Purpose:
This randomized controlled trial compared the efficacy between the Social Enterprise Intervention (SEI) and Individual Placement and Support (IPS) with homeless youth with mental illness to ...assess their impact on nonvocational outcomes.
Method:
Seventy-two homeless youth were recruited from one agency and randomized to the SEI (n = 36) or IPS (n = 36) conditions. Over 20 months, SEI participants received four SEI components, and IPS participants received eight IPS components. Data were collected on mental health, housing, and social support outcomes at baseline and one follow-up period.
Results:
Findings from mixed analysis of variance indicate that both SEI and IPS participants displayed statistically significant changes in their self-esteem, attention-deficit/hyperactivity disorder (ADHD) problems, inattention problems, living in a shelter, and living in a private residence.
Conclusions:
This is the first study to demonstrate the comparative efficacy and short-term nonvocational outcomes of SEI and IPS with homeless youth with mental illness. Assessment of long-term outcomes of both interventions is warranted.
Extreme heat and air pollution are important human health concerns; exposure can affect mental and physical well-being, particularly during periods of co-occurrence. Yet, the impacts on people are ...largely determined by underlying health conditions, coupled with the length and intensity of exposure. Preexisting adverse health conditions and prolonged exposure times are more common for people experiencing homelessness, particularly those with intersectional identity characteristics (e.g., disease, ability, age, etc.). Partially due to methodological limitations, such as data scarcity, there is a lack of research at the intersection of this at-risk population within the climate-health domain.
We have three distinct objectives throughout this article:
) to advance critical discussions around the state of concurrent high heat and air pollution exposure research as it relates to people experiencing homelessness;
) to assert the importance of heat and air pollution exposure research among a highly vulnerable, too-often homogenized population-people experiencing homelessness; and
) to underline challenges in this area of study while presenting potential ways to address such shortcomings.
The health insights from concurrent air pollution and heat exposure studies are consequential when studying unhoused communities who are already overexposed to harmful environmental conditions. Without holistic data sets and more advanced methods to study concurrent exposures, appropriate and targeted prevention and intervention strategies cannot be developed to protect this at-risk population. We highlight that
) concurrent high heat and air pollution exposure research among people experiencing homelessness is significantly underdeveloped considering the pressing human health implications;
) the severity of physiological responses elicited by high heat and air pollution are predicated on exposure intensity and time, and thus people without means of seeking climate-controlled shelter are most at risk; and
) collaboration among transdisciplinary teams is needed to resolve data resolution issues and enable targeted prevention and intervention strategies. https://doi.org/10.1289/EHP13402.
This study examined gender differences among homeless young adults' coping strategies and homelessness stressors as they relate to legal (e.g., full-time employment, selling personal possessions, ...selling blood/plasma) and illegal economic activity (e.g., selling drugs, theft, prostitution). A sample of 601 homeless young adults was recruited from 3 cities (Los Angeles, CA n = 200, Austin, TX n = 200, and Denver, CO n = 201) to participate in semi-structured interviews from March 2010 to July 2011. Risk and resilience correlates of legal and illegal economic activity were analyzed using six Ordinary Least Squares regression models with the full sample and with the female and male sub-samples. In the full sample, three variables (i.e., avoidant coping, problem-focused coping, and mania) were associated with legal income generation whereas eight variables (i.e., social coping, age, arrest history, transience, peer substance use, antisocial personality disorder ASPD, substance use disorder SUD, and major depressive episode MDE) were associated with illegal economic activity. In the female sub-sample, three variables (i.e., problem-focused coping, race/ethnicity, and transience) were correlated with legal income generation whereas six variables (i.e., problem-focused coping, social coping, age, arrest history, peer substance use, and ASPD) were correlated with illegal economic activity. Among males, the model depicting legal income generation was not significant yet seven variables (i.e., social coping, age, transience, peer substance use, ASPD, SUD, and MDE) were associated with illegal economic activity. Understanding gender differences in coping strategies and economic activity might help customize interventions aimed at safe and legal income generation for this population.
