Child Welfare

Human trafficking is a significant and growing public health concern. Subgroups of adolescents and young adults are particularly vulnerable to human trafficking, especially youth who are unstably housed or homeless. While youth experiencing trafficking come into contact with the healthcare system, they are often not identified during routine assessment due to lack of specific inquiry and low disclosure. Therefore, we utilized a mixed-methods study design to assess the differences in the identification of human trafficking among youth experiencing homelessness (n = 129) between a standard psychosocial assessment tool and a human trafficking specific assessment tool. Findings indicate that the tool developed to specifically assess for human trafficking was more likely to identify youth experiencing sexual and labor exploitation, as well as the risk factors for human trafficking. Secondly, youth reported that mistrust of the system, fear of involving the police if reported, not wanting to interact with the mental healthcare system, and stigma are barriers to disclosing human trafficking. In conclusion, healthcare providers caring for youth experiencing homelessness should adopt improved screening tools for human trafficking to reduce the risk of missed opportunities for prevention and treatment among this high-risk population of youth.

"Objective: This study examines the impacts of structural violence on women and how this can influence their trajectory into and their sustainable exits from homelessness.
Methods: The research is qualitative and community-based, including 15 interviews with mothers living in emergency shelters and a group interview with nine professionals. An advisory group was formed through partnership with community services to provide project oversight and guide and interpret the results. A member check group consisting of seven mothers with recent experiences of homelessness was engaged to further refine findings and implications. The research team used Critical Social Theory, in particular feminist theory, as an analysis framework in order to account for the implications of structural violence on mothers with diverse and complex histories.
Results The results highlight three structural-level factors: gendered pathways into homelessness, systems of support that create structural barriers, and disjointed services that exacerbate trauma.
Conclusion: The authors propose systems-level changes rooted in trauma-informed approaches to facilitate a sustainable exit from homelessness for mothers and their children."

"Research has identified higher rates of mental disorders among former child welfare youth and
youth experiencing homelessness when compared with their peers in the general population.
Given the growing number of campus support programs serving these youth, research should
focus on students in these programs to understand whether mental health problems interfere
with these students’ receipt of program services, which can lead to unsatisfactory academic
performance. This study collected both quantitative and qualitative data from students in a
campus support program to examine the prevalence of mental disorders, mental health
service use, receipt of program services, students’ grade point average, and their perceptions
of obstacles and motivations to academic success. Implications for social work research and
practice are discussed"

"Background
Homeless, runaway, and youth exiting foster care are vulnerable to sexual exploitation, but little research has parsed the societal, community, and individual factors that contribute to their risk.

Objectives
(1) To estimate child welfare characteristics in a sample of homeless young people who engaged in commercial sex (CS); and (2) To compare young people who were sex trafficked (ST) to those who engaged in some other form of CS.

Participants and setting
This study includes 98 homeless young people in Philadelphia, PA, Phoenix, AZ, and Washington, DC, who were interviewed for a larger study of ST and endorsed engagement in CS.

Methods
We used a non-probability, purposive, maximum variation sampling procedure. Interviews were recorded and responses were simultaneously noted on a standardized interview form. Data were analyzed through means, frequencies, and bivariate tests of association.

Results
Average age of the full sample of 98 homeless young people was 20.9 years; 48% were female and 50% were Black/African American. Forty-six percent of the full sample was sex trafficked. The full sample and the victims of ST differed significantly in three child welfare characteristics, with the ST group more likely to have been maltreated as children, more likely to have had family involvement with the child welfare system (CWS), and more likely to report higher rates of living someplace other than with their biological parents as children.

Conclusions
ST victims differ from those who engaged in other forms of CS in histories of maltreatment, involvement with the CWS, and exposure to residential instability while growing up."

"Objectives: The present study investigates the nature of homelessness among at-risk youth transitioning into adulthood. Current policies use multiple definitions to determine eligibility for homeless services among adolescents and emerging adults. Conflicting criteria demarcate different thresholds along an assumed continuum ranging from frequent mobility to living on the streets. Multiple eligibility criteria impede cohesive service provision and prevention efforts. Little research tests this continuum conceptualization, while developmental research suggests subgroups better capture homelessness in emerging adulthood. The present study leveraged prospective data on a national sample of child welfare-involved adolescents—a population vulnerable to homelessness in emerging adulthood.
Methods: Youth report experiences of housing instability and homelessness 18–36 months after child welfare investigation, as well as adaptive functioning in multiple behavioral domains. Latent variable analyses test for a continuum of housing insecurity with reliable thresholds versus a typology capturing subgroups of co-ccurring patterns of housing instability.
Results: Results show little support for a continuum of risk; instead, three subgroups of housing instability emerge. The largest group, ‘Stably Dependent’ (83%) youth, live with family without attaining education and employment experiences necessary for independence. A smaller group labeled ‘Transients’ (12%) exhibit multiple housing and behavior problems typical of runaway youth. The smallest group, ‘Unstably Independent’ (5%), youth struggled to maintain housing in the absence of supportive adults.
Conclusions: Findings affirm a developmental conceptualization of homelessness and identify opportunities for screening and prevention."

"Objectives:Housing insecurity and homelessness contribute to risk of maltreatment among one in five of the nearly 3.5 million children annually investigated for maltreatment in the United States. The Family Unification Program (FUP)—a federal initiative—connects inadequately housed families involved in child welfare with long-term rental subsidies to avoid foster placement. However, FUP remains understudied and underutilized with funding levels that serve only a fraction of eligible households. The present study uses system dynamics modeling to inform decision-making by testing policies for scaling FUP.
Method:Simulations model delivery of FUP within child welfare from a feedback perspective. Calibrated on national data, models replicate trends in child welfare involvement from 2013 through 2016, and analyses forecast rates through 2019. Experiments test policies that enhance FUP. Outcomes track system-wide rates of family separation and returns on investment of expanded housing interventions.
Results:Dramatic expansions of FUP benefit more families and improve marginal return on investment. Yet, scale-up fails to reduce system-wide rates of family separation or generates substantial cost-savings.
Conclusions:Simulations demonstrate structural challenges for scaling FUP. Constant demand for affordable housing constrains sustainable improvements in child protection. Child welfare responses to homelessness require innovations that reduce demand for housing services through prevention and earlier intervention."

Homelessness represents an enduring public health threat facing communities across the developed world. Children, families, and marginalized adults face life course implications of housing insecurity, while communities struggle to address the extensive array of needs within heterogeneous homeless populations. Trends in homelessness remain stubbornly high despite policy initiatives to end homelessness. A complex systems perspective provides insights into the dynamics underlying coordinated responses to homelessness. A constant demand for housing assistance strains service delivery, while prevention efforts remain inconsistently implemented in most countries. Feedback processes challenge efficient service delivery. A system dynamics model tests assumptions of policy interventions for ending homelessness. Simulations suggest that prevention provides a leverage point within the system; small efficiencies in keeping people housed yield disproportionately large reductions in homelessness. A need exists for policies that ensure reliable delivery of coordinated prevention efforts. A complex systems approach identifies capacities and constraints for sustainably solving homelessness.

Rates of child abuse appear to have fallen in 2020. Nevertheless, some experts, including physicians, have offered their opinions that child abuse must be on the rise because of the COVID-19 pandemic, even explicitly waving away evidence to the contrary. Recognizing the paradox of declining rates amid increased risks points to important lessons for prevention: perhaps a combination of family strengths, community resources, and government assistance has prevented many cases of child maltreatment. A review of available data suggests that there was not a significant rise in child abuse related to COVID-19. Child welfare re