Abstract

Radical Low to No Threshold Mobile Treatment Services for Transitional Age Youth and Young Adults Experiencing Homelessness with Behavioral Health Needs in San Francisco

Kali Cheung, MPH¹, Heather Weisbrod, LCSW¹, Maurice Byrd, LMFT², Jeannie Little, LCSW², Jason Brown, LCSW², Anna Berg, LCSW², Jia Broussard, ACSW², Marlo Simmons, MPH¹ (1)San Francisco Department of Public Health, (2)Harm Reduction Therapy Center

APHA 2022 Annual Meeting and Expo

The San Francisco Department of Homelessness & Supportive Housing’s, 2017 Point-in-Time Count reports, one in five people experiencing homelessness in San Francisco is a youth under the age of 25. In 2017, the San Francisco Department of Public Health’s Behavioral Health Services Transitional Age Youth System of Care (TAY SOC) assessed the needs of transitional age youth and young adults (TAYA) ages 16-24. We found that TAYA were underserved by routine and longitudinal care, frequently relied exclusively on urgent and emergency services, and that traditional adult behavioral health services often did not meet their needs. Furthermore, frontline staff in housing programs often felt unequipped to manage the behavioral health needs of TAYA served. Guided by the needs assessment findings and input from community partners, TAY SOC developed a continuum of behavioral health strategies including mobile treatment services tailored to TAYA experiencing homelessness. In partnership with the San Francisco Department of Children, Youth & Their Families, TAY SOC funded a collaboration between two youth-serving San Francisco community-based organizations, Harm Reduction Therapy Center and Homeless Youth Alliance, to 1) pilot an innovative mobile pop-up model to bring harm reduction therapy and integrated and alternative low-barrier behavioral health services to where TAYA experiencing homelessness live and congregate and 2) build capacity among providers already serving TAYA to address behavioral health needs. Launched in 2019, the program CAYA (Come as You Are), implemented this mobile model at 17 sites including open spaces, permanent supportive housing sites, service-enriched shelters, at encampments, to Shelter-In-Place hotels during the COVID-19 pandemic. CAYA has forged dozens of community partnerships to create multi-service drop-in sites that includes legal aid, HIV/STI testing, harm reduction equipment, Narcan, hygiene and first aid supplies, acupuncture, massage, portable showers, and a mobile kitchen. Since inception, CAYA has provided services to over 1000 TAYA with 415 having engaged in brief or long-term mental health services; and has provided ongoing consultation and over 25 Harm Reduction and TAYA Development trainings to providers. CAYA continues to be well received in engaging TAYA meaningfully in therapeutic relationships and in supporting TAYA-serving providers. CAYA’s success has also led to new investments and partnerships that tailor the collaboration and response to address the needs of other critical San Francisco populations identified experiencing homelessness face.