Homelessness

"Purpose
This study aimed to explore the association between direct exposure, indirect exposure, and perpetration of gun violence and suicidal ideation among young adults experiencing homelessness (YAEH).

Methods
YAEH (n = 1,426) in seven cities across the U.S. were surveyed. Logistic regression analyses were conducted to examine the association between lifetime gun violence exposure and suicidal ideation in the past 12 months.

Results
Forty-five percent (n = 641) of YAEH had experienced direct or indirect gun violence, whereas 17% (n = 247) had engaged in gun violence perpetration. Gun violence perpetration is associated with elevated suicidal ideation risk (odds ratio = 1.46; 95% confidence interval = 1.02–2.01) among YAEH.

Conclusions
A high percentage of YAEH were exposed to firearm violence. Cross-sector, multiagency collaborations are warranted to reduce firearm violence exposure among this vulnerable population. Homeless service providers should screen for gun violence exposure and suicide risk and target prevention efforts on YAEH with a history of gun violence perpetration."

Teens who experience homelessness are more likely to engage in risky sexual behavior, though less is reliably known about sexually transmitted infection (STI) testing rates in this group. We tested for differences in sexual behaviors and STI/HIV testing based on student homelessness and intersecting factors using data from the 2019 Youth Risk Behavior Survey administered in 7 states and 3 school districts. Students who experienced homelessness were more likely to report risky sexual behavior. Race moderated this link, suggesting that Asian students who experienced homelessness were at greater risk. Homelessness was linked to a greater likelihood of having been tested for STIs/HIV among those who seemed to be in groups recommended for testing. Student sex and lesbian, gay, and bisexual (LGB) identity did not moderate associations between homelessness and risky sexual behavior or STI/HIV testing. The overall sample demonstrated low STI testing rates, indicating a continued need to improve testing rates for all youth at risk for STIs/HIV.

"Aims and objectives: To explore homelessness among lesbian, gay, bisexual, transgender, queer/questioning plus (LGBTQ+) youth and to identify their support and care requirements.
Background: LGBTQ+ youth face many health and societal challenges including issues related to homelessness.
Design: A systematic review of qualitative, quantitative and mixed methods studies.
Methods: A search of relevant electronic databases was carried out and included the dates August 2008-August 2018 and limited to academic journals and peer-reviewed empirical studies written in English. Included studies specifically addressed the homeless experiences of youth aged 13-24 years old who identified as LGBTQ+. The PRISMA checklist was used in the review. A quality assessment instrument was used to review all of the selected papers and narrative methods utilized in the synthesis of the research evidence.
Results: The search resulted in 319 papers, and after applying distinct inclusion criteria, a total of 14 papers were considered suitable for the systematic review. Following analysis, the four main themes identified were stigma, discrimination and exclusion; mental health issues and substance use; sexual risks and vulnerability; and interventions and supports.
Conclusion: LGBTQ+ homeless youth is a major public health concern that has significant consequences for a young person's physical and psychosocial well-being.
Relevance to clinical practice: Practitioners need to be aware of the specific health and support requirements of LGBTQ+ youth in relation to homelessness. Inclusive and holistic care plans should exist that are fully responsive to the distinct needs of this group guided by definitive policies and sound clinical research. The implications for future nursing practice are presented and discussed.

Homeless youth have extremely high rates of suicidal ideation and attempts, but limited research has evaluated the efficacy of suicide prevention interventions. Suicidal homeless youth (N = 150) between the ages of 18 to 24 years were recruited from a local drop-in center. Of interest was (1) whether the proposed sample of eligible youth could be identified, (2) whether youth could be engaged and retained in the prevention intervention, and (3) whether the intervention was associated with reduced suicidal ideation, our primary outcome measure. In particular, youth were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) (N = 75) or TAU alone (N = 75). Findings showed that the proposed sample of eligible youth could be identified and engaged in the study, and all youth showed a significant decline in suicidal ideation over time, with a faster decline among youth assigned to CTSP. These findings suggest that (1) at-risk suicidal youth can be identified and engaged outside of hospital emergency rooms, such as in drop-in centers, and (2) intervention added to TAU can strengthen reductions in suicidal ideation. Ultimately, attention towards reducing suicide risk among these youth has the potential to reduce premature mortality, hospitalization and loss of human capital.

Pages: 402-411

"Background: Research is scarce regarding homeless students’ school-violence experiences, specifically while considering the role of school-climate and the different groups within the homeless student population. Understanding the relation between school-violence and school-climate might help towards the development of support for homeless students. Objective: Examine the association between school-climate components, homelessness and school discriminatory bullying, behavioral victimization and weapon involvement at the student and school levels. Participants: 389,569 high school students and 811 schools from a representative California statewide sample (2011–2013). Methods: Bivariate and multivariate analyses were used to examine differences between the subgroups of homeless students as compared to nonhomeless students. Hierarchical logistic regressions were conducted to examine the relation between school-climate and discriminatory bullying, behavioral victimization and weapon involvement in school at the individual level, and hierarchical linear regressions were conducted at the school level. Results: At the student level adding school-climate dimensions contributed significantly to each outcome. Positive school-climate was associated with lower rates of all school-violence outcomes. Safety, positive relationship, and connectedness were all significantly negatively associated with the outcomes, especially safety. At the school level, the partial linear regression coefficient of school-climate is negative and significantly (p < .001) decreases discriminatory bullying, behavioral discrimination and gun involvement. Conclusion: Positive school-climate serves as a protective factor for homeless students with regards to school violence outcomes. Enhancing whole-school interventions improving school climate at the school level, would benefit students experiencing homelessness."

One of the hardest parts about working with youth experiencing homelessness is coping with the loss of young people to violence, suicide, accidents, and illness. While each agency within the Hollywood Homeless Youth Partnership has developed their own rituals to support consumers and staff in the aftermath of a tragedy, we believe that a coordinated response across our service network will result in a more effective and trauma-informed response. This document was inspired and liberally adapted (with their generous permission) from Portland’s Homeless Youth Continuum’s “Best Practices: Workplace Tragedy,” a document produced in collaboration with Trauma Informed Oregon. This protocol is designed to provide a foundational philosophy and action steps around our collective response to tragedy and to offer best practices to agencies that are part of our network.

This journal article explores facets of youth peer support to address homelessness among youth. The journal article provides a description of the structure, processes, and preliminary outcomes of an intentional peer support program delivered in the context of tertiary prevention of youth homelessness in a large Canadian urban setting. Pre-post findings for a cohort of 28 youth are reported in key mental health and community engagement domains and qualitative data from interviews with participants, peer supports, and staff are presented. (author abstract modified)

This brief spotlights several Youth Homelessness Demonstration Program (YHDP) communities for how they have fostered youth leadership, as well as for lessons learned that may provide guidance for other communities seeking to establish effective youth collaboration in their local communities. The Youth Homelessness Demonstration Program (YHDP) is a national initiative designed to reduce the number of youth experiencing homelessness. Twenty-three communities were selected in Round 3 of YHDP. As a part of this initiative, these communities committed to authentic collaboration with youth and young adults who have lived experience of homelessness. (author abstract modified)

This article describes a study that uses an innovative method to translate how youth experience homelessness and view social inequality. This study used Photovoice methods with young adults experiencing homelessness to collaboratively identify issues that are of greatest importance in an open‐ended, exploratory, and inductive manner. Participants selected two concepts to focus their inquiry: freedom and prosperity. Within these concepts, participants discussed nature as a source of inspiration, a desire to better themselves and to change their situations, and passion for contributing to social change by exposing economic inequality and raising awareness about homelessness. (author abstract modified)