations, with a gap in evidence on interventions for youth experiencing homelessness on a broad range of outcomes. Among the current interventions for individuals experiencing homelessness, non-abstinence contingent permanent supportive housing and case management have shown promising results in terms of improving housing stability and mental health outcomes [ 17 ]. However, youth are a distinct population and they require specifically tailored, context appropriate, equity-focused interventions and research attention [ 18 ]. From systematically searching the literature for youth interventions, this paper will introduce four main categories of interventions applied to youth experiencing homelessness: 1) individual and family therapies (ie. cognitive behavioural therapy, motivational interviewing, etc.) 2) skill building programs, 3) case management, and 4) structural interventions (such as housing support, drop-in centres, and shelters). These interventions are designed to address the complex, multifaceted pathways and contributors to youth homelessness, whether it be addressing substance use issues through motivational interviewing, mental health care through cognitive behavioural therapy, improving unstable family environments through family therapies, increasing access to resources through case management, and enhancing structural support such as income and housing support [ 19 , 20 , 21 , 22 , 23 ]. Given the complexity and interconnectedness of these outcomes, one would hope that these interventions would have an impact on not only the primary outcome, but also extend to other facets of a youth’s life. For instance, family therapies have shown promising results on both family functioning as well as substance use, by addressing the toxic family environment and thereby decreasing its contribution to unhealthy substance use patterns [ 24 ].

Current research on interventions for the population of youth experiencing homelessness lacks a comprehensive synthesis on a broad range of social and health outcomes. The objective of this review is to synthesize the existing scientific literature on interventions for homeless or vulnerably housed youth in high income countries, and assess the impacts of the interventions on housing, mental health, substance use, and family cohesion, with an equity perspective.

We established an expert working group consisting of homeless health researchers, academics, clinicians and youth with lived experience of homelessness to conduct this review. We report our results according to PRISMA-E [see Additional file  3 ] and published an open access protocol on the Campbell and Cochrane Equity Methods website [ 25 , 26 ].

Data sources and search strategy

Without language restrictions, we systematically searched the following databases from inception until February 9, 2018: Medline, Embase, CINAHL, PsycINFO, Epistemonikos, HTA database, NHSEED, DARE, and Cochrane Central. Combinations of relevant keywords and MeSH terms were searched, including “homeless” and “homeless youth” [see Additional file  1 for search strategy]. We hand-searched included studies for primary studies and consulted experts for additional papers. We conducted a grey literature search on homeless health and public health websites.

Inclusion and exclusion criteria

We downloaded citation information into Rayyan online software [ 27 ]. All title and abstracts were screened according to our inclusion criteria (see Table  1 ) in duplicate by two independent reviewers, and any discrepancies were resolved. Throughout a process of several consultations, our working group, consisting of persons with lived experience and experts in the field, helped develop these inclusion criteria by identifying priority areas in which to focus this review. This study focused on youth between the ages of 13 to 24, however, the age categorizations of youth tend to differ between various definitions, with the medicolegal definition utilizing ages 16 to 21. It is important to note that the broader age range utilized in this paper may lead to risks of over-inclusion, but it was chosen as it is reflective of the currently literature on youth homelessness and includes both high school and university students who are generally still dependents living with family or relying on them for financial or moral support.

Data extraction and analysis

Data extraction proceeded in duplicate using a standardized data extraction form and a third reviewer resolved discrepancies [ 25 ]. We extracted data regarding the effectiveness of interventions on a broad range of social and health outcomes. We conducted a scoping exercise to identify key outcome categories in the literature and prioritized reported outcomes with our expert working group members, which included individuals of lived experience. The outcomes rated as being of highest priority (mental health, substance use, housing, and family outcomes) are reported in the body of this paper, and the remaining outcomes (violence, sexual health, personal and social, and health and social service utilization) are reported in the appendix [see Additional file  2 ]. To reduce overlap between single studies and systematic reviews, we reported the results of systematic reviews and supplemented with data from randomized control trials (RCTs) that were not included in the systematic reviews. Due to heterogeneity of interventions and outcomes studied, we qualitatively synthesized the results. We created a forest plot to summarize RCTs for mental health outcomes, as sufficient data were available and it was a highly ranked outcome.

Health equity analysis

We used the PROGRESS+ framework to apply a health equity lens and enable us to identify characteristics that socially stratify youth experiencing homelessness, and various drivers of homelessness [ 15 ]. In particular, we extracted the following from studies to inform our analysis: 1) study rationale for focusing on youth-centred interventions; 2) the measures used to assess differences in outcomes for women and men; 3) the study’s gender-related findings and conclusions; and 4) the study’s incorporation of equity considerations (e.g. race/ethnicity and socioeconomic status).

Critical appraisal

We assessed the methodological quality of systematic reviews with AMSTAR II and RCTs using the Cochrane Risk of Bias Tool [ 28 , 29 , 30 , 31 , 32 ]. When assessing the overall risk of bias of RCTs, we defined the risk of bias as “not serious” when there were low risk ratings in all categories or one or two unclear risk, “serious” with one or two high risk categories, and “very serious” with more than two high risk categories.

The search strategy yielded 11,934 potentially relevant citations. After we removed duplicates, we screened 7499 citations and assessed 103 full text articles. Twenty-two citations met the full inclusion criteria (See Fig.  1 ). Four of the included citations were systematic reviews [ 33 , 34 , 35 , 36 ] and the remaining 18 citations reported on 15 RCTs (see Table  2 for RCTs and Table  3 for SRs) [ 19 , 21 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ].

PRISMA Flow Diagram

Methodological quality of the included studies was low or very low, with serious risk of bias across most included studies (see Fig.  2 for RCTs and Table  4 for SRs). The most common domain with a high level of risk was knowledge of the allocated interventions, as blinding was often not possible or difficult with the nature of the interventions.

Methodological Quality of Included RCTs using Cochrane Risk of Bias Tool

The main categories of interventions applied to youth homelessness included: 1) individual and family therapy (e.g. cognitive behavioural therapy (CBT), motivational interviewing (MI), family therapy), 2) skills building (e.g. life skills, mindfulness), 3) case management and 4) structural interventions (e.g. housing support, drop-in centres, shelters). See Table  5 for the definitions of interventions. The results of RCTs have been summarized using a visual map (see Fig.  3 ).

Visual Summary of Results of RCTs by Outcome

Individual and family therapy

Cognitive behavioural therapy.

CBT led to improvements in substance use and depression, and one systematic review also reported improvements in internalizing behaviours and self-efficacy [ 33 , 34 , 35 , 36 ]. When a CBT-based therapy (community reinforcement approach) was delivered with case management in one study, there were improvements in percentage of days being housed, psychological distress, and substance use [ 33 ]. Two systematic reviews conducted meta-analyses on CBT and CBT-based interventions and found no statistically significant difference in mental health outcomes compared to services as usual, but noted that lack of a statistically significant difference may be due to heterogeneity between studies [ 34 , 35 , 36 ].

Family therapy

Family-based therapy was delivered in an office setting, known as functional family therapy, or in the home setting, called ecologically-based family therapy. Systematic reviews reported that all three family therapy RCTs showed a reduction in substance use [ 34 , 35 , 36 ]. However, Noh (2018) conducted a subgroup meta-analysis on two family intervention studies and found no significant effect on substance use [ 34 ]. Another meta-analysis found a statistically significant improvement in family cohesion, but called it a clinically marginal effect [ 36 ]. In a three arm RCT comparing home-based family therapy with MI and a CBT-based therapy, all three groups improved over time in internalizing and externalizing behaviours, family cohesion, and substance use [ 47 , 48 , 49 ]. Furthermore, when an RCT compared functional family therapy, home-based family therapy, and services as usual, all treatments showed improvements in days living at home at three, nine and 15 months, but no group was superior to another [ 52 ].

Motivational interviewing

Brief or group MI interventions were primarily designed to address substance use and/or risky sexual behaviours. A brief intervention showed declines in non-marijuana drug use at 1-month follow up, but the reduction was no longer significant after 3 months [ 33 , 34 , 35 ]. In another RCT, both the service as usual and intervention groups showed significant improvements over time, but there were no significant and durable results in favour of the experimental group [ 21 ]. A 16-week group MI intervention found significant declines in alcohol use and increased motivation to change drug use, but no significant decreases in marijuana use [ 37 ]. A two-session individual brief MI intervention compared to an education program reported significant improvements in readiness to change alcohol use [ 38 ].

Skill building

The interventions focused on vocational and life skills, mindfulness, and strengths-based skill building. One systematic review included one study evaluating a life skills intervention and found improvements in family contact and near significant improvements in depressive symptoms [ 33 ]. Another systematic review reported similar results but noted an increase in substance use over 6 months which could not be explained [ 35 ]. A training program based on a peer influence model showed non-statistically significant decreases in drug use in the treatment group. One study evaluated a strengths-based program deployed in a shelter to identify and make use of strengths in each youth [ 39 ]. This program showed no significant differences between groups but found improvements over time in depression, substance use, and satisfaction with family relations [ 39 ]. Two RCTs evaluated a vocational and life skills program and a mindfulness skills program, though did not report promising treatment effects [ 40 , 41 , 42 ].

We attempted to conduct meta-analyses whenever possible, but due to the heterogeneity between studies, it was inappropriate to pool the results into a combined effect size. As such, we developed a forest plot for short-term mental health outcomes of a mindfulness intervention, CBT intervention, strengths-based intervention, and CBT-based intervention [ 39 , 42 , 50 , 51 , 52 , 53 ]. The figure depicts a general trend favouring the interventions but none reaching statistical significance compared to control (see Fig.  4 ).

Intervention vs. Usual services for Short Term (0-6 months) Mental Health Outcomes)

Case management

Two systematic reviews reported on several case management programs, including intensive case management and multidisciplinary case management, and reported minimal additional benefit of the programs relative to their comparison interventions [ 33 , 34 , 35 ]. They noted that one program showed favourable results for substance use, but the study quality was very low due to low retention rates [ 33 ]. In a three-arm RCT, case management, a CBT-based intervention, and MI all showed significant improvements over time in housing stability, depression, and substance use, but no significant differences between groups [ 45 ]. Case management led to improvements over time in internalizing behaviours while the other groups did not [ 45 ]. Overall, there is evidence to suggest that case management may have impacts on substance use, depression, and housing stability, but different control conditions in each of the studies made it difficult to assess overall effectiveness of the intervention.

Structural support

Housing programs.

A subgroup analysis of young adults in an RCT of the housing first model for adults with mental illness found that, compared to treatment as usual, housing first significantly increased the proportion of days stably housed over the 24-month trial, but had no impact on self-rated mental health [ 43 ]. One systematic review included an independent living program and reported marginal results on psychological measures, however reported some positive outcomes on housing status [ 33 ]. The same systematic review also included a study evaluating a supportive housing program, which reported lower rates of substance abuse and improvements in self-reported health, but the study quality was noted to be low. Xiang evaluated the same supportive housing program and also concluded that the lower rates of substance use may be attributed to baseline differences between control and intervention groups instead of treatment effect [ 35 ].

Drop-in and shelter services

A systematic review included three shelter services studies, two evaluating residential services and one evaluating emergency shelter and crisis services [ 35 ]. The review showed some improvements in substance use but this was not consistent over the various studies and there were no enduring effects over time. An RCT compared referrals from case management made to drop-in versus shelter services programs [ 44 ]. There were no differential treatment effects, as both groups showed decreases in depression and substance use over time [ 44 ]. However, individuals assigned to the drop-in service had greater service contacts and access to care over 6 months [ 44 ].

Gender and equity analysis

Equity variables were not consistently measured, reported, or analyzed across studies. Several studies measured equity and PROGRESS+ factors with baseline sample characteristics, but very few included them as covariates. The most examined factors were gender and ethnicity/race, with some studies mentioning place of residence and occupation. A number of RCTs included equity variables in their analysis [ 21 , 37 , 39 , 40 , 41 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ], as did three systematic reviews [ 34 , 35 , 36 ].

A number of studies indicated that females responded differently to services than males. Slesnick’s studies have showed that females initially reported higher rates of depression than males, with a greater reduction throughout the study [ 44 , 45 , 46 ]. Female adolescents showed a greater improvement in family cohesion subsequent to treatment regardless of the treatment condition [ 47 ] and appeared to derive greater benefit from shelter services than males [ 35 ].

Some variance in relation to ethnicity and employment emerged as well. While youth from ethnic minorities had greater reductions in substance use, they also relapsed more quickly than white youth [ 49 ] and had more HIV risk behaviours [ 44 ]. African Americans showed a greater reduction in percent days homeless than other ethnic groups [ 45 ]. Non-Hispanic white youth more quickly reduced their number of days drinking to intoxication [ 44 ]. Those employed or in school at baseline were more likely to remain employed at follow-up [ 39 ].

This review identified a wide variety of interventions for youth experiencing housing instability. Regarding individual and family therapies, CBT interventions showed improvements in depression and substance use outcomes [ 33 , 34 , 35 , 36 ]. Family interventions led to improvements in alcohol and drug use measures and may have had an impact on family cohesion [ 34 , 35 , 36 ]. Motivational interviewing, skill-building programs and case management showed inconsistent effects on mental health and substance use when compared with services as usual and other interventions [ 21 , 33 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 45 , 46 , 47 , 48 , 49 ]. Among the structural support interventions, housing first led to improved housing stability outcomes, while drop-in and shelter services led to inconsistent effects [ 43 , 44 ]. The equity analysis revealed differential treatment effects based upon gender and ethnicity, with females often deriving more treatment benefit than males [ 44 , 45 , 47 , 48 , 49 ]. Equity analyses were limited, with very little mention of important considerations such as sexual orientation status, as LGBTQ+ youth are disproportionately represented in the homeless population [ 58 , 59 ].

While in many circumstances, differences were not statistically significant between treatment groups, this does not preclude the lack of effectiveness of these interventions. It is important to note that a treatment as usual group was not the absence of an intervention, but rather involved referral to other community services and follow-up with researchers. This may lessen the differences between the intervention and control arms, and decrease the detectable effect of the intervention. Providing non-specific support for youth may be enough to improve outcomes and reduce the toxic effects of adverse childhood experiences. However, that regression to the mean may also potentially explain the changes observed over time [ 60 ]. As participants may enter the research studies during a point of crisis, they may naturally improve over time regardless of the study group, and this effect may lessen the observed differences between intervention and control groups.

Tailoring interventions to the needs of youth

The dynamics of youth homelessness are complex; pathways to housing are precarious, sociocultural backgrounds are becoming increasingly diverse and available resources are inconsistent. Research has shown that unstable family relationships underlie youth homelessness, and many youth have left homes where they experienced interpersonal violence and abuse [ 3 , 4 , 5 , 61 ]. Among these difficult family issues, other personal factors arise as a result of their environmental contexts, which can interplay and lead to increased distress. These challenges include substance use, depression, and disability, and can compoundly contribute to strain [ 10 ]. The interventions identified in this review may help to address the specific needs of youth and may be tailored to their situation.

One important consideration to note is that while we have defined youth as those ages 13 to 24 for the purposes of this study, this grouping brings together minors as well as young adults of legal age. While this age categorization is reflective of the literature on the youth population, we recognize that there are differences between the experiences of younger versus older youth. Furthermore, there are medicolegal implications of the mature minor and capacity to consent. Clinicians and program implementers who work directly with this population need to consider the ethical considerations of consent for treatment participation with mature minors as well as the legal obligations provided by their governing college [ 62 ].

Strengths and limitations of the review

We conducted a high quality search, complying to PRISMA-E guidelines [ 26 ]. This review included only high quality study designs: RCTs and systematic reviews. This may, however, have limited the types of interventions that were included. Limitations include a broad range of outcomes and, thus, too few studies available for meta-analyses. There was heterogeneity in the interventions, and the available evidence was insufficient to use network meta-analysis to answer the question of the relative advantages of the different types of interventions. In our systematic review, the studies did not use placebo designs and, instead, used several different interventions/comparisons. However, there was considerable heterogeneity in the outcome measures and this prevented a pooling of the effects. The services-as-usual comparisons were often not adequately described in the primary studies, limiting the comparisons that could be made across different studies. Furthermore, our definition of youth experiencing homelessness focused on unaccompanied youth and did not include accompanied youth that enter homeless situations along with their families, as this youth population has quite distinct circumstances and needs.

Implications for future research, policy, and practice

The results suggest that tailored interventions for youth may have impacts on depression, substance use and housing. Given the diverse pathways to youth homelessness, health care policy-makers, practitioners and other stakeholders should consider the specific needs of youth during prevention and delivery of care. Furthermore, we recommend additional high quality research to be conducted in the area of family-based therapies, CBT, and housing interventions, which have shown some positive results thus far. We further recommend additional considerations for equity factors. Few studies examined equity factors, and those that did were limited largely to gender and ethnicity. There remains a large gap in data regarding the intersectionality between a variety of PROGRESS+ factors contributing to youth experiences.

