Addressing the behavioral health needs of homeless youth: A youth focused model of care

Homeless youth have disproportionate rates of mental health issues and disorders. The majority of these youth report histories of family dysfunction, experiences that often translate into mental health issues. Two-thirds of homeless adolescents met criteria for at least one of a handful of disorders (Cauce et al., 2000). In addition most have had significant traumatic experiences, either in their home, while on the streets, or both. Program participants report an extensive history of formal mental health care at intake.

It is not uncommon for youth to experiment with substance use, regardless of their living conditions. However, research shows there is a higher prevalence of substance use among homeless youth than among housed youth. Many use substances as a way to cope with life on the street to self-medicate for their mental health issues. Eighty-two percent of youth report previous drug use at intake, and 53% have tried to stop using at some point.

The key elements in providing behavioral health services to homeless youth are stabilization, intensive case management, and youth-centered care. It is important to focus on the impact to the youth's day-to-day functioning. Housing is in itself an intervention and is crucial to stabilizing the lives of homeless youth. Intensive case management assists youth with goal setting and accessing support services. Behavioral health services are provided within the context of a harm reduction model, a client centered approach that focuses on youth desire to change behavior and views the individual as the primary agent of reducing their risk.