•Homeless male and female young adults utilize different strategies to cope with stressors.•Problem-focused coping was associated with increased illegal and legal employment in females.•Less reliance on social coping was associated with greater involvement in illegal employment.•Transience had a differential impact on employment type depending on gender.•Interventions should maximize problem-focused and social coping and minimize avoidant coping.
Opportunity youths (OY) are youths between 16 and 24 years of age who are neither in school nor working. Research suggests that youth disconnection can have negative consequences on youths' ...well-being, their communities, and the economy at large. The existing literature however neglects the underlying socio-demographic and economic factors that systematically contribute to the cause of youth disconnection in the United States. This study aims to explore the characteristics associated with youth disconnection and their spatially varying effects in different regions across the contiguous United States. Using data from the 2015 to 2019 5-year American Community Survey Public Use Microdata Sample, results suggest that areas with higher percentages of OY are located in the Sunbelt region (e.g., southern California, Arizona, New Mexico, Texas, Louisiana, Alabama, and Georgia). Moreover, a multiscale geographically weighted regression (MGWR) analysis illustrated spatially varying relationships with disconnection, demonstrating that factors have unique effects across different geographic areas. The potential impact of intersectionality for OY by race and ethnicity, ability, nationality, language, income, and parenting status is discussed. These results highlight the influence of local contexts in creating and reinforcing youth disconnection as well as informing responses to local support services for OY.
Exposure to multiple forms of maltreatment during childhood is associated with serious mental health consequences among youth in the general population, but limited empirical attention has focused on ...homeless youth—a population with markedly high rates of childhood maltreatment followed by elevated rates of street victimization. This study investigated the rates of multiple childhood abuses (physical, sexual, and emotional abuse) and multiple street victimizations (robbery, physical assault, and sexual assault) and examined their relative relationships to mental health outcomes (meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for post-traumatic stress disorder PTSD, depression, and substance use disorder) among a large (N = 601) multisite sample of homeless youth. Approximately 79% of youth retrospectively reported multiple childhood abuses (two or more types) and 28% reported multiple street victimizations (two or more types). Each additional type of street victimization nearly doubled youths’ odds for meeting criteria for substance use disorder. Furthermore, each additional type of childhood abuse experienced more than doubled youths’ odds for meeting criteria for PTSD. Both multiple abuses and multiple street victimizations were associated with an approximate twofold increase in meeting depression criteria. Findings suggest the need for screening, assessment, and trauma-informed services for homeless youth who consider multiple types of abuse and victimization experiences.
The purpose of this qualitative study was to explore homeless young adults’ perceptions of the systemic, situational, and intrapersonal barriers they encounter across multiple systems in trying to ...exit homelessness and the ways these barriers are interrelated. Thirty-one homeless young adults (ages 18–26) in Phoenix and Tempe, Arizona were recruited for in-depth interviews from two resource centers serving homeless youth. Template analysis was used to systematically analyze and code participants’ verbatim transcripts from the interviews into a template (codebook). Characteristic quotes from the interviews are used to illustrate the emergent themes. Findings indicate that structural barriers faced by homeless youth include inadequate homeless resources, employment challenges, discrimination by law enforcement, hot climate, lack of transportation, and legal concerns. Situational barriers include interpersonal relationships, the street environment, and lack of personal resources. Intrapersonal barriers include behavioral, mental, and physical health challenges, reluctance to reach out for help, money management, and lack of desire for stable housing. Participants also outlined multiple ways in which these barriers interact to hinder their exiting homelessness. Findings support current literature applying ecological theory to the issue of homelessness while highlighting young people’s own contextual descriptions of their lived experiences. Three approaches are recommended for improving homeless services with integrated housing, employment, and clinical interventions to help young adults successfully exit homeless.