There is also a large gap in research on the impact of structural interventions such as housing and case management on youth experiencing homelessness. The predominance of psychological and family interventions in this paper suggests that more work could be done to study an area in which it may be more difficult to design studies. Nonetheless, future research on these interventions are important to addressing the root causes of poverty and homelessness. Furthermore, there are emerging models of housing which have not yet been evaluated rigorously in the literature. For instance, host homes provide safe and temporary housing for up to 6 months for youth while supporting them with a case manager to identify long term solutions [ 63 ]. Rapid re-housing programs provide short-term subsidies to allow persons experiencing homelessness to acquire stable housing as quickly as possible [ 64 , 65 ]. The landscape on housing models continues to evolve and future research will need to evaluate these in the context of youth experiencing homelessness.

This review identifies a variety of interventions targeted towards the unique needs of youth experiencing homelessness. CBT interventions may lead to improvements in depression and substance use, and family-based therapy may impact substance use and family outcomes. Housing programs may lead to improvements in housing support and stability. Other interventions such as skill building, case management, show inconsistent results on health and social outcomes.

Availability of data and materials

Not applicable.

Abbreviations

A MeaSurement Tool to Assess systematic Reviews

Cognitive Behavioural Therapy

Motivational Interviewing

Preferred Reporting Items for Equity-Focused Systematic Reviews and Meta-analyses

Place of Residence- Race/ethnicity/culture/language- Occupation- Gender/sex- Religion- Education- Socioeconomic status- Social capital + refers to: 1) personal characteristics associated with discrimination (e.g. age, disability). 2) features of relationships (e.g. smoking parents, excluded from school). 3) time-dependent relationships (e.g. leaving the hospital, respite care, other instances where a person may be temporarily at a disadvantage)

Randomized Control Trial

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Acknowledgements

Nicole Pinto for expert data extraction and critical appraisal.

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This study was funded by the Inner City Health Associates. ICHA was not involved in conducting the study including study design, data collection, analysis, interpretation, and writing the manuscript.

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Wang, J.Z., Mott, S., Magwood, O. et al. The impact of interventions for youth experiencing homelessness on housing, mental health, substance use, and family cohesion: a systematic review. BMC Public Health 19 , 1528 (2019). https://doi.org/10.1186/s12889-019-7856-0

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Youth Homelessness: A Global and National Analysis of Emerging Interventions for a Population at Risk

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This chapter analyzes national and global research and policies for serving homeless youth, including the causes and consequences of youth homelessness. The chapter will identify best practices for locating, assessing, interviewing, and intervening with homeless youth in order to meet their needs. This chapter will also help to prepare students for participating in social work research, engaging in policymaking processes, and working with agencies and organizations invested in the continued development of best practices. The information presented assists readers in becoming more well-rounded practitioners to advocate for and intervene with homeless youth.

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Kominkiewicz, L., Kominkiewicz, F.B. (2019). Youth Homelessness: A Global and National Analysis of Emerging Interventions for a Population at Risk. In: Larkin, H., Aykanian, A., Streeter, C.L. (eds) Homelessness Prevention and Intervention in Social Work. Springer, Cham. https://doi.org/10.1007/978-3-030-03727-7_15

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Preventing and Ending Youth Homelessness in America

A thrive by 25 ® brief.

Not all young people have the benefit of growing up in a safe and stable home. In fact: Across America, 1 in 30 youth between the ages of 13 to 24 and 1 in 10 young adults between the ages of 18 to 25 will experience homelessness over the course of a year. This scenario — which occurs during an important developmental period — can inject trauma into a young person’s life, limit their growth and carry costly community consequences.

The Annie E. Casey Foundation and Youth Homelessness

In recognition of these challenges, the Annie E. Casey Foundation is joining partners in the field, such as Funders Together to End Homelessness, to ensure that young people have safe, stable housing access to meaningful educational and economic opportunities.

This brief, released by the Foundation, shares facts about youth homelessness in America. It also reviews the nation’s current response to youth homelessness, the risks that young people face when homeless, and what leaders can be doing to prevent and end housing instability among young people today.

Funding, Policy and Practice Recommendations on Youth Homelessness

To ensure that all young people have a safe and stable place to live and the resources needed to thrive and grow into adulthood, the Foundation makes the following recommendations:

• develop a unified definition of youth homelessness;
• focus on prevention;
• target funding to basic needs and other youth homelessness risks;
• support cross-systems partnerships;
• advance equity;
• elevate youth voices;
• transform the justice system response; and
• help young people leaving foster care prepare for adulthood.

About the Thrive by 25 Series

The document kicks off a series devoted to highlighting both the challenges and opportunities facing youth ages 14 through 24. It is also part of the Casey Foundation’s Thrive by 25® efforts, which are a set of investments focused on promoting basic needs, permanent connections, education and credentials, financial stability and youth leadership for young people.

Findings & Stats

Millions of youth affected.

About 3.5 million young adults ages 18 to 25 and 700,000 youth ages 13 to 17 experience some form of homelessness in a given year, according to Chapin Hall, an independent, nonpartisan policy research center at the University of Chicago.

The Risk of Homelessness Varies

Not all young people experience homeliness at the same rate. Youth who are Black (83% higher), LGBTQ (120% higher) and non-white Hispanic (33% higher) all experience greater rates of homelessness.

Wanted: A Unified Definition of Homelessness

Establishing a unified and inclusive definition of youth homelessness is key. Such work makes data collection, sharing and analysis easier across systems and also helps to improve how quickly and effectively these systems can identify and support youth in need.

Statements & Quotations

Because of differing definitions of homelessness and research methodologies, no single data source paints a complete picture of youth homelessness within the United States.

A youth homelessness response focused almost exclusively on crisis intervention results in missed opportunities to prevent homelessness and its compounding harmful effects for millions of young people each year.

Key Takeaway

Unstable, unsafe housing situations sets youth on a pathway to greater trauma, risk and instability.

Youth experiencing homelessness on their own are more likely than their peers in the general population to endure threats to their health, safety and well-being. These threats include:

• missing school, resulting in higher rates of dropping out, poverty and involvement in the criminal justice system;
• struggling with mental health issues, including suicidal thoughts and suicide attempts;
• abusing alcohol or drugs;
• being physically assaulted;
• being sexually assaulted;
• being trafficked for sex or labor; and
• resorting to “survival crime,” including selling drugs, stealing and exchanging sex for basic needs.

Subscribe to our newsletter to get our data, reports and news in your inbox.

Youth and Young Adults

Updated December 2023.

How Many Youth Are Homeless?

On a single night in 2023 :

• 34,703 unaccompanied youth were counted as homeless. Of those, 90.6 percent were between the ages of 18 to 24. The remaining 9.3 percent (or 3,240 unaccompanied children) were under the age of 18.
• 40.8 percent of homeless youth are unsheltered — sleeping outside, in a car, or some place not meant for human habitation.

These numbers are imprecise, and the single night number is likely an undercount. The most commonly quoted number of homeless youth under the age of 18 comes from the National Incidence Studies of Missing, Abducted, Runaway and Thrownaway Children (NISMART). According to the NISMART, while over 99 percent of youth eventually return home, many remain away from home for over one week and some remain gone for over one month. Communities are working to improve the way they collect data and their Point-In-Time Counts in order to more accurately reflect the numbers of unaccompanied young people experiencing homelessness.

What Causes Youth Homelessness?

Youth homelessness is often rooted in family conflict. Other contributing factors include economic circumstances like poverty and housing insecurity, racial disparities, and mental health and substance use disorders. Young people who have had involvement with the child welfare, foster care, and juvenile justice systems are also more likely to become homeless.

Many homeless youth and young adults have experienced significant trauma before and after becoming homeless and are particularly vulnerable, including victims of sexual trafficking and exploitation. Youth who identify as LGBTQIA+; pregnant and parenting youth; youth with special needs or disabilities, and youth of color, particularly African-American and Native American youth, are also more likely to become homeless.

Ending Homelessness for Youth and Young Adults

To end their homelessness , youth and young adults need stable housing, supportive connections to caring adults, and access to mainstream services that will place them on a path to long-term success. Reunifying youth with family or a support system, when safe and appropriate, should be at the core of any approach. Young adults may also require broader education and employment supports, and may need more low-barrier short- and long-term housing options, including rapid re-housing .

• Prioritize family reunification or support as the initial intervention for youth experiencing homelessness. Most youth return home to family, and programs interacting with youth can facilitate that process when safe and appropriate. Basic Center Programs already prioritize this, but other youth-serving programs and coordinated entry systems should also adopt it as an initial focus. Family intervention could also be done earlier to avoid a young person separating from their family altogether.
• Improve the crisis response to serve both youth and young adults. A larger investment is needed from federal, state, and local governments to prevent youth from sleeping on the streets and to more quickly facilitate their reunification with family when possible. In the meantime, communities should also consider alternative models to house youth in crisis so that no young person remains unsheltered, such as more flexible shelter responses, the new CoC TH-RRH joint component , or host homes .
• Expand the reach and effectiveness of housing programs for homeless young adults. More needs to be done to provide youth with short- and long-term housing options when reunification with family is not possible. Rapid re-housing is being effectively tailored for young adults around the country. Available permanent supportive housing programs should be prioritized only to the most vulnerable youth who have demonstrated a need for the most intensive interventions to successfully exit homelessness.
• Developing an effective systemic response. Youth and young adults that are experiencing homelessness have not historically been served within a single, coordinated system. Collaboration across federal, state and local partners is crucial to providing a coordinated community response and the full range of solutions youth require.

Make Rapid Re-Housing Part of Your Community's Solution for Youth

Rapid Re-Housing for Youth is a six-part webinar series designed to help communities learn more about the intervention and how it can be used to end and prevent youth homelessness.

Practice Knowledge Project

Explore the findings and learn from a diverse group of homeless youth practitioners about best practices in preventing and ending homelessness among youth.

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Home > Topics > Homeless Youth: A Vulnerable Population

Infographics

Homeless Youth: A Vulnerable Population

Health Equity / Health Care Coverage / Social Determinants of Health

Published on: May 04, 2021.

4.2 million

youth and young people experience homelessness every year

About this Data Insights

Each year, an estimated 4.2 million youth and young adults experience homelessness in the United States. Every night, thousands of young people experience homelessness without a parent or guardian - going to sleep without the support and stability of a family or a home. Among homeless youth, 40% identify as LGBTQ and they have more than twice the risk of being homeless than their heterosexual peers.

This infographic explores youth homelessness, risk factors for becoming homeless, the health toll associated with being homeless, and what can be done to address this crisis.

Call 1-888-373-7888 or text HELP or INFO to BeFree (233733). The mission of the National Runaway Switchboard is to help keep America's runaway and homeless youth safe and off the streets.

National crisis line for runaway, homeless and at-risk youth. Free, confidential, 24/7 support for youth in crisis. Call: 1-800-786-2929 Chat: http://1800RUNAWAY.org

What Is the State of Youth Homelessness in the US?

4.2 million youth experience homelessness every year : Chapin Hall at the University of Chicago - Voices of Youth Count, Missed Opportunities: Youth Homelessness in America - National Estimates, November 2017 Homeless youth on a single night in January : The U.S. Department of Housing and Urban Development, The 2020 Annual Homeless Assessment Report to Congress, January 2021

NOTE: Unaccompanied Homeless Youth: are people in households with only children who are not part of a family with children or accompanied by their parent or guardian during their episode of homelessness

Over half of homeless youth are unsheltered : Chapin Hall at the University of Chicago - Voices of Youth Count, Missed Opportunities: Youth Homelessness in America - National Estimates, November 2017

NOTE: Unsheltered Homelessness refers to people whose primary nighttime location is a public or private place not designated for, or ordinarily used as, a regular sleeping accommodation for people

Experiencing homelessness for the first time : The U.S. Department of Housing and Urban Development, The 2020 Annual Homeless Assessment Report to Congress, January 2021

1 in 30 youth experience homelessness in a given year : Chapin Hall at the University of Chicago - Voices of Youth Count, Missed Opportunities: Youth Homelessness in America - National Estimates, November 2017

African Americans and indigenous people are overrepresented : The U.S. Department of Housing and Urban Development, The 2020 Annual Homeless Assessment Report to Congress, January 2021

Why Are Youth Experiencing Homelessness?

Family conflict the major reason for being homeless : Congressional Research Service, Runaway and Homeless Youth: Demographics and Programs, April 26, 2018

Reasons for family conflict : Congressional Research Service, Runaway and Homeless Youth: Demographics and Programs, April 26, 2018 LGBTQ young people are 120% more likely to experience homelessness : Chapin Hall at the University of Chicago - Voices of Youth Count, Missed Opportunities: Youth Homelessness in America - National Estimates, November 2017

Up to 40% of homeless youth identifies as LGBTQ : True Colors United, Serving Our Youth: Service Provider Survey & Report, June 2015

Families react similarly across racial/ethnic groups : Merighi JR, Grimes MD. Coming Out to Families in a Multicultural Context. Families in Society . 2000;81(1):32-41

Primary reasons for LGBTQ homelessness : True Colors United, Serving Our Youth: Service Provider Survey & Report, June 2015

What Is the Health Toll of Being Homeless?

Lifetime prevalence of psychiatric disorders : Edidin, J. P., Ganim, Z., Hunter, S. J., & Karnik, N. S. (2012). The Mental and Physical Health of Homeless Youth: A Literature Review. Child Psychiatry & Human Development, 43(3), 354–375. November 2011

Homeless youth higher health risks : SAMSHA, Current Statistics on the Prevalence and Characteristics of People Experiencing Homelessness in the United States, July 2011

Higher rates of HIV : Logan JL, Frye A, Pursell HO, Anderson-Nathe M, Scholl JE, Korthuis PT. Correlates of HIV risk behaviors among homeless and unstably housed young adults. Public Health Rep. 2013;128(3):153-160. doi:10.1177/003335491312800305

Life expectancy of people experiencing homelessness : National Health Care for the Homeless Council, Homelessness & Health: What’s the Connection?, February 2019

Homelessness & health connection : National Health Care for the Homeless Council, data from Health Center Patient Survey (HCPS) 2009 shared in the Homelessness & Health: What’s the Connection? report, February 2019

Reunifying families : National Alliance to End Homelessness, Youth and Young Adults, April 2021

What Are Some Strategies To Combat Youth Homelessness?

Family Acceptance Project : Family acceptance project

Existing systems can help prevent youth homelessness : Raikes Foundation

Ensuring access to shelters and lowering barriers to housing : Raikes Foundation

Ensuring providers are equipped and trained to help LGBTQ homeless youth : True Colors United

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Report Youth Homelessness Overview

Easily browse the critical components of this report…

Each year, an estimated  4.2 million youth and young adults  experience homelessness in the United States, 700,000 of which are unaccompanied minors—meaning they are not part of a family or accompanied by a parent or guardian. These estimates indicate that approximately one in 10 adults ages 18 to 25, and one in 30 youth ages 13 to 17 will experience homelessness each year.

This is likely an undercount due to varying definitions of homelessness and challenges with contacting unhoused people, particularly unhoused youth. Homelessness is often hidden among youth and young adults since many are not in shelters and may transition between temporary sleeping arrangements with friends or acquaintances. National survey data reflects that homelessness affects youth living in rural, suburban and urban communities at similar rates.  

Youth homelessness is a complex issue that intersects with multiple public and private entities. To deliver effective services for youth experiencing homelessness, state legislators can consider coordinating with municipal governments and others including state agencies, advocates, legal and health care professionals, philanthropic organizations, people who have experienced homelessness and other stakeholders.

Key Takeaways

Many youth experiencing homelessness who have been in foster care consider their experience in the foster system as the beginning of their homelessness.

According to the  National Sexual Violence Resource Center , one in three teens on the street will be lured into prostitution within 48 hours of leaving home.

States have addressed the intersection between youth homelessness and juvenile justice involvement in many ways, including redefining status offenses, decriminalizing the survival aspects of being homeless (e.g., sleeping in public) and regulating how youth are discharged from the juvenile justice system.

Modal title

Definitions .

Accurately defining the issue of youth homelessness is a challenge. The defined age ranges for a “youth” or “young adult” vary across and within federal agencies and state governments. This makes it difficult to accurately measure the scope of and response to youth experiencing homelessness.

Federal Definitions

The Department of Housing and Urban Development applies a specific categorical definition to unaccompanied youth under age 25. The  Runaway and Homeless Youth Act , used in connection with assistance programs administered by the U.S. Department of Health and Human Services, defines homeless youth as unaccompanied individuals under age 21. The Department of Education, however, provides resources to students experiencing homelessness and determines eligibility based on the definition outlined in the McKinney-Vento Homeless Assistance Act .

McKinney-Vento defines homeless youth more broadly and without a specific age range. Specifically, it defines homeless children and youths as individuals who lack a fixed, regular and adequate nighttime residence, and includes children and youths who: 

• Share the housing of others due to loss of housing, economic hardship or a similar reason. 
• Live in motels, hotels, trailer parks or camping grounds due to the lack of alternative adequate accommodations. 
• Live in an emergency or transitional shelters or are abandoned in hospitals. 
• Have a primary nighttime residence that is a public or private place not designed for nor ordinarily used as a regular sleeping accommodation for human beings; or live in cars, parks, public spaces, abandoned buildings, substandard housing, bus or train stations, or similar settings. 
• Who are migratory children living in one of the above circumstances. 

