By Wanda Hudson, South Southwest PTTC Product Development & Distance Learning Coordinator

The role of a substance misuse prevention professional in addressing homelessness within their community is complicated by many factors. Data collection challenges, cross-training staff, focused funding streams, and political willpower further complicate this work. Additionally, accurately defining the issue of homelessness is a challenge.      

Age is one challenge. The defined age ranges for “youth” or “young adult” vary across and within federal agencies and state governments, making it difficult to measure the scope of and response to youth experiencing homelessness. Furthermore, accurately defining homelessness determines whether youth and adults can access services. Some states define runaway youth, homeless youth, and homeless persons separately, while other states do not define homelessness at all.¹ Sheltered and unsheltered are also defined differently. A young person may be moving from one friend’s couch to another or staying in other unstable conditions but may be considered “sheltered” when applying for services.

Many youth leave home because of family conflict, abuse, substance misuse within the family, poverty, and other reasons, all of which increase their risk of other behavioral health consequences. Compared with students with stable housing, students experiencing homelessness are twice as likely to report misuse of prescription pain medicine, three times as likely to be threatened or injured with a weapon at school, and three times as likely to report attempting suicide. One in three teens on the street will be lured into prostitution within 48 hours of leaving home. These findings indicate a need for a multi-sector approach to interventions across the Spectrum of Mental, Emotional, and Behavioral Interventions, also known as the Continuum of Care, to increase support, resources, and services for homeless youth and their families.

A Multi-Sector Approach

A recent case study brief by the Assistant Secretary for Planning and Evaluation, Office of Human Services Policy, summarizes findings from nine sites that integrated human services with a prevention lens.² All nine sites collaborated with other community organizations and partners to deliver these services, and all provided more than one type of prevention strategy (universal, selective, and indicated). Examples of prevention strategies that included all three are: a parenting program for everyone in the community (universal), working with child welfare agencies to refer families to the program (selective), and services open to those with open child welfare cases (indicated).

Considering some of the case study strategies below for designing and implementing these integrated services may help other prevention programs as they partner with agencies in their community to impact homelessness.

• A shared vision was developed with partners to establish strong partnerships and implementation from the beginning.
• Regular communication between partners facilitated timely access to services. Some staff reported scheduling weekly, monthly, or quarterly calls to facilitate communication.
• Participants could access multiple services through a flexible ‘no wrong door’ approach with services co-located in one location. This approach removes barriers and builds trust as agencies work with one another to follow through with services for participants.
• A person-centered approach was used by providing case management and navigation services.
• Staff developed a common language and used community and cultural practices to build community and cultural values, thus strengthening protective factors.
• Needs assessments were used to inform the integrative services.
• Sites were committed to understanding and measuring well-being.
• External evaluators were used to add data and analytic capacity.

Becoming part of an integrated service system in your community to address homelessness can not only reduce the burden experienced by individuals and families facing homelessness, but also helps decrease the burden on service providers as they learn to provide services more efficiently. By collaborating and communicating with others, our perspectives and goals can change, allowing us to concentrate on strengthening communities and building on protective factors.

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1. National Conference of State Legislatures. Youth Homelessness Overview. 2023. https://www.ncsl.org/human-services/youth-homelessness-overview

2. Smith-Grant, J., Kilmer, G., Brener, N. et al. Risk Behaviors and Experiences Among Youth Experiencing Homelessness—Youth Risk Behavior Survey, 23 U.S. States and 11 Local School Districts, 2019. J Community Health 47, 324–333 (2022). https://doi.org/10.1007/s10900-021-01056-2