Objective: Limited research exists on how employment interventions contribute to employment outcomes for homeless youth. This study examines the comparative efficacy of 2 interventions—Social ...Enterprise Intervention (SEI) and Individual Placement and Support (IPS)—provided to homeless youth with mental illness in a randomized controlled trial. Method: Participants were recruited from 1 homeless youth agency in Los Angeles, CA, and randomized to the SEI (n = 36) or IPS (n = 36) conditions. Over 20 months, SEI participants received 4 SEI components, and IPS participants received IPS services based on 8 principles. Data were collected at baseline and follow-up for the primary employment outcome (paid employment) and 5 secondary employment outcomes. Results: Over 20 months, 39% of SEI participants and 32% of IPS participants reported any paid employment. Across both groups, participants who reported working at baseline had nearly 8 times the odds of working at follow-up (OR = 7.91, p < 0.05). No statistically significant differences were detected across the full sample or between groups on the primary or secondary employment outcomes. Conclusions: Future effectiveness research is needed to compare the long-term employment outcomes of the SEI and IPS with a more heterogeneous sample of homeless youth using customized homelessness support services and more nuanced employment outcomes.
This qualitative study used data from the Social Enterprise Intervention (SEI) pilot study, a comprehensive vocational training program with integrated clinical services for homeless youth. In-depth ...interviews were conducted with 28 homeless youth participating in the SEI study to explore their perceptions of family environment characteristics and abuse experiences. The constant comparative method was used to analyze transcripts from in-depth interviews with the youth participants. Emergent themes related to family characteristics include home instability, abandonment, and caregiver substance abuse. Abuse-related subthemes include intrafamilial abuse, caregiver abuse, rejection, and deprecation by caregivers. Grounded theory is used to interpret findings and develop working hypotheses to guide future studies of multitype maltreatment among homeless youth.
Despite the growing integration of supported employment within the mental health system in the United States as well as the widespread use of social enterprises abroad, the fields of mental health ...and social enterprises remain largely separate in the USA. The mental health field currently lacks a response that strengthens homeless youths’ existing human and social capital, provides them with marketable job skills and employment, and impacts their mental health. To address this gap, this paper establishes a case for using social enterprises with homeless youths, drawing on both global precedents and findings from a mixed-methods study of a social enterprise intervention with homeless youths. Recommendations are offered for how to integrate social enterprises with mental health treatment as well as how to evaluate their impact on mental health outcomes.
Young adults experiencing homelessness (YAEH) are at higher risk for intimate partner violence (IPV) victimization than their housed peers. This is often due to their increased vulnerability to abuse ...and victimization before and during homelessness, which can result in a cycle of violence in which YAEH also perpetrates IPV. Identifying and addressing factors contributing to IPV perpetration at an early stage can reduce the risk of IPV. Yet to date, research examining YAEH’s IPV perpetration is scarce and has largely employed conventional statistical approaches that are limited in modeling this complex phenomenon. To address these gaps, this study used an interpretable machine learning approach to answer the research question: What are the most salient predictors of IPV perpetration among a large sample of YAEH in seven U.S. cities? Participants ( N = 1,426) on average were 21 years old ( SD = 2.09) and were largely cisgender males (59%) and racially/ethnically diverse (81% were from historically excluded racial/ethnic groups; i.e., African American, Latino/a, American Indian, Asian or Pacific Islander, and mixed race/ethnicity). Over one-quarter (26%) reported IPV victimization, and 20% reported IPV perpetration while homeless. Experiencing IPV victimization while homeless was the most important factor in predicting IPV perpetration. An additional 11 predictors (e.g., faced frequent discrimination) were positively associated with IPV perpetration, whereas 8 predictors (e.g., reported higher scores of mindfulness) were negatively associated. These findings underscore the importance of developing and implementing effective interventions with YAEH that can prevent IPV, particularly those that recognize the positive association between victimization and perpetration experiences.
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