State Definitions  

States also define youth homelessness in various ways, many of which determine whether youth can access services. Some states define runaway youth, homeless children, homeless youth and homeless persons separately, while other states do not define homelessness at all. In addition, the age range between which youth are considered homeless varies. 

Homeless Youth  

According to a report by the National Law Center on Homelessness and Poverty and the National Network for Youth, at least 23 states  explicitly define the terms homeless child, homeless youth, homeless minor or homeless student. At least 12 states define the term youth and at least 19 states specifically define the term runaway, habitual runaway or chronic runaway. Some states’ definitions mirror or refer to the McKinney-Vento Act and include children who are sharing housing with others due to economic necessity, while other states mirror or refer to the Federal Runaway and Homeless Youth Act’s definition of homeless youth.

Runaway Youth  

Research  shows that almost 7% of youth, or 1.5 million children and adolescents, run away each year. Youth most often run away from home and become homeless due to family conflicts, abuse and/or neglect. At least 19 states explicitly define the term “runaway” in both criminal and civil statutes.

Risk Factors and Vulnerable Populations  

During adolescence, the brain grows and changes in significant ways, transitioning from childhood to adulthood. This stage of rapid brain development is shaped through thinking, planning, learning and acting and is dependent on experiences and opportunities. Peer relationships become more valuable, youth explore identity and autonomy and examine risks and rewards. Youth and young adults thrive with supportive relationships and in safe environments. The lack of these supports can contribute to youth and young adult homelessness.  

The Congressional Research Service identified a youth’s sexual orientation, school problems, pregnancy and substance use as primary risk factors for family conflict or disagreement. Family conflict is most often cited as the reason youth give for their homelessness or episodes of running away. The report notes that females are more likely than males to run away, and among white, Black and Hispanic youth, Black youth have the highest rates of running away.  

The Voices of Youth Count was established to better understand the gaps and scope of youth experiencing homelessness. The study found that while youth across all backgrounds and upbringings can become homeless, certain demographics are more susceptible. People of color, people who identify as LGBTQ+ and young parents disproportionately experience youth homelessness at higher rates. Native American youth have more than double the risk of experiencing homelessness compared to other youth. LGBTQ+ youth experience a 120% higher risk of becoming homeless after coming out to their families. Additionally, a person’s identity can intersect with multiple demographic categories and put them at an even higher risk of homelessness. 

All homeless youth, due to their unstable housing and a lack of a safe, caring adult, are inherently vulnerable to their surroundings. Youth in or aging out of foster care and youth involved in the juvenile justice system are even more vulnerable to the dangers of homelessness. 

Youth In or Exiting the Foster Care System  

According to the National Foster Youth Institute , over 250,000 children enter foster care each year and more than 23,000 youth age out annually. Children in foster care face multiple factors that increase their risk of homelessness, including age, the number of foster care placements, history of running away from placements and time spent in a group home or institutional setting. Many youth experiencing homelessness who have been in foster care consider their experience in the foster system as the beginning of their homelessness. They describe their experience as part of a larger pattern of instability, bouncing from foster home to group home, running away, back to another foster home or back home with their parents.

Finding safe and stable housing can be challenging in and of itself, and often is greater for youth exiting the foster care system due to interrelated disparities, including lack of financial support, lower educational attainment and limited employment opportunities. The National Youth in Transition Database collects information about the housing outcomes of youth who have aged out of foster care. The data illustrate an interconnected relationship between homelessness and readiness indicators (e.g., a high school diploma, enrolled in school or employment by age 21). Youth who demonstrated indicators of readiness were less likely to experience homelessness compared to those without the same indicators, and youth who experienced homelessness after the age of 17 were less likely to be ready for successful independent living. 

Older youth in foster care can benefit significantly from staying in foster care beyond age 18. Known as extended foster care, this is an option implemented by some states to lessen the risk of homelessness. This provides young adults with the opportunity to receive services and establish permanent connections with supportive adults prior to leaving the foster care system. 

The federal Family First Prevention Services Act was enacted in 2018 to overhaul child welfare systems and focus resources on preventing child maltreatment and reducing the use of congregate care. The law also created an opportunity for state policymakers to bolster services for youth experiencing homelessness. 

Family First allows states to use Title IV-E funding for services that reduce the need for out-of-home placements. Title IV-E funds can also be spent on prevention services, including mental health programs, substance use treatment and parenting skills courses. 

For example, the Minnesota legislature allocated Title IV-E funds to the Department of Human Services in collaboration with Hennepin County, YMCA, YouthLink and the Youth Law Project. Funds were used to create Project Minor Connect, a pilot program to assist youth ages 15 to 17 experiencing homelessness or at risk of becoming homeless. Project Minor Connect conducts individual needs assessments, helps youth access housing and provides family reunification supports. Minnesota’s Department of Human Services is required to report to the legislature about the project and the ongoing needs of youth experiencing homelessness. 

Additionally, Family First extends eligibility for the Chaffee Program to 23-year-olds, instead of the previous limit of 21—cultivating a stronger foundation for young adults to have a successful transition into independent living. 

Youth In or Exiting Juvenile Justice System  

The Voices of Youth Count found that  46% of youth  who experienced homelessness had also been in a juvenile detention facility, jail or prison compared with only 15% of the general population. Homeless youth who had been in foster care also had a greater likelihood of being involved in the juvenile justice system and were more likely to identify as LGBTQ+. These youth were also less likely to be in school or employed and more likely to be receiving SNAP benefits.  

Youth who have been in the juvenile justice system have an  increased likelihood  of experiencing homelessness. Similarly, once youth are homeless, they are more likely to encounter the juvenile justice system. Further, having a juvenile delinquency record often makes it more difficult to find employment post-incarceration, and without employment, youth and young adults often find themselves homeless again. 

Youth who are homeless often become involved with the juvenile justice system due to status offenses—situations that would not be illegal, but for their age—such as breaking curfew or running away. Youth are also arrested for status offenses, often associated with survival, such as sitting or sleeping in a public location. States have addressed the intersection between youth homelessness and juvenile justice involvement in many ways, including redefining status offenses, decriminalizing the survival aspects of being homeless (e.g., sleeping in public) and regulating how youth are discharged from the juvenile justice system.

Lack of transition planning increases the risk of youth becoming homeless upon release from the juvenile justice system. The Coalition for Juvenile Justice has identified key components to a successful transition plan for youth exiting the juvenile justice system, including housing, access to vital documents, educational and employment support, life skills coaching, mentoring, healthcare services, legal aid and help with strengthening personal relationships.

Adverse Impacts  

Like many complex social problems, it can be challenging to differentiate the causes of youth homelessness from the consequences of homelessness. Many of the risk factors for youth and young adult homelessness are also adverse impacts of experiencing homelessness, including mental illness, substance use and abuse, expectant and parenting youth, criminal activity and victimization. Moreover, youth who have experienced homelessness generally have much higher rates of early death than their stably housed peers. Suicide is the leading cause of death for unaccompanied youth without shelter.   

Children who experience homelessness are also more likely to experience homelessness in adulthood. Approximately 1.1 million children had a young parent experiencing homelessness. Therefore, the experience of homelessness potentially impacts both current and future generations. The Voices of Youth Count found that 44% of young women between the ages of 18 and 25 are pregnant or a parent, while 18% of young men between the ages of 18 and 25 have a pregnant partner or are a parent. 

Human Trafficking  

Human trafficking is a major vulnerability for homeless youth. According to the  National Sexual Violence Resource Center , one in three teens on the street will be lured into prostitution within 48 hours of leaving home. Youth who are homeless struggle to survive, and trading sex for money, food or a place to sleep can lead to human trafficking.

The National Network for Youth estimates that 20% of runaway and homeless youth are survivors of human trafficking and that 68% of the youth who had either been trafficked or engaged in survival sex had done so while homeless. Further, LGBTQ+ youth and former foster youth are subjected to human trafficking at higher rates than other homeless youth. 

The National Center for Missing and Exploited Children estimates that  one in six of the nearly 25,000 youth reported to them as runaways in 2022 were sex trafficking victims, and approximately 88% of those youth were in foster care or the child welfare system when they went missing.  

States have addressed human trafficking of minors with a variety of laws , including criminal penalties, judicial protections, funds and services, administration and cooperation, and awareness and regulation.

Systems Coordination  

The complex nature of youth homelessness makes it unlikely any single government entity could effectively meet the challenge of ending youth homelessness. Coordinating across levels of government will be necessary.

Local governments face the direct, day-to-day impacts of youth homelessness and provide an essential perspective for state policymakers. Many laws that impact youth experiencing homelessness are decided at the municipal level, including allocation of funding, criminalization of activities stemming from homelessness and access to sanitation services for unhoused youth. In addition, federal funds allocated to states often are reallocated to local governments and community service providers.

United States Interagency Council on Homelessness  

The United States Interagency Council on Homelessness was created by the McKinney-Vento Act in 1987 to coordinate the federal government’s collaborative response to homelessness. The Council  works in partnership with 19 federal agencies and a national network of state and local affiliates to prevent and end homelessness in America.

In 2022, USICH published a new federal strategic plan to prevent and end homelessness, with the goal of reducing homelessness by 25% by 2025. This comprehensive strategy has a multifaceted approach to mitigating nationwide homelessness including for youth and young adults. Policies focused on youth include improving data collection for students experiencing homelessness, increasing funding for programs that work with homeless youth, expanding access to supportive housing, providing training for employees of emergency shelters, and cultivating intergovernmental collaboration.

State Interagency Councils on Homelessness  

USICH also helps states establish their own interagency councils and develop and implement plans to end homelessness. A state interagency council can be established in one of three ways: 1) an executive order of the governor, 2) legislative action or 3) both an executive order and legislative action. Council membership often includes elected and appointed representatives, secretaries and commissioners from state agencies and community stakeholders. 

At least 15 states and the District of Columbia have an interagency council on homelessness or other coordinating body to address homelessness. Most of these councils and coordinating bodies produce research and recommendations to address youth homelessness. 

Department of Housing and Urban Development  

The U.S. Department of Housing and Urban Development is responsible for developing and improving housing policies to better address the needs of communities throughout the country. HUD programs include community development block grants, rental assistance, subsidized housing, homelessness support and fair housing public education and enforcement. 

Continuums of Care  

HUD requires communities to submit a single application for McKinney-Vento Homeless Assistance Grants to streamline the funding application process, encourage coordination of local service providers and promote the development of continuums of care. Continuum of care organizations are local or regional planning bodies that coordinate housing services and program funding for people experiencing homelessness. HUD outlines five components of a continuum of care that are eligible for funding, including 1) permanent housing, 2) supportive housing, 3) supportive services, 4) homelessness prevention and 5) homeless management information system maintenance. 

Youth action boards are also an integral component of continuums of care. They are composed of youth who are currently experiencing or formerly experienced homelessness. The boards ensure youth consultation is included in policy discussions. Members participate in workgroups, engage in legislative advocacy and educate schools and other organizations on how to identify and support youth who are experiencing homelessness. The youth on these boards are seen as experts on youth homelessness and help direct the implementation of a continuum of care programs. 

Youth Homelessness Demonstration Program   

The Youth Homelessness Demonstration Program is a HUD initiative focused on coordinated community approaches to reduce rates of youth homelessness. The project is designed to provide federal funding to urban, suburban and rural communities to reduce youth homelessness. The funding is allocated to continuums of care that provide resources to homeless youth. In 2022 , HUD allocated $72 million for the program to provide 25 grants ranging from $1 million to $15 million. 

U.S. Department of Education  

The U.S. Department of Education’s role in mitigating youth homelessness is primarily through the McKinney-Vento Act and data reporting. Each year, the Department of Education releases data on homeless student enrollment, but it is dependent on state and local educational agencies’ reporting procedures. Longitudinal data includes a breakdown of the residences for homeless students, proficiency gaps and McKinney-Vento funding. 

McKinney-Vento Requirements  

Under McKinney-Vento, schools must provide an equal education to all students regardless of their housing status. The law also ensures that the privacy of youth experiencing homelessness is respected. Some states have codified McKinney-Vento and enacted additional laws to help ensure students experiencing homeless can receive an education. 

In 2015, the  Every Student Succeeds Act amended McKinney-Vento to detail the specific rights homeless youth are entitled to, including the right to continue attending their school of origin, the right to be immediately enrolled in a new school, free transportation to and from school, the ability to participate in all programs and services offered to other students and the right to not be separated from other students. These amendments require schools to be accountable for the educational outcomes of homeless students including preschool children, and mandate that schools track and report high school graduation rates of homeless students. 

Homeless youth and their families have the right to formally dispute educational decisions in violation of McKinney-Vento. Dispute-resolution processes help ensure procedural safeguards for homeless students and their families when challenging a school’s decision. Some states have safeguarded equal access to education for youth who are experiencing homelessness by codifying McKinney-Vento dispute resolution provisions into state law, while other states use agency rules to outline the process for appealing a school’s decision under the act. 

U.S. Department of Health and Human Services  

The Department of Health and Human Services conducts research and provides grant programs related to homelessness. Services are provided through several HHS agencies, including the Administration for Children and Families. 

Administration for Children and Families  

The Administration for Children and Families promotes the economic and social well-being of children, families and communities. ACF maintains many offices, departments and bureaus focused on different facets of child, youth and family well-being.  

The Family and Youth Services Bureau works to reduce the risk of youth homelessness, teen pregnancy and domestic violence. It operates the Runaway and Homeless Youth Program which supports street outreach, shelters and transitional living community programs. It also operates the National Runaway Safeline , which provides support to youth at risk of running away or those that have run away or are homeless. 

Additionally, the Children’s Bureau provides guidance, funding, training and technical assistance, research and oversight across child welfare issues, including child abuse and neglect prevention and protection, foster care and guardianship. The bureau monitors child welfare outcomes and provide reports to Congress on progress. This data can be useful when understanding the intersection of foster care and youth homelessness. 

Office on Trafficking in Persons is another intersectional office that develops anti-trafficking strategies, policies and programs to prevent human trafficking and support victims. 

State Offices of Youth Homelessness  

To prevent youth homelessness and meet the needs of youth experiencing homelessness, some states have created dedicated state agencies, offices or cabinets to coordinate services and prevention efforts. Colorado and Washington  have dedicated offices of youth homelessness through state legislation. 

Colorado’s Office of Homeless Youth Services is located within its Department of Local Affairs and was created to provide information, coordination and support services to public and private entities serving homeless youth. The Office of Homeless Youth Prevention and Protection Programs in Washington, located within the state’s Department of Commerce, leads efforts to coordinate a spectrum of funding, policy and practice efforts related to improving the safety, health and welfare of homeless youth. 

New Jersey has a statewide Office of Homelessness Prevention within its Department of Community Affairs. Responsibilities of the Office of Homelessness Prevention include establishing a comprehensive prevention program that focuses on providing outreach, shelter services and transitional housing for homeless and runaway youth. 

Utah established a Homeless Network Steering Committee within the state’s Office of Homeless Services. The steering committee is not solely focused on youth homelessness; however, it is required to support connections across continuums of care, local homeless councils and local governments. It also coordinates statewide emergency services for individuals experiencing homelessness. While not a designated government office in Iowa, the Council on Homelessness administered through the state’s Finance Authority helps conduct research, suggest policy recommendations and collaborate with various stakeholders.  

State Policy Scan  

State policymakers are increasingly enacting legislation to meet the needs of youth and young adults at risk of or experiencing homelessness. Recent legislation has broadly included adopting state definitions of youth homelessness, addressing the disparate outcomes of vulnerable populations and protecting the federally guaranteed educational rights of homeless youth. States have also passed legislation to address common barriers to housing stability and better align systems serving youth. In addition, legislatures are also enacting legislation to prevent homelessness before it happens.  

Homeless youth often face barriers to enrolling, attending and thriving in school. Not having a secure home environment, reliable transportation or a quiet place to study can make learning much more difficult. Recent data suggests that students experiencing homelessness have a high school graduation rate of 68% compared to the national average of nearly 86%. Under the Every Student Succeeds Act, states are required to report high school graduation rates of homeless students, but it remains a difficult statistic to accurately measure.

State policymakers have prioritized bolstering educational support for students experiencing homelessness. Legislation focused on youth homelessness and education includes expanding reporting requirements, awarding partial scholastic credit to youth who must transfer schools due to housing instability, increasing access to social workers in K-12 education and providing rental assistance to students’ families experiencing homelessness. 

California requires all local educational agencies to establish homeless education program policies that are consistent with state laws and requires these policies to be updated at least every three years. Colorado provides access to school social workers in public elementary schools with the K-5 Social and Emotional Health Act.

Kentucky offers coursework completion alternatives for students experiencing homelessness and exempts these students from any additional requirements a local school board may impose beyond the state’s minimum high school graduation requirements. Oregon has a pilot program through which certain school districts make one-time distributions to families of students to assist with unpaid rent, past-due utilities or move-in expenses. 

