Missed Opportunities:  Youth Homelessness in America

Voices of Youth Count is an unprecedented initiative to understand, address and prevent youth homelessness. Chapin Hall, using its substantial research and policy assets, has conducted the most comprehensive research to date on youth homelessness, incorporating youth voices to develop achievable solutions. This research creates a foundation on which we can build solutions –effective policies and practices –to end homelessness for young people. Here are some of the findings:

Youth homelessness is a broad and hidden challenge

• Over a 12-month period, 4.3% of households with 13-17 year-olds reported youth homelessness. This is 1 in 30 youth in America in that age group. This translates to a minimum of 700,000 adolescent minors or the equivalent of over 800 average-sized high schools. About three-quarters of them involved explicit homelessness (including running away or being kicked out) and one-quarter involved couch surfing only.

Youth homelessness involves diverse experiences and circumstances.

• Nearly three-quarters of the young people who experienced “literal homelessness” (sleeping on the streets, in a car, or in a shelter) also said they had stayed with others while unstably housed.
• About half of the follow-up interview respondents believed that the youth was unsafe during their experiences of explicit homelessness or couch surfing.
• Young people struggle with a range of issues: 28% reported having substance use problems, and 66% reported mental health problems.

Prevention and early intervention are essential

• Half of the youth who experienced homelessness in the past year did so for the first time.
• This means that it is not enough to respond to the problem; we must get in front of it.
• This finding was supported by the in-depth interviews that we did in five sites. The majority of the youth interviewed had experiences of housing instability that started in childhood or adolescence.

Youth homelessness affects urban and rural youth at similar levels

• In predominantly rural counties, 9.2 % of young adults reported any homelessness while, in predominantly urban counties, the prevalence rate was 9.6%.
• For 13-17 year-olds, household prevalence of any homelessness was 4.4% in predominantly rural counties, and 4.2% in mainly urban counties.
• Homelessness is just as much of a challenge in rural communities as it is in more urban communities. Of course the number of youth experiencing homelessness in urban and suburban areas is much larger given population density.

Access the full brief or one pager here: http://voicesofyouthcount.org/brief/national-estimates-of-youth-homelessness/  

OAH Fiscal Year 2017 Annual Report

The HHS Office of Adolescent Health (OAH) is pleased to announce the release of the HHS Office of Adolescent Health Fiscal Year 2017 Annual Report. The report documents accomplishments and progress made in the past year across the five focus areas of OAH's strategic framework: educating the public and professionals, supporting evidence-based programs and practices, leading through action, promoting multi-sector partnerships, and investing in evaluation and research.

In Fiscal Year (FY) 2017, OAH:

• Published a supplement in the peer-reviewed Journal of Adolescent Health, sharing results of the communitywide teen pregnancy prevention initiatives project by OAH and the Centers for Disease Control and Prevention.
• Produced videos featuring adolescent health experts for the Adolescent Health: Think, Act, Grow^® (TAG) call to action.
• Reached 213,000 youth through the TPP Program, more than tripling the number served in FY 2016.
• Revamped its website for easier navigation and access on mobile devices.
• Increased subscribers to TAG e-updates by 25%, Twitter followers by 12%, and subscribers to OAH e-updates by 9%.

Visit the OAH Mission page to read the report and learn more about OAH's work.

HHS Bulletin: The Opioid Epidemic: A Focus on Adolescents

Defining the Issue:
The opioid epidemic affects individuals and communities across the United States in a variety of ways. Opioids are a broad class of drugs that relieve pain and include prescription pain relievers, synthetic drugs such as fentanyl, and heroin. Overall, overdose deaths from heroin and other opioids have increased over the past decade, and the public, private, and nonprofit sectors are working to address the growing epidemic.

The Numbers:
In 2016, 3.6 percent of adolescents ages 12-17 had misused opioids over the past year, a figure that has remained stable over the past decade. However, overdose deaths from opioids for adolescents ages 15-19 increased from 1999 through 2007, declined from 2007-2014, and then began rising again in 2015.

Adolescents at Risk:
All adolescents are at risk for misusing opioids, even those who have not previously used drugs and who disapprove of illegal drug use. In fact, there is a 33 percent increased risk of future opioid misuse if a high school student uses opioids as prescribed by a doctor.

Few adolescents with an opioid use disorder (OUD) receive treatment, and disparities exist. From 2001 to 2014, for insured youth with an OUD, only one in four received treatment. Females were less likely to receive treatment compared to males, and youth who were Hispanic or non-Hispanic black were less likely to receive treatment than their non-Hispanic white counterparts.

Preventing Opioid Misuse:
The fact that the adolescent brain is still growing means that teens are vulnerable to addiction, but the adolescent brain is also ripe for learning healthy habits and behavior.

To help prevent opioid misuse, those who care about and for adolescents should:

• Treat pain cautiously. Adolescents often are initially exposed to opioids through prescriptions; dentist prescriptions account for 31 percent of adolescents’ first exposure to opioids. While the effectiveness of alternative treatment options is still being studied, health care providers should turn to other treatment options before prescribing opioids for acute and chronic pain. The National Institutes for Health has pain information for health professionals, and the Turn the Tide pain treatment toolbox also has a range of resources.