Most youth and young adults need financial assistance to attend college. This is particularly true for homeless youth. At least 15 states —Arkansas, California, Colorado, Florida, Georgia, Illinois, Louisiana, Maine, Maryland, Minnesota, Nevada, New Jersey, Oregon, Tennessee and Washington—have policies to help homeless college students attain degrees. Meanwhile, at least  nine states —California, Colorado, Florida, Georgia, Louisiana, Maine, Maryland, Nevada and Oregon—exempt homeless students from paying tuition and fees or give residency status and in-state tuition rates to homeless students.

Florida , for example, waives tuition and fees at all Florida College System institutions and state universities.  Nevada  waives tuition and fees for all residents of the state experiencing homelessness provided they maintain at least a 2.0 GPA each semester. Louisiana  authorizes its public postsecondary education institutions to grant resident status to youth who are homeless and 19 years old or younger. Tennessee requires postsecondary educational institutions to designate a staff member to serve as a homeless student liaison who assists homeless students who are enrolled or planning to enroll. 

Foster Care  

Ending the pipeline from foster care to homelessness is a significant opportunity for legislatures. Half of the youth who leave foster care are not reunited with their families. Many are not ready for independent living, and too often they become homeless. Some states have addressed this by providing transitional housing assistance. Others have extended the time youth and young adults can stay in foster care. 

According to the Children’s Bureau , 48 states, the District of Columbia and American Samoa allow 18-year-olds to extend their out-of-home care and continue receiving services from the social services agency. Most states allow youth to remain under agency supervision until they are 21 years old; however, six states—Iowa, Louisiana, Massachusetts, New Hampshire, Vermont and West Virginia—have extended foster care support beyond the age of 21 and up to 26 in some situations. Oregon and Utah are the only two states that do not offer continued foster care and supervision beyond age 18; however, they do provide supportive services to youth formerly in foster care up to age 21. 

Thirty-three states allow youth who leave foster care when they are 18 years old to request a return to foster care at any point before age 21. Iowa and Vermont allow the request before age 22, and Connecticut permits a return to foster care until age 23. Youth are allowed to return to foster care to help further their education, employment, personal safety or self-sufficiency. Illinois has an interagency agreement between the Department of Children and Family Services, the Illinois State Board of Education and several other government agencies to provide homelessness prevention services to youth in care and young adults who are aging out of, or have recently aged out of, the custody or guardianship of the Department. Prevention services include support with housing, education and employment.

Juvenile Justice  

Youth experiencing homelessness may resort to criminal behavior for survival and this can lead to involvement with the juvenile justice system. Nearly 62% of youth experiencing homelessness reported being arrested at least once in their life. Prevention policies such as housing assistance, trauma-informed care and substance use counseling can reduce contact with the juvenile justice system. 

Virginia requires local social services departments to provide up to six months of housing support to anyone 18 to 21 years old who turned 18 in foster care or while in the custody of the Department of Juvenile Justice. Housing support includes direct rental payments to help build self-sufficiency. 

Washington requires the Office of Homeless Youth Prevention and Protection, in coordination with other state offices, to create a rapid response team that supports youth and young adults exiting a publicly funded system of care, including the juvenile court system. The rapid response team supports youth and young adults who are at risk of becoming homeless and who are exiting a publicly funded system of care. 

Minor Consent for Services  

Accessing essential services (e.g., housing, health care and legal services) often is challenging for youth experiencing homelessness, especially in states that require parental consent. Some state legislatures have taken steps to enable unaccompanied minors to access legal support, medical services, housing and other basic needs.

Housing 

Oregon allows pregnant or parenting youth to contract for housing without a parent or legal guardian.  Indiana  permits shelters to provide services to homeless youth without notifying parents or guardians.  Missouri  allows homeless youth ages 16 or 17 to apply for admission to a shelter, engage in a housing contract, apply for employment, enter high school or apply for college admission, establish a bank account, obtain medical care, purchase a vehicle, apply for student loans and receive domestic violence or sexual assault victim services. 

Health care 

In some states, youth do not have the right to consent to health care which can limit their ability to access preventive and emergency health care. At least 35 states and the District of Columbia allow minors to  consent to health care . Some states, like Alabama , permit youth older than 14 to consent to medical, dental or mental health services. Other states, including Maine , allow youth to consent to the same services, provided they are living separately from their parents or legal guardians. Arkansas authorizes a McKinney-Vento liaison to consent to medical treatment for a homeless minor. 

The District of Columbia allows, on a temporary basis, emancipated minors, unaccompanied homeless minors, minors who are or have been pregnant or minors who are separated from their parents or legal guardian without support to consent to receive a vaccine. Florida   allows unaccompanied homeless youth at least 16 years old to consent to medical, dental, psychological, substance abuse and surgical diagnosis and treatment, including preventive care for themselves or their child, if the youth is unmarried and has custody of the child. 

Driver’s Licenses, IDs and Vital Records  

Everyone needs a government-issued identification card or driver’s license to apply for housing, open a bank account, get a job or receive public assistance. Homeless youth who cannot access these vital identification records are limited in their ability to become self-sufficient. 

Minor youth under 18 years old often need a parent or guardian’s signature or a parent or guardian to be present when applying for identification. Many states also require fees and proof of residency to apply for state-issued identification cards. A government-issued identification card is required to obtain a copy of a birth certificate which homeless youth often lack. Some states have taken measures to remove these barriers by: 

• Waiving or reducing fees for non-driver identification cards and/or birth certificates. 
• Allowing applicants to prove residency with a signed affidavit, regardless of homeless status. 
• Allowing applicants to submit an affidavit or certification of homeless status as documentation of residency. 
• Waiving the requirement that a parent or guardian be present. 

Indiana allows youth experiencing homeless to obtain photo identification cards and driver's licenses, as well as copies of their birth certificate, without charge or consent of a parent, guardian or custodian. To do so, the youth must meet certain guidelines and possess a waiver affidavit. Kentucky waives birth certificate fees for any youth experiencing homelessness. The exemption applies to anyone experiencing homelessness under the age of 25. New Mexico waives all fees for birth certificates for homeless individuals and removed restrictions on access to vital records for unaccompanied youth and youth experiencing homelessness.

Shelters  

States have taken a variety of approaches to offer and regulate access to homeless shelters and supportive services. Common policy elements include age requirements, training for shelter staff and access to wraparound services. 

Utah allows any youth at least 15 years old and managing their income to access shelter services. Wisconsin allows 17-year-olds to access shelters if the minor is not under the supervision of a county department, a child welfare agency, the department of corrections or under the authority of the court. New York requires all employees of programs that provide care to runaway and/or homeless youth to complete training related to LGBTQ+ runaway and homeless youth.

In 2019, Maryland created a work group to study shelter and supportive services for unaccompanied homeless minors. The work group issued a report to the governor detailing policy recommendations to reduce barriers to services for youth experiencing homelessness. Recommendations include allowing minors to consent to housing and shelter services and establishing a registry of service providers that work with youth experiencing homelessness.

• NCSL on Housing and Homelessness Legislation Database NCSL Database
• NCSL on Youth Homelessness Fellows Program NCSL Resource
• NCSL on Youth Homelessness Toolkit NCSL Toolkit
• NCSL on Housing and Homelessness Toolkit NCSL Toolkit

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Diverse profiles of homeless young adults: implications for tailored prevention strategies—insights from belgian homelessness counts.

1. Introduction

• Youth homelessness
• Homelessness Prevention

2. Methodology

3.1. quantitative results: three groups of homeless young adults, 3.1.1. youth care leavers, 3.1.2. belgian and no care history, 3.1.3. newcomers, 3.2. qualitative results.

• Access to rights (and hope)

“Step by step, young people want to determine their futures. But a lot of young adults are stuck for a couple of months: what should I do first? Look for a job? Look for housing? Follow a course? Finish their education? One decision determines a lot of the other ones.” (Team leader—youth care organization)

• Underreported health problems

“After six months of experiencing homelessness, young people have abandoned their dreams and aspirations, often leading to substance abuse due to a lack of future prospects.” (Caregiver—non-profit organization)

“In our organization, we are in contact with a lot of young people with such (mental disability) issues. Often, young people are very skilled in behaving socially desirable, and we understand too late what they actually mean.” (Team leader—youth care organization)

• Vulnerable family situation

“Many young people with intellectual disabilities, who often come from very vulnerable family situations but have never received any form of counseling, face significant challenges. Moreover, it is very difficult to initiate a support process now, for instance with the Flemish Agency for Persons with Disabilities (VAPH). It takes years to get them in the right place.” (Team leader—general welfare organization)

• Limited access to services and welfare conditionality

“It is remarkable to see how many young individuals leave youth care and become homeless. They have to exit care facilities once they turn 18 years old, and this is very disturbing.” (Team leader—youth care organization)

“Young people are repeatedly faced with the inaccessibility of rights and social assistance. Often, they do not have an ID or a reference address. Obtaining such a reference address in Antwerp is really difficult. Young people do not have any knowledge about such -and other- rights. Our organization tries to help them in administrative application processes.” (Care giver—non-profit organization)

4. Discussion

Author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Share and Cite

Demaerschalk, E.; Robben, L.-l.; Mertens, N.; Hermans, K. Diverse Profiles of Homeless Young Adults: Implications for Tailored Prevention Strategies—Insights from Belgian Homelessness Counts. Youth 2024 , 4 , 1271-1286. https://doi.org/10.3390/youth4030080

Demaerschalk E, Robben L-l, Mertens N, Hermans K. Diverse Profiles of Homeless Young Adults: Implications for Tailored Prevention Strategies—Insights from Belgian Homelessness Counts. Youth . 2024; 4(3):1271-1286. https://doi.org/10.3390/youth4030080

Demaerschalk, Evelien, Laure-lise Robben, Nana Mertens, and Koen Hermans. 2024. "Diverse Profiles of Homeless Young Adults: Implications for Tailored Prevention Strategies—Insights from Belgian Homelessness Counts" Youth 4, no. 3: 1271-1286. https://doi.org/10.3390/youth4030080

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Mental health effects of poverty, hunger, and homelessness on children and teens

Rising inflation and an uncertain economy are deeply affecting the lives of millions of Americans, particularly those living in low-income communities. It may seem impossible for a family of four to survive on just over $27,000 per year or a single person on just over $15,000, but that’s what millions of people do everyday in the United States. Approximately 37.9 million Americans, or just under 12%, now live in poverty, according to the U.S. Census Bureau .

Additional data from the Bureau show that children are more likely to experience poverty than people over the age of 18. Approximately one in six kids, 16% of all children, live in families with incomes below the official poverty line.

Those who are poor face challenges beyond a lack of resources. They also experience mental and physical issues at a much higher rate than those living above the poverty line. Read on for a summary of the myriad effects of poverty, homelessness, and hunger on children and youth. And for more information on APA’s work on issues surrounding socioeconomic status, please see the Office of Socioeconomic Status .

Who is most affected?

Poverty rates are disproportionately higher among most non-White populations. Compared to 8.2% of White Americans living in poverty, 26.8% of American Indian and Alaska Natives, 19.5% of Blacks, 17% of Hispanics and 8.1% of Asians are currently living in poverty.

Similarly, Black, Hispanic, and Indigenous children are overrepresented among children living below the poverty line. More specifically, 35.5% of Black people living in poverty in the U.S. are below the age of 18. In addition, 40.7% of Hispanic people living below the poverty line in the U.S. are younger than age 18, and 29.1% of American Indian and Native American children lived in poverty in 2018. In contrast, approximately 21% of White people living in poverty in the U.S. are less than 18 years old.

Furthermore, families with a female head of household are more than twice as likely to live in poverty compared to families with a male head of household. Twenty-three percent of female-headed households live in poverty compared to 11.4% of male-headed households, according to the U.S. Census Bureau .

What are the effects of poverty on children and teens?

The impact of poverty on young children is significant and long lasting. Poverty is associated with substandard housing, hunger, homelessness, inadequate childcare, unsafe neighborhoods, and under-resourced schools. In addition, low-income children are at greater risk than higher-income children for a range of cognitive, emotional, and health-related problems, including detrimental effects on executive functioning, below average academic achievement, poor social emotional functioning, developmental delays, behavioral problems, asthma, inadequate nutrition, low birth weight, and higher rates of pneumonia.

Psychological research also shows that living in poverty is associated with differences in structural and functional brain development in children and adolescents in areas related to cognitive processes that are critical for learning, communication, and academic achievement, including social emotional processing, memory, language, and executive functioning.

Children and families living in poverty often attend under-resourced, overcrowded schools that lack educational opportunities, books, supplies, and appropriate technology due to local funding policies. In addition, families living below the poverty line often live in school districts without adequate equal learning experiences for both gifted and special needs students with learning differences and where high school dropout rates are high .

What are the effects of hunger on children and teens?

One in eight U.S. households with children, approximately 12.5%, could not buy enough food for their families in 2021 , considerably higher than the rate for households without children (9.4%). Black (19.8%) and Latinx (16.25%) households are disproportionately impacted by food insecurity, with food insecurity rates in 2021 triple and double the rate of White households (7%), respectively.

Research has found that hunger and undernutrition can have a host of negative effects on child development. For example, maternal undernutrition during pregnancy increases the risk of negative birth outcomes, including premature birth, low birth weight, smaller head size, and lower brain weight. In addition, children experiencing hunger are at least twice as likely to report being in fair or poor health and at least 1.4 times more likely to have asthma, compared to food-secure children.

The first three years of a child’s life are a period of rapid brain development. Too little energy, protein and nutrients during this sensitive period can lead to lasting deficits in cognitive, social and emotional development . School-age children who experience severe hunger are at increased risk for poor mental health and lower academic performance , and often lag behind their peers in social and emotional skills .

What are the effects of homelessness on children and teens?

Approximately 1.2 million public school students experienced homelessness during the 2019-2020 school year, according to the National Center for Homeless Education (PDF, 1.4MB) . The report also found that students of color experienced homelessness at higher proportions than expected based on the overall number of students. Hispanic and Latino students accounted for 28% of the overall student body but 38% of students experiencing homelessness, while Black students accounted for 15% of the overall student body but 27% of students experiencing homelessness. While White students accounted for 46% of all students enrolled in public schools, they represented 26% of students experiencing homelessness.

Homelessness can have a tremendous impact on children, from their education, physical and mental health, sense of safety, and overall development. Children experiencing homelessness frequently need to worry about where they will live, their pets, their belongings, and other family members. In addition, homeless children are less likely to have adequate access to medical and dental care, and may be affected by a variety of health challenges due to inadequate nutrition and access to food, education interruptions, trauma, and disruption in family dynamics.

In terms of academic achievement, students experiencing homelessness are more than twice as likely to be chronically absent than non-homeless students , with greater rates among Black and Native American or Alaska Native students. They are also more likely to change schools multiple times and to be suspended—especially students of color.

Further, research shows that students reporting homelessness have higher rates of victimization, including increased odds of being sexually and physically victimized, and bullied. Student homelessness correlates with other problems, even when controlling for other risks. They experienced significantly greater odds of suicidality, substance abuse, alcohol abuse, risky sexual behavior, and poor grades in school.

What can you do to help children and families experiencing poverty, hunger, and homelessness?

There are many ways that you can help fight poverty in America. You can:

• Volunteer your time with charities and organizations that provide assistance to low-income and homeless children and families.
• Donate money, food, and clothing to homeless shelters and other charities in your community.
• Donate school supplies and books to underresourced schools in your area.
• Improve access to physical, mental, and behavioral health care for low-income Americans by eliminating barriers such as limitations in health care coverage.
• Create a “safety net” for children and families that provides real protection against the harmful effects of economic insecurity.
• Increase the minimum wage, affordable housing and job skills training for low-income and homeless Americans.
• Intervene in early childhood to support the health and educational development of low-income children.
• Provide support for low-income and food insecure children such as Head Start , the National School Lunch Program , and Temporary Assistance for Needy Families (TANF) .
• Increase resources for public education and access to higher education.
• Support research on poverty and its relationship to health, education, and well-being.
• Resolution on Poverty and SES
• Pathways for addressing deep poverty
• APA Deep Poverty Initiative

Youth-led Homeless Education Action Research Uniting Systems

What is y-hear-us.

The Y-HEAR initiative (Youth-led Homeless Education Action Research Uniting Systems) is a two-prong action research strategy mobilizing young leaders from California high schools through Y-PLAN action research and university students through the PLUS leadership initiative to improve learning systems for K-12 youth facing homelessness and housing instability.

For 20 years, these two signature CC+S initiatives – Y-PLAN and PLUS – have moved young people beyond an awareness of the world’s many problems by offering them the tools and agency to craft their own solutions. Systematizing these models with a renewed focus on unhoused K-12 student policy, Y-HEAR-US deepens university-school-community partnerships.

Y-HEAR-US reflects students experiencing homelessness’ desire to be heard and to belong

Starting in 2020, CC+S has deployed best practices from our award-winning Y-PLAN and PLUS action research strategies to better understand what is happening, what is needed, and where our expertise can help move the needle on student homelessness in California. This initiative partners young people with school districts, policy leaders and advocates to lift up the next generation’s vision for change with an expanded commitment to oversee their project’s implementation through continued advocacy and communications training. Y-PLAN project partners then identify opportunities to broaden the impact of young people’s ideas and elevate students as agents of change. At the same time, we engage UC Berkeley students to work directly with cities and school districts to nurture collaboration and identify innovative, win-win policy solutions as part of the PLUS research lab.

Students as Thought Leaders

For long-term solutions to pressing policy issues including student homelessness, our most powerful and underused tools are the perspective and insights of youth. While adults frequently move from crisis to crisis, young people often take a preventative, proactive approach.  Youth also bring a renewed sense of urgency to pressing public policy decisions. Four years may seem like a short time to measure progress –  but the sense of urgency is heightened when they span your freshman to senior years of high school – or college. Expanding youth-led research projects like this across our state can lead to better educational outcomes for our students and improve material realities for unhoused youth and their families at the same time.

Housing insecurity is a multifaceted issue to which there is no easy or universal answer. Who better to forge our path to a more just and joyful world than the generations who stand to inherit it?

Core Components

Y-HEAR fuels collaboration between young people and adult professionals at universities, school districts, community organizations, and local, regional and statewide governmental agencies with its unique interdisciplinary approach. Three core components include:

• This includes statewide community schools, linked learning/career pathways, and more!
• Examples include authentic project-based learning and civic work-based learning opportunities
• Including youth-led speaking engagements and presentations at public events; publishing with and for young people in different formats, such as opinion pieces and interactive StoryMaps

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Office of the Assistant Secretary for Planning and Evaluation

Toward Understanding Homelessness: The 2007 National Symposium on Homelessness Research. Homeless Youth in the United States: Recent Research Findings and Intervention Approaches

By: Paul A. Toro, PhD, Wayne State University, Detroit, MI Amy Dworsky, PhD, University of Chicago, Chicago, IL Patrick J. Fowler, MA, Wayne State University, Detroit, MI

Disclaimer:  This paper was developed for the National Symposium on Homelessness Research held on March 1-2, 2007. The Symposium was conducted by Abt Associates Inc. and Policy Research Associates Inc. under contract for the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services; and the Office of Policy, Development, and Research, U.S. Department of Housing and Urban Development. The paper presents the views and opinions of the respective author(s) and does not necessarily represent the views, positions, and policies of the federal government.

In this paper, the authors cite research indicating that youth may be the single age group most at risk of becoming homeless, yet comparatively little research has been done in the past decade on this vulnerable population. Some important progress has been made, including longitudinal studies on youth “aging out” of foster care. After reviewing the characteristics of homeless youth, the authors review recent research findings on the homeless youth population and interventions developed to address their housing and service needs. These include interventions directed at youth themselves (education, employment, social skills training) as well as family-focused strategies. The authors conclude with future directions for both research and practice.

Introduction

Homelessness among adolescents and young adults is a major social concern in the United States. Robertson and Toro (1999) concluded that youth maybe the single age group most at risk of becoming homeless. Nevertheless, most of the research that has been conducted over the last two decades has focused on homeless adults, including those with mental disorders and substance abuse problems. Studies that have examined homelessness among adolescents and young adults as well as other age groups, have often cast the problem as one of individual vulnerabilities rather than as a social phenomenon involving transactions between individuals and their environments (Haber & Toro,2004; Shinn, 1992; Toro et al., 1991). This research has also been of limited value with respect to the development of public policies or empirically based interventions that either assist youth who are currently homeless or prevent homelessness among adolescents and young adults who are at risk (Shinn & Baumohl, 1999; Toro, Lombardo, & Yapchai, 2002).

These problems notwithstanding, some progress has been made since Robertson and Toro reviewed the literature on homeless youth over eight years ago for the 1998 National Symposium on Homelessness Research. Longitudinal studies, including research on youth “aging out” of foster care, have been an important source of information. Our knowledge about what works when it comes to prevention and programs that target homeless youth has also increased, although significant gaps remain. After briefly discussing some definitional issues and describing the homeless youth population and its constituent subgroups along a number of dimensions, we summarize what has been learned in recent years.

Definitional Issues.  We begin with a fundamental question. What does it mean to say that a youth is homeless? Alternatively, who does the population of homeless youth include? The Runaway and HomelessYouth Act (RHYA) defines homeless youth as individuals who are “not more than 21 years of age … for whom it is not possible to live in a safe environment with a relative and who have no other safe alternative living arrangement.” Implicit in this definition is the notion that homeless youth are not accompanied by a parent or guardian (Haber & Toro, 2004). The McKinney-Vento Homeless Assistance Act, the primary piece of federal legislation pertaining to the education of homeless children, provides a somewhat different definition. According to Subtitle B of Title VII of that legislation, youth are homeless if they “lack a fixed, regular, and adequate nighttime residence.” In contrast to the RHYA, McKinney-Ventoapplies not only to unaccompanied youth but also to those who are homeless or doubled up with their families. Because homeless families with children are the focus of another paper in this Symposium, we will adopt a more restrictive definition that excludes youth who are homeless with a parent or other guardian and youth who are wards of the state.

Homeless youth can be distinguished from two other homeless populations: single adults, who are predominantly male and do not have children in their custody; and homeless families, typically comprising a mother and her children. 1  Homeless youth include  runaways , who have left home without parental permission,  throwaways , who have been forced to leave home by their parents, and  street youth , who have spent at least some time living on the streets as well as  systems youth —i.e., young people who become homeless after aging out of foster care or exiting the juvenile justice system (Farrow, et al., 1992). Although these categories reflect important distinctions among youth with respect to the reasons they are homeless and their experiences while homeless, they are neither static nor mutually exclusive(Hammer, Finkelhor, & Sedlak, 2002), and it can be difficult to determine which label best applies. Youth may perceive themselves as being thrown out by their parents, while parents may perceive their son or daughter as running away. In other cases, youth may be removed from their home by child welfare authorities and then run away from their out-of-home care placement or leave home by mutual agreement with their parents. Street youth often spend significant amounts of time in adult caregivers’ homes, shelters, and temporary quarters with friends or other family (Greenblatt & Robertson, 1993). The one thing homeless youth have in common is that they are on their own without the supervision of an adult caretaker (Haber & Toro, 2004). In order to allow review of the full array of relevant literature, the present paper uses a broad definition, including all youth ages 12 to 25 who fit either the RHYA or McKinney-Vento definition (so long as they are “homeless on their own”).

1. In the U.S. and other developed nations, relatively few homeless families (12 to 20 percent) include children age 12 or older (Buckner, Bassuk, Weinreb, & Brooks, 1999; Burt et al., 2001), and children under age 12 are rarely found homeless on their own (Robertson & Toro, 1999). In fact, many shelters for homeless families exclude children age 12 or older who shelter staff fear might prey upon the younger ones. As a result, homeless families with older children are often compelled to leave their older children with friends or relatives before entering a shelter.

Prevalence and Geographical Distribution of Youth Homelessness

Just how many youth are homeless in a given year is difficult to know. Estimates vary widely depending on how “homeless” is defined and the agerange that is used. Different sampling and estimation techniques can also yield different results. For example, Ringwalt and colleagues analyzed data collected from a representative U.S. household sample of nearly 6,500 youth,ages 12 to 17, as part of the Youth Risk Behavior Survey (YRBS) and found that approximately 7.6 percent had been homeless for at least one night during the past 12 months (Ringwalt et al., 1998). This would translate into approximately 1.6 million homeless youth each year. Similarly, the Second National Incidence Study of Missing, Abducted, Runaway and Thrownaway Children (NISMART II), which combined data from three different surveys (the National Household Survey of Adult Caretakers, the National Household Survey of Youth, and the Juvenile Facilities Study) estimated that approximately 1.7 million youth experienced a runaway or throwaway episode in 1999 (Hammer, Finkelhor,& Sedlack, 2002). Other studies have looked at the likelihood of ever becoming homeless during adolescence. According to one estimate, 15 percent of youth will become homeless at least once before age 18 (Ringwalt, Greene, & Iachan, 1994).

Homeless youth can be found in urban, suburban, and rural areas throughout the U.S., but tend to be most visible in major cities (Robertson & Toro, 1999). Moreover, although they may be an understudied population, homeless youth in rural areas have proven difficult to recruit (e.g., Heinze, Toro, & Urberg, 2004; Thrane & Yoder, 2000). Nevertheless, few differences have been found when urban, suburban, and rural homeless youth have been compared (Cauce et al., 2000; Thrane & Yoder, 2000). Studies investigating street youth have generally been based in large metropolitan areas on the east and west coasts (e.g., Los Angeles, San Francisco, Seattle, and New York City), in part because researchers have not found large numbers of homeless street youth under age 18 in most midwestern and southern cities (Robertson & Toro, 1999).

Greenblatt and Robertson (1993) found both episodic and chronic patterns of homelessness among the youth they studied. However, the number of homeless episodes youth have experienced and the length of time they have been homeless seem to depend on whether shelter youth or street youth have been studied. Many youth in shelter samples are homeless for the first time and have not been homeless for very long (McCaskill, Toro, & Wolfe, 1998), whereas street youth tend to experience longer and more frequent episodes of homelessness (Whitbeck, Hoyt, & Yoder, 1999; Witken et al., 2005).

Homeless Youth: A Brief Summary of the Existing Research Literature

In this section, we briefly review how homeless youth have been studied in the past and what is known about homeless youth from this research (for amore comprehensive review, see Robertson & Toro, 1999).

Haber and Toro (2004) describe four basic approaches used by researchers to sample homeless youth. The first approach is to survey large groups of youth in the general population and identify those with a history of homelessness (e.g., Ringwalt et al., 1998; Windle, 1989). These methods may misrepresent the total homeless youth population because they do not include youth who are currently homeless, who may well have longer histories of homelessness and other negative characteristics. The second draws youth from service settings such as inner-city clinics (Kipke, Montgomery, & MacKenzie, 1993; Yateset al., 1988). Of course, youth seeking services may be different from those who do not seek help. The third approach samples youth from shelters (e.g.,McCaskill, Toro, & Wolfe, 1998). Some of the youth these facilities serve have been brought to the shelter by their families or third parties such as the police. Many have never spent a night on the streets. Such youth are often younger and less likely to have extensive histories of homelessness than street youth (Robertson & Toro, 1999). The fourth approach involves sampling from street locations where homeless youth are known to congregate and/or from drop-in centers designed to serve street youth (e.g., Cauce et al., 1994; Kipke, O’Connor, Palmer, & MacKenzie, 1995; Roy et al.,1998). This method often yields a sample biased toward youth who are engaged in a variety of deviant behaviors, especially if the sample includes many youth who are 18 or older. Some recent studies have combined the four methods in an effort to obtain more representative samples (e.g., Heinze, Toro, & Urberg, 2004; Paradise et al., 2001; Toro & Goldstein, 2000; Unger et al., 1998; Whitbeck, Hoyt, & Yoder, 1999; Witken et al., 2005).

Age, Gender, Race/Ethnicity, Sexual Orientation, and Pregnancy

The vast majority of homeless youth are age 13 or older, although a few studies have identified small numbers of youth who are homeless on their own as young as 9 years old (Clark & Robertson, 1996; Robertson, 1991). Although at least one national survey of youth found that males were significantly more likely than females to report recent homelessness (Ringwalt et al. 1998),the distribution of males and females among homeless youth seems to vary depending on the source and age of the sample. Shelter samples tend to include either equal numbers of males and females or more females (e.g., Heinze, Toro, & Urberg, 2004). Samples of street youth or older homeless youth are disproportionately male (e.g., Cauce et al., 2000). There is also some evidence that during the transition from adolescence to young adulthood the risk of becoming homeless declines for females but rises for males (Boesky, Toro, & Bukowski, 1997).

There have been contradictory findings with respect to race/ethnicity. Neither Ringwalt et al. (1998) nor Hammer et al. (2002) found racial or ethnic differences in rates of homelessness among the youth they studied, and at least some research suggests that homeless youth tend to reflect the racial and ethnic make-up of the surrounding area. However, other studies indicate that racial and ethnic minority youth are over-represented (Cauce et al., 1994; McCaskill, Toro, & Wolfe, 1998; Owen et al., 1998).

Gay, lesbian, bisexual, and transgender (GLBT) youth comprise 6 percent of the homeless youth population according to the National Network of Runaway and Youth Services. However, other prevalence estimates range from 11 to 35 percent (Kruks, 1991; Tenner et al., 1998; Whitbeck et al., 2004). Compared to heterosexual homeless youth, GLBT homeless youth leave home more frequently and are exposed to greater victimization while on the streets (Cochran et al., 2002). In addition, these youth may experience more physical and sexual abuse from caretakers (Whitbeck et al., 2004). GLBT youth may be at particular risk for homelessness due to conflict with their family regarding their sexual orientation (Milburn, Ayala, Rice, Batterham, & Rotheram-Borus, 2006; Remafedi, 1987).

A significant percentage of homeless youth are pregnant or parenting. Greene and Ringwalt (1998) found that 48 percent of street youth and 33 percent of shelter youth had ever been pregnant or impregnated someone, compared to 10 percent of a nationally representative sample of housed youth. Research also suggests that approximately 10 percent of both street and shelter female youth are currently pregnant (Greene & Ringwalt, 1998; Solorio et al., 2006). The high rates of pregnancy in this population may reflect the fact that many homeless youth engage in risky behaviors, including sex at an early age, survival sex, and inconsistent use of birth control.

Background Characteristics

Regardless of their pathways into homelessness, homeless youth share many background characteristics and experience many of the same psychosocial problems (MacLean, Embry, & Cauce, 1999). For example, they tend to come from low-income communities (McCaskill, Toro, & Wolfe, 1998) and their families are disproportionately poor or working class (Whitbeck et al., 1997). It is also not uncommon for homeless youth to report a history of family disruption. Many grew up in single-parent households or “blended” (i.e., stepparent) families (Boesky, Toro, & Wright, 1995; Greenblatt & Robertson, 1993), and a significant number of these youth have not had any contact with their non-custodial parent (Greenblatt & Robertson, 1993). The families of homeless youth also seem to have experienced far more residential moves than those of their housed peers (Cauce et al., 2000; Toro & Goldstein, 2000). In other words, their homelessness seems to be part of a longer pattern of residential instability.

Difficulties with School

Homeless youth often have a history of academic and school behavior problems. Between 25 and 35 percent of homeless youth report that they had to repeat a grade (Clark & Robertson, 1996; Robertson, 1989; Upshur, 1986; Younget al., 1983), and many have been suspended or expelled (Toro & Goldstein, 2000). Drop-out rates are also high (Thompson, Kost, & Pollio, 2003). Research suggests that at least some of these academic and school behavior problems may be attributable to attention deficit disorder (Cauce et al., 2000) or learning disabilities (Barwick & Siegel, 1996), which may be why homeless youth often report being placed in special education or remedial classes (Clark & Robertson, 1996; Robertson, 1989). Regardless of their cause, these academic and school behavior problems can be a source of family conflict and hence contribute to homelessness.

Family Conflict and Child Maltreatment

Youth consistently identify conflict with their parents as the primary reason for their homelessness (Whitbeck et al., 2002; Robertson & Toro, 1999), and they tend to report more family conflict than their peers who are housed (Toro & Goldstein, 2000; Wolfe, Toro, & McCaskill, 1999). These conflictst end to reflect longstanding patterns rather than problems that arise just before youth leave home (Smollar, 1999). Conflicts related to step-parent relationships, sexual activity, pregnancy, sexual orientation, school problems, and alcohol or drug use seem to be the most common (Owen et al., 1998; Robertson & Toro, 1999; Whitbeck & Hoyt, 1999).

In addition to family conflict, many homeless youth have experienced child abuse and/or neglect (Boesky, Toro, & Wright, 1995; Molnar et al., 1998; Powers, Eckenrode, & Jacklitsh, 1990; Robertson, 1989; Rotherman-Boruset al., 1996; Rothman & David, 1985; Ryan et al., 2000; Tyler et al.,2001; Unger et al., 1998; Yates et al., 1988). In fact, homeless youth often cite physical or sexual abuse as their reason for leaving home (Robertson, 1989). Although the percentage of homeless youth who report a history of maltreatment varies widely across studies, research using comparison groups has found that homeless youth are more likely to have been abused and/or neglected than their peers who are housed (Wolfe, Toro, & McCaskill,1999). This may also explain why homeless youth are more likely to have been verbally and physically aggressive toward their parents compared to their housed peers (Toro & Goldstein, 2000). That is, their aggression may be in response to parental aggression directed at them (Haber & Toro, 2003).

Mental Health and Behavioral Disorders

Homeless youth seem to be at elevated risk for a variety of mental health problems, including mood disorders, suicide attempts, and post traumatic stress disorder (Cauce et al., 2000; Clark & Robertson, 1996; Feitel et al., 1992; Fronczak & Toro, 2003; Greenblatt & Robertson, 1993; McCaskill, Toro, & Wolfe, 1998; Powers, Eckenrode, & Jaklitsch, 1990; Rew, Thomas, Horner, Resnick, & Beuhring, 2001; Rotheram-Borus, 1993; Robertson, 1989; Stewart et al., 2004; Toro & Goldstein, 2000, Yates et al., 1988). The risk of mental health problems may be particularly high among street youth, who tend to have experienced more stressful events and to exhibit more psychological symptoms than homeless youth who have not spent time on the streets (Robertson & Toro, 1999; Whitbeck & Hoyt, 1999).