• Talk with teens in your life about pain treatment and management. Regardless of drug use history, reach out to youth. Building strong relationships with adolescents is the first step to connecting with youth on drug prevention. Collaboration between and within youth-serving sectors and community partnerships present opportunities to reach at-risk and drug-naïve adolescents by increasing the efficiency of care, communicating across providers, and breaking down stigmas. Combining services such as trauma-informed care and psychological support with mentors and peers in the same location also can be an effective way to reach and help youth.

• Act when you suspect an adolescent or someone close to them is misusing opioids. Signs of opioid misuse include: drowsiness, constipation, nausea, dizziness, vomiting, dry mouth, headaches, sweating, and mood changes, among others. If you are concerned about opioid misuse, call the National Helpline at 1-800-662-HELP (4345) and consult the directory for opioid treatment programs in your area.

Additional Resources for Stopping and Preventing Opioid Misuse:

• Follow Best Practices. The American Academy of Pediatrics’ Committee on Substance Use and Prevention outlines best practices for the health sector to screen, treat, and refer adolescents with substance use issues.

• Find Research and Resources. The NIH Public-Private Initiative to Address the Opioid Crisis researches “new and improved” approaches to prevent, detect, and reverse overdoses as well as identify nonaddictive treatments for chronic pain. Also, OAH’s Adolescent Health Library has a range of relevant resources on illicit and non-illicit drug use.

• Utilize Lesson Plans.  Educators can find lesson plans from the National Institute on Drug Abuse that help them inform their students and answer questions about the nature of prescription drug abuse. 

• Build Relationships. Keeping Youth Drug Free provides parents and caregivers with tips on building strong relationships with adolescents, guidance for tough conversations about substance use, and a list of common drugs and their street names. OAH also has tips on how parents and caregivers can have start these conversations with their teen.

• Know the Laws. The Prescription Drug Abuse Policy System keeps track of important state laws about prescription drug abuse such as prescription drug monitoring programs, opioid prescribing guidelines, and Good Samaritan overdose prevention laws.

FYSB and the National Runaway Safeline Release Crisis Contacts Report

November is National Runaway Prevention Month (NRPM). This month serves as a reminder of the importance of supporting runaway and homeless youth in our communities. This year’s NRPM theme is “Friends Helping Friends.” A “friend” can be a youth, teacher, mentor, youth serving organization, family member, or other caring adult. That person or group of people plays an important role in providing support to the youth or just a listening ear. In support of National Runaway Prevention Month, the Family and Youth Services Bureau (FYSB) and the National Runaway Safeline (NRS), the federally funded national communication system for runaway and homeless youth, have released the National Runaway Safeline Crisis Contacts Report. This report provides a snapshot of what thousands of youth in crisis faced during the year. It also reveals trends and describes how the NRS encourages young people to work through their problems before they end up on the street. FYSB and the NRS hope that this data report can assist youth-serving organizations and other key stakeholders better understand the youth who need their assistance.

Click here to view the crisis contacts report: https://www.acf.hhs.gov/sites/default/files/fysb/nrs_crisis_contacts_report_1.pdf

ASPE Briefs: Available Research on Prolonged Youth Homelessness

The U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation (ASPE) has published three briefs gathering data from available research about youth that experience prolonged homelessness.

Factors Associated with Prolonged Youth Homelessness is available here: https://aspe.hhs.gov/pdf-report/factors-associated-prolonged-youth-homelessness.

This brief aims to summarize factors associated with prolonged episodes of homelessness among youth. While further research is needed to explore cause and effect relationships, available evidence demonstrates these youth experience:

• Increased involvement in child welfare and criminal justice systems;
• Higher rates of child maltreatment, substance abuse and mental health challenges; and
• Greater likelihood of dropping out of school, unemployment and housing instability.

Serious Mental Illness and Prolonged Youth Homelessness can be found here: https://aspe.hhs.gov/pdf-report/serious-mental-illness-and-prolonged-youth-homelessness.

This brief considers whether the known intersection between chronic adult homelessness and serious mental illness extends to youth.  While additional research is needed, including the extent to which serious mental illness may contribute to prolonged experiences of homelessness among youth, or vice versa, this brief concludes that:

• Mental health disorders among youth can increase the risk for homelessness;
• The more time youth spend on the streets, the greater their likelihood of mental health disorders; and
• Early interventions for youth with mental health issues may help prevent and address prolonged homelessness among young people.

Interventions for Addressing Prolonged Youth Homelessness is available here: https://aspe.hhs.gov/pdf-report/interventions-addressing-prolonged-youth-homelessness.

This brief explores evidence of effective interventions to prevent or reduce prolonged youth homelessness.  While additional research is needed, including the extent to which the promising practices that have had success with similar populations effectively translate to youth experiencing prolonged homelessness, ASPE did identify promising interventions.  Those include:

• Supportive housing;
• Social Enterprise Intervention;
• Coordinated Specialty Care; and
• Functional Family Therapy.