Behavioral problems, such as conduct or oppositional defiant disorder, maybe even more prevalent than mental health problems (Cauce et al., 2000; McCaskill, Toro, & Wolfe, 1998; Toro & Goldstein, 2000). Homeless youth also exhibit high rates of substance use disorders, including alcohol abuse or dependence and drug abuse or dependence (e.g., Baer, Ginzler, & Peterson, 2003; MacLean, Paradise, & Cauce, 1999; Robertson, 1989; Rotheram-Borus, 1993; Thompson, Sayfer, & Polio, 2001; Thompson, Kost, & Pollio, 2003; Van Leeuwen, 2002; Van Leeuwen et al., 2005; Yates et al., 1988).

Although the prevalence of some diagnoses (e.g., depression) has been consistent across studies, lower rates are found for other disorders (e.g., conduct disorder) when more rigorous assessments are used and when homeless youth are recruited from shelters rather than the streets (Robertson & Toro, 1999). Nevertheless, regardless of the sample or the assessment method used, mental health and behavioral disorders seem to be more prevalent among homeless youth than among matched housed peers or the general adolescent population (McCaskill, Toro, & Wolfe, 1998; Toro & Goldstein, 2000). Unfortunately, the reason for the high prevalence rates observed among homeless youth is far from clear (Robertson, 1992; Robertson & Toro, 1999; Toro, 1998). Mental health and behavioral disorders contribute to family conflict and thus to homelessness. However, causality could also be in the opposite direction (Cauce et al., 1994; MacLean, Embry, & Cauce, 1999). Alternatively, some other factor or combination of factors could be a cause of both.

Risky Behaviors and Victimization

A number of studies have found not only that many homeless youth are sexually active, but also that they engage in sexual behaviors that put them at high risk for both sexually transmitted diseases and pregnancy (Cauce et al., 1994; Kipke et al., 1995; Lombardo & Toro, 2004; Rotheram-Borus, 1991; Rotheram-Borus et al., 1992a, 1992b; Staller & Kirk, 1997; Toro & Goldstein, 2000; Whitbeck & Hoyt, 1999).

Homeless youth also report engaging in delinquent or illegal activities, including stealing, forcibly entering a residence, prostitution, and dealing drugs (Whitbeck, Hoyt, & Ackley, 1997). Youth who engage in these “deviant” behaviors often report that they do so to obtain money, food or shelter (Van Leeuwen, 2002; Van Leeuwen et al., 2005). In other words, these behaviors may be part of a survival strategy (Robertson & Toro, 1999).

Being on their own without adult supervision means not only that homeless youth are likely to behave in ways that are unsafe, but also that they comprise an especially vulnerable group. This is reflected in the high rates of physical and sexual victimization they report (Greenblatt & Robertson, 1993; Tyler et al., 2004). Research has found not only that homeless youth are far morelikely to be victimized than their peers who are housed (Stewart et al., 2004; Yates et al., 1988) but that many homeless youth are victimized repeatedly (Whitbeck, Hoyt, & Ackley, 1997).

Service Utilization

Despite extensive demonstration of the needs of homeless adolescents, few studies have explicitly attempted to document the full range of service utilization among this needy group. In a recent study done in Detroit (described in more detail below), a majority of both homeless and matched housed youth failed to receive adequate services given their risks for disturbances in medical and psychosocial functioning (Toro & Goldstein, 2000). Only 2 percent of the homeless youth reported utilizing soup kitchen or outreach services, while 18 percent reported using inpatient or outpatient psychological services (Toro & Goldstein, 2000). Following youths for over two years showed that less than 1 percent reported using services after the initial interview.

New Areas of Research Since 1998

Several new areas of research on homeless youth have emerged since Robertson and Toro completed their review for the 1998 National Symposium on Homelessness Research. These areas include longitudinal studies of homeless youth, research on youth leaving the foster care and juvenile justice systems, and intervention and prevention research. Also there has been some development and evaluation of theoretical models explaining youth homelessness.

Longitudinal Studies

Tracking homeless youth over time can suggest both causes of and possibles olutions to the problems they experience. Unfortunately, only a few such studies have been done to date (e.g., Cauce et al., 1994), and few of their findings have yet been published in peer reviewed journals. In part, this paucity of data reflects the fact that data in these longitudinal studies are still being collected. However, it also indicates a general lack of research on homeless youth (as compared to other homeless groups) and a particular lack of longitudinal research on this population.

In any event, we can draw some conclusions based on preliminary results from a study by Toro and his colleagues. A probability sample of 249 homeless youth from throughout the Detroit metropolitan area, plus a matched sample of 149 housed youth, were initially interviewed at ages 13 to 17 and have been followed since at six time-points over a seven-year period. The youth are now aged 20 to 24, and data collection is nearly complete. Most of the adolescents returned fairly quickly to their family of origin. Nearly all (93 percent) of the initially homeless adolescents in the sample were no longer homeless at the 4.5-year follow-up, with one-third living with their parents (33 percent), another third living on their own (34 percent), and still others living with friends or relatives (21 percent). At follow-up, the initially homeless adolescents also reported significantly less conflict with their family and fewer stressful events (Toro & Janisse, 2004). Such trends have also been observed in longitudinal studies of homeless adults (e.g., Toro et al., 1999). People who are sampled because they are currently homeless are often at a particularly low point in their lives. Over time, many exit homelessness and thus appear to function at least somewhat better at follow-up, even though they often are not fully part of “mainstream society” and are likely to be at risk for future homelessness and/or other poor life outcomes.

Ahmed and Toro (2004) used data from the same longitudinal study to examine the relationship between several dimensions of religiosity and substance abuse outcomes over an 18-month follow-up period. Both cross-sectional and longitudinal analyses found that religiosity “buffered” the potentially harmful impact of stress on the outcomes. At the 4.5- year follow-up, greater spirituality protected African American, but not European American, young adults exposed to high levels of community violence or alcohol and drug abuse (Fowler, Ahmed et al., 2006).

Roy and her colleagues in Montreal have been studying various samples of street youth (age 14 to 25) and have followed one sample to observe various health outcomes, including HIV infection (Roy et al., 2003). They have, for example, found high mortality, with an annual death rate of 1 percent (Roy et al., 2004). The most common cause of death, by far, was suicide. This research group is now conducting another longitudinal study with more general purposes. Longitudinal findings will begin to be available in late 2007.

Milburn and her colleagues have followed homeless youth, aged 12 to 20, in Los Angeles ( N =498) and in Melbourne, Australia ( N =398), over a 12-month period (see Milburn, Rotheram-Borus et al., 2006; Witken et al., 2005). The longitudinal findings are just beginning to be reported in the professional literature (e.g., Milburn, Ayala, et al., 2006; Rosenthal et al., 2007).

Homelessness Among Former Foster Youth

Many homeless youth report a history of out-of-home care placement. The percentage who report being placed in foster care or an institutional setting varies across studies, but estimates range between 21 and 53 percent (Cauce et al., 1998; Robertson, 1989, 1991; Toro & Goldstein, 2000). A similar pattern has been observed among homeless adults (Firdion, 2004; Toro, Wolfe et al., 1999).

Of particular concern in this regard is the experience of youth who "age out" of foster care when they turn 18 or, in some states, 21. Although these youth are expected to live independently and support themselves once they leave the child welfare system, they often lack the financial, social, and personal resources needed to do so (Lindblom, 1996). As a result, this population is at high risk of becoming homeless after they age out. In fact, studies conducted in both Hollywood and San Francisco found that more than one-quarter of the street youth who had been discharged from state care spent their first night in a shelter or on the streets (Clark & Robertson, 1996; Robertson, 1989). Findings from several recent studies of youth aging out of foster care also illustrate this link.

The Foster Youth Transitions to Adulthood Study.  Courtney et al. (2001) collected baseline survey data from 141 Wisconsin foster youth in 1995. The youth were 17 or 18 years old and had been in care for a minimum of 18 months. Eighty percent, or 113, of these foster youth were re-interviewed 12 to 18 months after they left care. These young adults were similar to the baseline sample with respect to gender, race/ethnicity, and placement region (Milwaukee vs. the balance of the state). Among the outcomes the researchers examined was homelessness. Twelve percent of the follow-up sample reported being homeless for at least one night within 12 months of aging out (Courtney et al., 2001).

Youth Aging Out of Foster Care in Metropolitan Detroit.  Fowler, Toro et al. (2006) surveyed 264 youth from the total population of the 867 youth who had aged out over a two-year period from the foster care system in the three largest counties in the metropolitan Detroit area. The 264 youth were interviewed, on average, 3.6 years after exiting from foster care. At follow-up, the sample had an average age of 20.6 years; 52 percent were female; and 78 percent were African American. The follow-up sample of 264 was representative of the population of 867 in terms of demographic characteristics (e.g., gender, age, race/ethnicity) and foster care experiences (e.g., number of placements, age at entry, reason for placement). The purpose of the survey was to assess the functioning of these youth across various life domains since leaving foster care. The domains included housing, education, employment, emotional and behavioral well-being, substance abuse, risky sexual behavior, and victimization.

A total of 17 percent of the youth experienced literal homelessness during the follow-up period, including 3 percent who were literally homeless at the time they were interviewed. By comparison, the national five-year prevalence rate for literal homelessness among all adults in the United States was just 2 percent in 2001 (Tompsett et al., 2006). Those who experienced literal homelessness did so for an average of 61 days; the likelihood of experiencing literal homelessness did not vary by gender or race/ethnicity.

Just because youth were not literally homeless did not mean that they always had a stable place to live. On the contrary, one-third of the youth had spent time doubled up with other families or “couch surfing” among friends and relatives because they could not afford more permanent housing. This includes 12 percent who were precariously housed at the time of their interview. The mean number of times that these youth were precariously housed was 2.8 and the median duration of each episode was 13 months.

Most commonly, youth attributed their precarious housing or homelessness to economic factors such as a lack of employment, lack of affordable housing, termination of public assistance, or eviction. One-quarter of the youth who became homeless attributed their homelessness to problems with their families. In fact, this was the most common reason for becoming homeless immediately following exit from the foster care system.

Significant differences were found among the literally homeless, the precariously housed, and the continuously housed. Literally homeless youth reported significantly more personal victimization and deviant behavior than youth who were either continuously or precariously housed. However, both literally homeless and precariously housed youth experienced higher rates of psychological distress and alcohol or other drug abuse than continuously housed youth. In addition, literally homeless youth were more likely to report engaging in risky sexual behavior as compared to housed youth. Additional analyses suggested that both literal homelessness and precarious housing increased the risk of personal victimization, which in turn, increased the likelihood of other negative outcomes, such as psychological distress, deviant behavior, and marijuana use, even after controlling for age, gender, and race.

There was also some evidence that becoming homeless immediately post-discharge may have particularly negative effects. Youth who experienced homelessness right after they left care reported greater psychological distress, victimization, and deviant behavior than those who did not become homeless until later. The former were also less likely to have a high school diploma or GED and less likely to have received additional schooling since leaving care. What is not clear is whether the youth who became homeless immediately were already more vulnerable at the time they exited, or whether they became more vulnerable as a result of becoming homeless so quickly.

In many cases, the youth who experienced housing problems after exiting foster care did not receive services to address their needs. Less than one-third received services at homeless shelters and only 3 percent received help from outreach services. Although nearly two thirds reported going a whole day without food, just 15 percent received assistance from soup kitchens.  Likewise, 70 percent of these youth had clinically significant mental health, substance abuse, or behavioral problems, but only 21 percent received psychological services.  In contrast, 88 percent of these precariously housed and homeless youth received medical care since aging out of the system. Many of the youth were able to take advantage of Medicaid eligibility allowed under state foster care policy in order to get medical care.

The Midwest Evaluation of the Adult Functioning of Former Foster Youth.  The relationship between homelessness and out-of-home care placement is also being examined by an ongoing three-state longitudinal study that is following a sample of 732 foster youth from Iowa (63 youth), Wisconsin (195), and Illinois (474) as they age out of the child welfare system and transition into adulthood (Courtney et al., 2005). All of these youth had been victims of child maltreatment and entered foster care before age 16. The youth were initially interviewed at age 17 or 18, while they were still state wards, and then again at age 19. Just over half (321) of the 603 foster youth who completed a follow-up interview were no longer in care, and their mean time since leaving care was 14.5 months.

Although few of these youth were currently living on the streets, 14 percent (45) had been homeless for at least one night since they aged out. Homelessness was defined as sleeping “in a place where people weren't meant to sleep,” sleeping “in a homeless shelter,” or not having “a regular residence in which to sleep.” Two-thirds of the ever-homeless group had become homeless within six months of exiting and more than half (54 percent) had experienced more than one homeless episode.

A multivariate analysis using logistic regression showed that the best predictor of becoming homeless after aging out was whether a youth had repeatedly runaway from an out-of-home care placement. Running away more than once was associated with an almost ninefold increase in the odds of becoming homeless. There was also a positive relationship between the odds of becoming homeless and the number of delinquent behaviors in which the youth had engaged. By contrast, feeling very close to at least one family member reduced the odds of becoming homeless by nearly 80 percent. 

Homelessness Among Youthful Offenders

Every year, approximately 200,000 juveniles and young adults ages 10 to 24 years are released from secure detention or correctional facilities and reenter their communities. Most of these individuals are not high school graduates and most have never held a job. Many have physical, mental health, or substance abuse problems. A recent study of 1,800 arrested and detained youth found that nearly two-thirds of males and nearly three-quarters of females met diagnostic criteria for one or more psychiatric disorders (Teplin, Abram, McClelland, Dulcan, & Mericle, 2002). Yet, few youth will have received high quality services while in custody. Moreover, as if their transition back into society were not difficult enough, they are often returning to neighborhoods with high rates of poverty, unemployment, and crime (Mears & Travis, 2004).

Although relatively little is known about the process of reentry among this population, Altschuler and Brash (2004) have identified a number of challenges they are likely to confront, including problems with family and living arrangements. Some youth return to supportive homes; others do not. Still others are precluded from doing so by policies that prohibit individuals who have been convicted of certain drug offenses and other crimes from living in public or Section 8 housing (Popkin & Cunningham, 2001). Without a positive support network or stable living arrangement to which they can return, these juvenile and young adult offenders are at high risk of becoming homeless after their release. Once homeless, they may find themselves engaging in prostitution, selling or using drugs, or participating in other activities that could lead to their re-arrest.

There are no good estimates of the number of juveniles or young adults who become homeless upon release from detention or incarceration. Covenant House, a shelter for homeless youth in New York City, reports that approximately 30 percent of the youth they serve have been detained or incarcerated (New York City Association, 2005). These data also indicate that 68 percent had been living with family or guardians before incarceration. Eighty percent of the youthful offenders they served had neither completed high school nor obtained a GED, and 41 percent had a history of substance use. Interestingly, 49 percent also had a history of out-of-home care placement. In some instances, their child welfare case had been closed when they were detained or incarcerated and they had nowhere else to go upon release. This is true even if they had not yet turned 18 years of age because child welfare agencies are reluctant to take these youth back into their custody, especially if they have frequently “gone AWOL” or exhibited violent behavior (Riley, 2003; Travis, 2002).

Although most studies of youthful offenders have not included homelessness as an outcome measure, at least some research suggests that they are more likely to be homeless or precariously housed than other youth. Specifically, Feldman and Patterson (2003) compared 209 court-involved youth who participated in Workforce Investment Act (WIA) programs in Seattle–King County, Washington to 419 non-involved youth who participated in the same programs between July 1, 2000 and June 30, 2002. At program entry, the court-involved youth were less likely to be living with their parents and more likely to have no permanent address. Research on homeless adults has also consistently found high rates of prior incarceration, including incarceration while the adults were juveniles (Toro, 1998).

Intervention Research

Much progress has been made in providing services to homeless youth and families since 1987 when the Stuart B. McKinney Homeless Assistance Act (Public Law 100-77) was signed into law. There now exist a vast array of shelters and other emergency services to address the diverse needs of homeless individuals and families, including homeless youth (Toro & Warren, 1999). Increased funding from the federal government as well as other sources has also led to the development of new interventions. Although many of these interventions are designed to help homeless youth become and remain housed, some include other components such as mental health services, alcohol and other drug treatment, or HIV/AIDS risk reduction.

Unfortunately, few of these new interventions have been formally evaluated, and when evaluations have been done, rigorous experimental or quasi-experimental designs have generally not been used. In fact, we are aware of only one rigorous evaluation of a program for homeless youth (Cauce et al., 1998). Below, we describe some of the interventions that have been evaluated, discuss the results of those evaluations, and suggest directions for future research on promising interventions, even if those interventions have yet to be tested among homeless youth.

Case management.  Recognizing the multiple and diverse needs of homeless youth, Robertson and Toro (1999) advocated for a comprehensive and intensive case management approach that would address the unique needs of each homeless youth. Such an approach could be implemented in existing shelters and drop-in centers, and the relationship that developed between homeless youth and their case managers could become an important resource for the homeless youth and their families.

Intensive case management has been used successfully with homeless families and adults (Homan et al., 1993; James, Smith, & Mann, 1991; Toro et al., 1997). At least some research suggests that it might also be effective with homeless youth (Paradise et al., 2001). For example, Cauce et al. (1994) evaluated an intensive case management program for homeless youth in King County (Seattle), Washington. Youth were randomly assigned to either intensive or regular case management. Both groups experienced improved psychological well-being and a reduction in problem behaviors after the first three months of the intervention. However, youth who received intensive case management exhibited less aggression, fewer externalizing behaviors, and more satisfaction with their quality of life than youth who received “treatment as usual.”

Another promising service model is Urban Peak Denver, which provides overnight shelter as well as a variety of other services to homeless youth between the ages of 15 and 21 years. A case manager conducts a needs assessment and develops a case plan that includes educational and employment goals. Youthcan receive shelter for as long as they are moving forward on their case plans, and those who have been discharged are followed for six months. According to Urban Peak’s Client Database, which tracks the housing outcomes of youth who receive services, the percentage who experienced a positive housing outcome (e.g., moving into their own apartment, obtaining permanent supportive housing, or returning to their family of origin) ranged from a low of 48 percent in 2000 to a high of 65 percent in 2003 (Burt, Pearson, & Montgomery, 2005).

Family-focused interventions.  Although many programs work primarily, if not exclusively, with the youth who are homeless, others have targeted the family. This makes sense given that youth often cite family conflict as the cause of their homelessness (Whitbeck et al., 2002; Robertson & Toro, 1999) and they often end up returning to their families of origin anyway (Toro & Janisse, 2004). Moreover, at least one study found that youth who return home to live with their parents experience more positive outcomes than other youth (Thompson, Pollio, & Bitner, 2000). Of course, this could simply reflect the fact that the youth who are able to reunify are the youth with the fewest problems.

In any event, there is relatively little evidence as to the effectiveness of family-focused interventions. One example that is sometimes cited is a 1998 study by Coco and Courtney. They described a family systems approach for preventing recidivism among runaway females. Unfortunately, their evaluation of the intervention was weak, being based on a single-case design with a simple pre and post assessment of family satisfaction to assess the impact of the intervention.

It should be recognized that there are cases in which a family-focused intervention would not be in a homeless youth’s best interest. The most obvious example is a youth who has been severely neglected or abused. Other examples would include youth who have irreconcilable differences with their families, youth who have lost contact with their families, and youth whose families are homeless or precariously housed. In these cases, efforts must be made to find alternatives such as placement in foster care or independent living. Unfortunately, placement options may be limited, and may not represent an improvement in living situation (e.g., Benedict et al., 1994; Rosenthal, et al., 1991).

Social skills training.  In addition to their various service needs, many homeless youth lack what might be considered basic life skills, including meal preparation, household cleaning, time management, and budgeting (Aviles & Helfrich, 2004). Such skills are essential if they are to successfully transition out of homelessness and into successful adult functioning. Teare, Authier, and Peterson (1994) evaluated an intervention that used role-playing and a token economy to teach social skills to homeless youth receiving emergency shelter services. The assumption was that youth with social skills would experience fewer conflicts both during and after their shelter stay. The researchers reported that youth satisfaction with the program was generally high, that only 13 percent of the youth engaged in or expressed an intention to engage in self-destructive behavior, and that 69 percent did not exhibit any behaviors that were considered “out of control” (e.g., verbal or physical aggression). However, the researchers did not examine whether these outcomes reflected a change in behavior and their design did not include a comparison group that would have allowed them to assess the relationship between outcomes and participation.

School-based interventions.  School contexts provide an opportunity to assess and address the needs of homeless youth. Although there is some evidence that school-based interventions can benefit school age children who are homeless with their families, we are not aware of any school-based interventions that target unaccompanied homeless youth. However, we believe that such interventions could easily be adapted for homeless youth, most of whom do attend school (even if not consistently). For example, the Empowerment Zone provided a mental health treatment package for low-income and homeless elementary school age children during summer school (Nabors, Proescher, & DeSilva, 2001). Trained teachers and mental health providers administered classroom and small group interventions and individual counseling, and parents were offered parenting classes. Results showed that parents reported a significant decrease in child behavioral problems following the intervention. Another study found favorable results for a classroom behavioral management system in which trained teacher assistants used bracelets to reinforce positive behavior among homeless elementary school age children (Nabors, Hines, & Monnier, 2002). Although these initial findings are promising, the programs need to be expanded and more thoroughly evaluated.

Other intervention research.  A number of other studies have also examined the outcomes of homeless youth who received shelter services. Several of these studies have analyzed data from the Runaway and Homeless Youth Management Information System (RHYMIS). RHYMIS includes information about all of the runaway and homeless youth served by the Family and Youth Services Bureau’s (FYSB) Basic Center and Transitional Living and Street Outreach programs. RHYMIS includes demographic characteristics, services provided, and status at program exit (Family and Youth Services Bureau, 2006).

For example, Thompson et al. (2002) examined the outcomes of 261 runaway and homeless youth in four Midwestern states who received emergency shelter and crisis services, and compared their outcomes to the outcomes of 47 at-risk youth who received services from longer-term day treatment programs. Demographic information about the runaway and homeless youth was obtained from RHYMIS. Baseline data were collected from both groups at program intake. Follow-up data were collected six weeks post-discharge from the runaway or homeless youth and six weeks after intake from the comparison youth. Both the shelter youth and the day treatment youth experienced positive changes across six domains (runaway behavior, family relationships, school behavior, employment, sexual behavior, and self-esteem) and there were no significant group differences in the amount of change they experienced. Whether these improved outcomes persisted beyond the six-week observation period was not addressed.

Prevention Research

In addition to research on how to best address the needs of youth who are already homeless, other studies have focused on preventive interventions. This interest in the prevention of homelessness among youth is a relativelyr ecent development (e.g., Lindblom, 1996; Shinn & Baumohl, 1999; Toro, Lombardo, & Yapchai, 2002), and many interventions designed to prevent youth from ever becoming homeless (primary prevention) could just as easily be used to prevent youth who are currently homeless from becoming homeless again (secondary prevention; see Dalton, Elias, & Wandersman, 2007). Below, we discuss a number of issues regarding the prevention of homelessness. We focus on two groups of youth for whom the risk of becoming homeless appears to be particularly high: youth aging out of foster care and juvenile offenders.

Family-focused preventive programs.  Given that the youth frequently cite family conflict as the main reason for their homelessness, it should not be surprising that some homelessness prevention programs have focused on family dynamics and their impact on youth development. These programs include support groups for parents, parenting skills classes, and teaching conflict resolution skills. The assumption is that these programs will lead to improved family relationships, and thus prevent youth from becoming homeless.

One example of this approach is Project SAFE, a program operated by Cocoon House in Snohomish County, Washington (National Alliance to End Homelessness, 2002). Project SAFE provides three services to parents and other caretakers who are concerned about a youth’s behavior: phone consultation, groups or workshops, and a resource library. Parents or caretakers can call and speak with a master's level therapist who works with parents to develop a plan of action and decide what community resources will be needed to implement the plan. Plans can include steps to help parents deal with personal problems that may be contributing to the conflict with their youth. Parents receive a follow-up call, usually one week later, to check on their situation and provide any additional referrals. Parents can also participate in support groups that focus on cognitive behavioral skills or educational workshops that seek to raise awareness of parental risk factors that contribute to problem behaviors. In both cases, the goal is to promote healthier family functioning and to prevent teen homelessness. In FY 2005–2006, Project SAFE served 194 parents/caretakers. Outcome data showed a significant increase in parents’ perceived ability to cope with their youth as well as a significant decrease in parental perception of the youth needing to leave the home (Gagliano, 2006).

Another family-focused intervention that has the potential to reduce youth homelessness is multisystemic therapy (MST). Families are provided with intensive, home-based services. Master’s-level therapists empower parents to control their adolescent’s behavior by enhancing supervisory and monitoring skills. They also coordinate service provision among parents, individual counselors, teachers, peers, and others with a stake in the youth’s future.

Numerous randomized controlled trials have shown that MST can reduce antisocial behavior, even years following the treatment among chronic juvenile delinquents (Henggeler et al., 1997; Henggeler, Pickrel, & Brondino, 1999). MST clients have significantly fewer out-of-home placements and decreased recidivism (Henggeler et al., 1997; Henggeler, Pickrel, & Brondino, 1999). MST has also been successfully adapted for a wide range of other target groups of youth, including those with mental disorders and chronic health problems (Henggeler, 2006).

Homeless youth and delinquent youth have many similarities, including an absence of adult supervision, a lack of consistent discipline, and association with deviant peers (Whitbeck & Hoyt, 1999). Thus, future research should examine ways to tailor such programs to directly address the needs of youth at risk for homelessness as well as evaluate the efficacy of such programs.

School-based preventive programs.  School-based programs have the potential to prevent homelessness in adolescents at risk to run away by providing prosocial niches outside the home where they may be less vulnerable to influences of deviant peers (Johanson, Duffy, & Anthony, 1996). In addition, youth may have more opportunity to develop positive social bonds that discourage deviant behavior often associated with family conflict (Hirschi, 1969). However, programs that target youth at risk for homelessness have yet to be developed or evaluated. In-school and after-school prevention programs have shown to be effective in reducing the risk of youth delinquency and substance abuse (Crank, Crank, & Christensen, 2003; Pierce & Shields, 1998), and thus, may be extended to reductions of homelessness.

Preventing homelessness among youth aging out of foster care.  Preventing homelessness among youth aging out of care has long been a goal of federal policy. In fact, it was partly in response to several studies indicating that young adults who had aged out of care were at high risk of becoming homeless that Congress created the Title IV-E Independent Living Program in 1986 (Citizens’ Committee for Children of New York City, 1984; New York State Council on Children and Families, 1984; Shaffer & Caton, 1984). For more than a decade, this was the primary source of funding available to states to prepare their foster youth for the transition to young adulthood. States could use their Title IV-E funds to provide housing services such as helping youth find a place to live; however, the law prohibited those funds from being used for transitional housing or independent living subsidies (Allen, Bonner, & Greenan, 1988; Barth, 1990).

The Title IV-E program was replaced when Congress passed the Foster Care Independence Act of 1999 (FCIA). Title I of this legislation established the John H. Chafee Foster Care Independence Program and doubled the federal allotment for state independent living programs that prepare foster youth for the transition to adulthood. These funds can be used to provide youth with a wide range of services, including services to promote education and employment, life skills training, health education, case management, and mentoring (Ansell, 2001). Two provisions, in particular, are relevant to the prevention of homeless among youth aging out of foster care. One allows states to use up to 30 percent of their federal Chafee funds to pay for the room and board of former foster youth who are at least 18 years old but not yet 21. The other requires states to use at least some portion of their funds to provide follow-up services to foster youth after they age out. In the past, such services could be provided at state option, but seldom were.

States are currently using their Chafee funds as well as funding from other sources to assist foster youth with housing. For example, the Massachusetts Department of Social Services uses some of its Chafee money to fund its Discharge Support Program, which helps foster youth with their first month’s rent, security deposits, and other assistance, but the youth must be employed and able to pay their own rent. Connecticut's Community Housing Assistance Program (CHAPS) provides foster youth, age 18 and older who are working and enrolled in school, with a subsidy for rent and other living expenses. In fact, CHAPS is part of a continuum of housing options for Connecticut foster youth that also includes group homes for 14- to 16-year-olds and transitional living apartments for 16- and 17-year-olds. Illinois’s Youth Housing Assistance Program targets youth who have aged out or will soon age out and are at risk of becoming homeless. The program provides housing advocacy services to help youth between the ages of 17.5 and 21 to secure and maintain stable housing as well as cash assistance to help with deposits, emergency rental assistance, temporary rental subsidies, and furniture and appliances.

Partnering is another strategy that states have implemented to address the housing needs of foster youth. Some states are taking advantage of federal legislation that made youth aging out of foster care eligible for housing assistance under the Department of Housing and Urban Development’s Family Unification Program (FUP). In these states, child welfare agencies collaborate with housing authorities and/or community-based organizations to provide foster youth with time-limited housing vouchers over 18 months as well as other services. States with FUP programs for foster youth include New York, Colorado, Ohio, and California. In addition, some localities, including New York City, give foster youth priority access to Section 8 vouchers.

Most recently, Toro, et al. (2006) have proposed a comprehensive program that would both prevent homelessness and other negative outcomes among youth aging out of foster care and improve their emotional, behavioral, and socioeconomic well-being. The intervention would target foster youth transitioning to adulthood beginning at age 17. The program would be based on an intensive case management model and MST approaches and would involve the assessment of service needs across a number of domains, advocacy for the provision of services, coordination of service provision, and monitoring of service delivery. Small caseloads and frequent contact between case managers and youth would be important to keep youth who lack support from family members or other adults from falling through the cracks and because the quality of the client-case manager relationship is a key predictor of successful outcomes (Casey Family Programs, 2005; Thompson et al., 2006).

Youth would generally be referred to community resources, but program staff could provide services that are not available as well as direct funds to support independence (e.g., rent money to avoid eviction). In addition to service provision, the program would focus on empowering youth to make responsible life decisions. Toward this end, case managers would use a person-centered approach that emphasizes youth’s strengths and preferences as well as motivational interviewing (Miller & Rollnick, 2002), a therapeutic technique that seems to be effective in promoting positive change behavior seven among multi-problem populations such as low-income, African American substance abusing mothers (Ondersma et a., 2005). Toro et al. (2006) have also recommended that the intervention be evaluated using random assignment within a longitudinal design, with data collected at baseline and then again at 6-month intervals for 18 months in total. It is hoped that this intervention will be implemented and evaluated starting in late 2007.

Although independent living programs have been described (e.g., Hoge & Idalski, 2001), there is very little in the way of empirical data regarding their effectiveness. Due to another provision in the FCIA, states will soon be required to track the outcomes of current and former foster youth at ages 17, 19, and 21 and report those outcomes to the National Youth in Transition Database. Homelessness is one of the six outcomes about which they will be required to report.

Several other issues related to research on the prevention of homelessness among youth aging out of care also merit attention. First, findings from the Midwest study indicate that some foster youth, including those who run away repeatedly, are at even greater risk. Targeting those youth for preventive interventions both before and after they leave care would seem to make sense, and the impacts of those interventions should be formally evaluated. Second, the Midwest study also found that feeling close to at least one family member reduced the likelihood of becoming homeless. This has important practice implications for child welfare agencies. Specifically, it suggests that more attention should be paid to maintaining relationships between foster youth and members of their biological family, including grandparents and siblings. Such attention may, perhaps, even be appropriate when the family is somewhat dysfunctional, because, if we wish to prevent homelessness, some (even imperfect) support from family may be better than no support at all. What is not yet clear, and merits further investigation, is why closeness to family has what appears to be a protective effect. One possibility is that family members are a resource to whom foster youth can turn if there is no other place for them to stay. Another is that strong family ties reflect underlying individual or environmental resources that function to protect youth. In any event, interventions aimed at promoting family ties, where doing so is in a youth’s best interest, should be developed and their ability to reduce the risk of homelessness should be explored.

Third, one of the most striking findings to emerge from the Midwest study was that the foster youth who were still in care at age 19 seemed to be faring better than their peers who had left. There were statistically significant differences across a number of domains, including college enrollment, access to health care, and criminal justice system involvement, and they consistently favored the 19-year-olds who were still in care. It remains to be seen whether those differences will persist once the foster youth who were still in care at age 19 have also exited. A third wave of survey data being collected from the foster youth when they are 21 years old will begin to address this question. For now, at least, the results suggest that one way to reduce the percentage of youth who become homeless after aging out of care would be to extend their eligibility until age 21, as is already the case in a few states like Illinois.

Fourth, an often overlooked provision of the FCIA requires states to use some of their federal training funds to assist foster parents, group home workers, and case managers do a better job of preparing foster youth for the challenges they face during the transition to adulthood. With respect to preventing homelessness, this means educating foster parents, group home workers, and case managers about how to help their foster youth find housing and remain housed. To this end, Casey Family Programs (2005) has published  It’s My Life , a series of guides, including one focused on housing, that contain practical strategies and on-line resources for adults working with these youth. Researchers could examine whether educating foster parents, group home workers, or case managers about these or other strategies leads to more stable housing and lower rates of homelessness.

Finally, although the FCIA requires states to use a portion of their Chafee funds to provide supportive services to foster youth after they age out, at least some research suggests that young adults may not take advantage of such services even when they are available (Lindblom, 1996). Just why this is the case is not well understood. It may be that young adults are reluctant to participate in services that they associate with foster care or that they object to the conditions of participation. It is also possible that such services are perceived to be of little help.

Preventing homelessness among youthful offenders.  As explained above, youthful offenders can become trapped in a cycle of homelessness and incarceration. If they return to the streets after their release, there is a strong chance they will become involved in the same behaviors that initially led to their arrest (National Alliance to End Homelessness, 2001). Thus, programs that assist youthful offenders to find housing and stay housed have the potential not only to prevent homelessness but also to reduce recidivism in the criminal justice system.

Unfortunately, although a number of programs have been developed to help youthful offenders with the process of reentry, not much is known about their effects on homelessness prevention. One exception is the young adult component of the Going Home Reentry Grant in Polk County, Iowa. This program targets youthful offenders, aged 17.5 to 20 years, who are leaving state training schools. A Community Transition Team works with the youthful offender to create an individualized wrap-around plan that addresses housing and other service needs. In some cases, this plan involves reunification with parents or other family members. In other cases, housing is secured using project funds. Although there has been no formal evaluation of the program, there are outcome data for the 47 youthful offenders (32 males and 15 females) who were served during a three-year grant period. Seventy-nine percent of the females and 84 percent of the males were able to establish a stable residence.

The housing needs of youthful offenders have also been addressed by programs that target youth aging out of foster care. For example, Lighthouse Youth Services in Cincinnati, Ohio, runs an independent living program that focuses on foster youth between the ages of 16 and 19 as well as a transitional living program that targets homeless youth between the ages of 18 and 25 (Kroner, 2005). However, a number of youthful offenders are also served each year. Referrals come from child welfare agencies, homeless shelters, juvenile courts, and community-based organizations. Lighthouse's housing continuum includes several housing options for youth: scattered-site apartments, supervised apartments, shared homes (for four or five youth), host homes, and boarding homes. Youth move from more structured to less restrictive living arrangements, depending on the level of support and services they need. Unfortunately, no formal outcome data have been collected to date.

Employment programs as a prevention strategy.  Although preventing homelessness is usually not a primary goal of employment programs, it stands to reason that youth and young adults are less likely to become homeless if they are self-sufficient and stably employed. From this perspective, several programs funded by the U.S. Department of Labor (DOL) could be considered preventive interventions. One example of this approach involves programs funded under the Workforce Investment Act (WIA). Low-income youth between the ages of 14 and 21 are eligible to receive WIA-funded services if they face one or more recognized barriers to completing school and attaining economic self-sufficiency. These services allow youth to continue their education and pursue employment. Youth aging out of foster care, homeless youth, and youth who have been involved with the juvenile justice system are among WIA's target populations.

In addition to these WIA services, DOL also funds a number of other workforce development and support services that can help prevent homelessness among at-risk youth. Job Corps is the largest and most comprehensive residential vocational training and education program for at-risk youth between the ages of 16 and 24. Youth aging out of foster care and runaway or homeless youth are among the target populations of Job Corps. In a multi-year evaluation of the program, eligible youth were randomly assigned to a treatment group that received Job Corps services or a control group that did not. They were interviewed at the time of enrollment and then again at 12, 30, and 48 months after random assignment. The researchers did not look specifically at homelessness. However, Job Corps participation was related to independent living at the 48-month interview. A slightly smaller percentage of program group members were living with their parents, and a slightly larger percentage were living with a partner and reported being the head of the household (Burghart et al., 2001; Schochet, Burghardt, & Glazerman, 2001).

Likewise, DOL's Youth Offender Demonstration Program (YODP) is a labor-focused reentry program for youth ages 14 to 24 returning to their communities from detention or incarceration and who are already involved in the juvenile/criminal justice system, are gang members, or are at risk of gang or court involvement. Of particular relevance to homelessness prevention, some YODP sites are working with nonprofit housing programs. Unfortunately, no formal evaluation of the YODP has ever been completed.

Theoretical Developments

Haber and Toro (2004) provide a thorough review of various theories that have been applied in recent research on homeless children and youth. The theories most relevant to homeless youth include variants based on social learning theory (Bandura, 1977; Patterson, 1982). The Risk Amplification Model (RAM), one of the most widely applied of these variants, posits that noxious early environments, including poor parenting practices in the home, put youth at risk for homelessness and that being homeless further "amplifies" the risk for poor outcomes among such youth (Paradise et al., 2001; Whitbeck & Hoyt, 1999). The RAM suggests that risk is amplified by homelessness through victimization on the streets, engagement in subsistence strategies (e.g., stealing food, prostitution), association with deviant peers and adults, and other negative experiences.

Cross-sectional studies provide some empirical support for the RAM. For example, homeless youth tend to come from more deleterious home environments and experience higher rates of victimization compared to matched housed youth (Robertson & Toro, 1999). In a more direct test of the RAM, Whitbeck, Hoyt, and Yoder (1999) found that affiliation with deviant peers, deviant subsistence strategies, risky sexual behaviors, and substance use amplified the effects of a negative family environment on victimization and depressive symptoms among homeless female youth (but not among homeless males).

There is also some support from longitudinal studies. Using the Detroit-based dataset described earlier, Lombardo and Toro (2005) found that family conflict was related to heightened self-reported symptomatology and deviant peer associations, and that both of these were associated with risky sexual behaviors and substance abuse six months later. Analyses testing the RAM over longer periods of time (up to 6.5 years) are currently being conducted by Toro and colleagues.

Much has been learned since Robertson and Toro reviewed the literature on homeless youth for the 1998 National Symposium on Homelessness Research. Yet many important questions remain unanswered. Several areas, in particular, could be the focus of future research.

• Many risk factors associated with youth homelessness have been identified. Examples include family conflict, aging out of foster care, and identifying as GLBT. What is not well understood is how these factors operate. That is, what are the pathways leading to homelessness among youth with these risk factors? Future research needs to explore these pathways and consider how other factors (e.g., access to and quality of services received during childhood or early adolescence, growing up in a family that experienced homelessness) either aggravate or mitigate those risks.
• Although many interventions have been developed to address the diverse needs of homeless youth, the vast majority have not been evaluated. As a result, we know relatively little about what works. Closing this gap will require methodologically sound studies that include control (or at least comparison) groups in experimental (or at least quasi-experimental) research designs.
• Researchers should examine whether certain types of interventions are more effective with some homeless youth than others (e.g., runaway youth vs. throwaway youth vs. systems youth; street youth vs. shelter youth; rural youth vs. urban youth; youth homeless with their families vs. youth homeless on their own). Groups that are likely to have unique needs and hence for whom unique interventions may be merited include LGBT youth and youth who are pregnant or parenting.
• Broadly speaking, there are two types of prevention strategies: universal approaches that seek to promote positive youth development, and more targeted approaches that focus on youth thought to be at greatest risk. Research is needed on both types of strategies to determine whether both can prevent homelessness and other negative outcomes among youth.
• Because so many homeless youth cite family conflict as the reason for their homelessness, more attention should be paid to prevention and intervention strategies that focus on the family. Strategies might involve improving communication, developing conflict resolution skills, and increasing understanding of adolescent development. It is important for social workers and others assisting homeless youth and those at risk for homelessness (such as youth aging out of foster care) to help these youth connect with family members who might assist them in the future (often after the workers end their assistance). It is also important that "family" be broadly defined to include not only biological relatives but also others (e.g., fictive kin, close friends) who youth regard as part of their family.
• Although interventions may benefit from tapping into familial resources, reunification may not be a good option for certain homeless youth. More research is needed to determine the individual and environmental circumstances that argue for and against familial reunification. Interventions should be developed using this information.
• Not much is known about why so few homeless youth, whether in shelters or on the streets, use human services available to them (aside from short-term use of shelters for some). Similar to recent studies of homelessness among adults (e.g., Acosta & Toro, 2000), future research needs to ask the homeless youth themselves about their experiences and satisfaction with various services. Most likely, attention will be needed to alter approaches used by existing programs and services to make them more accessible and "user friendly."
• Most existing research on homeless youth has focused on the "literally homeless," those who have spent at least some time in homeless shelters, on the streets, or living in other unconventional settings (Toro, 1998). Future research should also focus on youth who "couch surf" or who are otherwise precariously housed. This group may be larger than, and at equal risk as, those who are literally homeless.
• Developing effective prevention and intervention strategies requires a clearer understanding of what youth experience before and after they become homeless. Toward that end, we need more quantitative and qualitative research to explore the outcomes of homeless youth, including the pathways through which they exit, or fail to exit, homelessness. More longitudinal studies are also needed to examine how environmental, family, and individual factors affect both their short-term and long-term outcomes. Disentangling the effects of these different types of factors will also require multivariate data analytic techniques.
• Preventive interventions with youth aging out of foster care and youthful offenders should be expanded. Although some programs exist, little firm empirical evidence exists on what works. Broader and better designed preventive interventions are needed.
• It appears that few if any of the studies reviewed above directly involved homeless or other at-risk youth in the research process. We believe that such youth should, ideally, be consulted at every stage, including the design of the study, the development of survey instruments or interview protocols, the collection of data, the interpretation of results, and the dissemination of findings. Not only can involving homeless or other at-risk youth in the research process improve the quality of the research (Jason et al., 2004), but it may increase the likelihood that the research leads to better policy and practice. Similarly, there should be more collaboration between service providers and researchers, both to improve the quality of the research and the ability for the research to be applied to policy and intervention.
• With regard to theoretical approaches, there is a need to move beyond the pervasive deficit orientation in much of the research toward more positive, resilience-based frameworks. There is also a need to more carefully consider the developmental contexts in which youth who are homeless or at risk for homelessness exist and to develop a better international understanding of homeless youth.

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Hammer, H., Finkelhor, D. & Sedlak, A. (2002, October). Runaway/Thrownaway children: National estimates and characteristics.  National Incident Studies of Missing, Abducted, Runaway, and Thrownaway Children.  Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Heinze, H., Toro, P. A., & Urberg, K. A. (2004). Delinquent behaviors and affiliation with male and female peers.  Journal of Clinical Child and Adolescent Psychology, 33 , 336-346.

Henggeler, S. W. (2006, September).  Multisystemic therapy approaches.  Presented at Wayne State University Children's Bridge and Children's Hospital of Michigan Children's Conference, Promoting the Well-Being of Children and Youth in Urban America: Best Practices to Next Practices, Detroit, MI.

Henggeler, S. W., Melton, G. B., Brondino, M. J., Scherer, D. G., & Hanley, J. H. (1997). Multisystemic therapy with violent and chronic juvenile offenders and their families: The role of treatment fidelity in successful dissemination.  Journal of Consulting and Clinical Psychology 65 , 821-833.

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[1]   In the U.S. and other developed nations, relatively few homeless families (12 to 20 percent) include children age 12 or older (Buckner, Bassuk, Weinreb, & Brooks, 1999; Burt et al., 2001), and children under age 12 are rarely found homeless on their own (Robertson & Toro, 1999). In fact, many shelters for homeless families exclude children age 12 or older who shelter staff fear might prey upon the younger ones. As a result, homeless families with older children are often compelled to leave their older children with friends or relatives before entering a shelter.

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Research Topics

• Adult residential facilities
• Black communities
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• criminalization
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• ethnic inequalities
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Research Types

Foster youth and homelessness.

Homelessness Policy Research Institute

The goal of the foster care system in the United States is to place these children in a situation of permanency, either with their own family or with an adoptive family (Children’s Bureau, 2020) (Papovich, 2020). While most of the roughly 600,000 children who enter the foster care system each year do end up with a permanent placement, about 7% of children in foster care exit the system and are immediately emancipated (Children’s Bureau, 2020). For these young people, the transition to adulthood is abrupt and often turbulent. Because of this sudden transition, the lack of support provided to young people in foster care, and the trauma these young people often carry, homelessness is a significant problem among youth who have recently aged out of the system (Rosenberg & Kim, 2017). Estimates of how many young people exiting foster care experience homelessness vary depending on the interview age of the sample, the study’s location, the definition of homelessness used, and various other factors (Curry & Abrams, 2014). A recent California study interviewed young people in foster care at age 17 and then four years later at age 21. The interviewers asked these young people whether they had been homeless and if they had couch surfed. Over 24% of respondents indicated they had experienced homelessness during that time and 36% of respondents said that they had “couch-surfed” (Courtney et al., 2018). This literature review describes the foster care system, focusing on its association with homelessness, particularly highlighting the disparities in how often foster care children experience homelessness after aging out and explore policy solutions to lessen this disparity.

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A Closer Look at Our Transitional Housing Program

Covenant House has transitional living programs in 24 cities across the United States, Canada, and Mexico, serving more than 500 youth each night on their path to independence.

What Is Transitional Housing?

Our transitional housing programs provide young people facing homelessness with a stable, dependable, and safe place to live for an extended period of time. We also provide them with case management and critical supportive services. Transitional living programs are a proven means to help youth move from homelessness to lifelong stability.

Our Transitional Housing Research

Our research shows transitional housing works. In 2021, Covenant House, along with sister organizations Schoolhouse Connection and National Network for Youth, conducted a study where we analyzed outcomes for 564 young people who exited our transitional living programs in 15 U.S. cities over the course of 12 months. Of those 564 youth, 73% exited the program to stable housing, and 69% were employed or enrolled in school when they left the program.

Transitional Housing Improves Outcomes for Youth Facing Homelessness

Every year, millions of young people experience homelessness across the United States, Canada, and Latin America. We are committed to serving youth facing homelessness and survivors of human trafficking in the most effective ways possible.

Transitional housing is proven to significantly improve outcomes for young people experiencing homelessness. The longer a youth stays in the program, the more likely they are to secure permanent housing, employment, education, and access to services. That’s why our transitional living programs are 18 to 24 months in the United States and Canada, and 12 months in Mexico.   And there’s more: An analysis of our transitional living programs in 2021 showed that youth who identify as Black, Indigenous, or people of color experience the highest rates of exiting the program to stable housing and employment. That is critical to advancing racial equity since young people of color are at far greater risk of experiencing homelessness than their white peers.

More Than Just a House

With a safe and stable place to live in transitional housing, young people are free to work on the skills and abilities that will ensure their path to independence. In our transitional living programs, we provide youth supportive services for behavioral health, educational and career development, a savings plan so they can bank money they earn toward permanent housing, financial literacy and planning, life skills, and medical and mental health programs.

Where Are Covenant House’s Transitional Housing Programs Located?

We have transitional living programs in 24 cities across the United States, Canada, and Mexico, serving more than 500 youth each night on their path to independence. We often refer to these programs as Rights of Passage, or ROP. In Mexico City, it is called Programa Departamentos (Apartment Program).

They are located in:

• ALASKA: Anchorage
• CALIFORNIA: Los Angeles , Oakland , Santa Clara
• FLORIDA: Fort Lauderdale , Orlando
• GEORGIA: Atlanta
• LOUISIANA: New Orleans
• MARYLAND: Prince George’s County
• MICHIGAN: Detroit
• MISSOURI: St. Louis
• NEW JERSEY: Asbury Park , Atlantic City , Elizabeth , Montclair , Newark
• NEW YORK: New York City
• PENNSYLVANIA: Philadelphia
• TEXAS: Houston
• WASHINGTON, D.C .
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“You’re always learning something you need to finally make it. And the great thing is, when you go out on a ledge, and even if you fall a few times, there’s always someone there to catch you and say, ‘It’s ok, try again.’”

Shelter Is Only the Beginning

From crisis to care: Find out what it's like when a young person enters our doors.

News and Insights

The Youth Homlessness Research Group

The Youth Homelessness Research Group

It is estimated that at least 235,000 Canadians experience homelessness each year (Gaetz et al., 2013), making it a major public health concern. In any given year there are at least 35,000 to 40,000 youth between the ages of 13 – 24 experiencing homelessness in Canada (Gaetz et al, 2016). Youth experience unique pathways into homelessness and have specific needs that require tailored interventions prior to and while experiencing homelessness. Once homeless, youth experiences are also different from those of adults, making them even more vulnerable to social and health inequities.

The Youth Homelessness Research Group conducts public health intervention research on youth homelessness and its prevention. We focus on understanding what factors lead to youth homelessness, its impact on youth health and well-being, and interventions to address them. We develop new and adapt existing interventions, and evaluate policies, practices and programs that provide youth at risk of or experiencing homelessness with relevant support to improve their health and well-being. The ultimate goal of our work is to contribute to the prevention of youth homelessness in the future and to eliminate mental and physical health consequences linked to youth homelessness. 

Projects & Participants

Improving interventions for youth experiencing homelessness .

To read more about our research project examining interventions for youth experiencing homlessness in Montreal, click on the link below to visit the project page. 

Pregnancy, Motherhood, and housing insecurity project

To read more about our teenage pregnancy project lick below to visit our project page. Or, sign up to be a participant in life-course mapping interviews . 

Focus Groups

If you are interested in participating in a focus group (starting in 2024) as part of our teenage pregnancy project, please click below to learn more about focus groups and sign up for future information. 

REports and Publications

To read the latest reports and publications produced by the team and our partners, please use the link below. 

Latest Publications

Interventions to prevent pregnant youth and young mothers experiencing homelessness: A systematic review of available evidence.

Lakrouf, R., Roy, L. & Stich, C. (2023). Interventions to prevent pregnant youth and young mothers experiencing homelessness: A systematic review of available evidence. PROSPERO 2023 CRD42023396479 Available from:  https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023396479

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The Workforce Investment Act after Five Years: Results from the National Evaluation of the Implementation of WIA

Publication info, description.