IntroductionEvery year an estimated number of 40,000 Canadian youth(ages 13-24) experience rooflessness (living rough), homelessness, and insecureand inadequate housing due to a multitude of factors that have unfortunatelypushed them to the brink of vagrancy (Eva’s Initiatives for Homeless Youth, n.d;Quilgars, Fitzpatrick & Pleace, 2011).A nationwide study by Sznajder-Murray, Jang, Slesnick, & Snyder (2015)suggest that “multiple runaway episodes, non-traditional family structure,lower educational attainment, and parental work limitations due to healthincreased the risk of homelessness” (p. 1015). Equally as concerning are the 25000 to 30 000 of youth who age out of foster care each year and remain thelargest group at risk (Dworsky, Napolitano , 2013). Among these numbers is an inconsistent, invariable, andambiguous amount of youth temporarily living with relatives, friends, orin-and-out of cars—also referred to as hidden homelessness (Rodrigue, 2016).
Thegrowing recognition and understanding of youth homelessness has broughtattention to the importance of further acknowledging this unjust socialchallenge. This paper will explore why this issue is important to address; morespecifically, the impact of youth homeless in areas related to the physical,mental, and social implications. In addition, this paper will also exploreareas of future research in hopes to reform and ameliorate the adversityassociated with youth homelessness.
Rationale One:Physical health implicationsYouth homelessness is associated with severe healthimplications, including “increased risk of dying prematurely, … seizures,chronic obstructive pulmonary disease, musculoskeletal disorders, tuberculosis,and skin and foot problems” (Hwang, 2001, p. 229). To further compound thephysical health risks imposed by homelessness, unsheltered youth face varyingbarriers to accessing health care (Hwang, 2001). This may come to surprise dueto Canada’s affluent system of universal health insurance; however, many homelessyouths misplaced their identification, had it stolen, or left their home withnothing to their name (Hwang, 2001). As a result, the risk of acquiring moreadvanced illnesses, coupled with minimal access to resources may lead to morecomplicated—if not fatal—health challenges (Edidin, Ganim, Hunter & Karnik, 2012).
Of greatest concern is the average life expectancyamong homeless youth: 39 (Eva’s Initiatives for Homeless Youth, n.d). In Quebecalone, mortality rates among street youth in Montreal are 9 times higher formales and 31 times higher for females” (Hwang, 2001, p.
230). Studies suggestthat exposure to the elements, street violence, or overuse of drugs and/oralcohol are relevant contributors to high rates of mortality associated withyouth homelessness (Hwang, 2001) In addition, risk of disease and illnessremains higher for street youth due to “extreme poverty, delays in seekingcare, nonadherence to therapy, cognitive impairment and the adverse healtheffects of homelessness itself” (Hwang, 2001, p. 230). Although homelessshelters provide many with short-term assistance, crowded shelter conditionspose significant health risks. Studies demonstrate how poor conditions mayresult “in exposure to tuberculosis or infestations with scabies and lice, andlong periods of walking and standing and prolonged exposure of the feet tomoisture and cold can lead to cellulitis, venous stasis and fungal infections”(Frankish, Hwang, & Quantz, 2005, p.524-525). Moreover, the unsanitary living circumstances on the streets andoverpopulated homeless shelters are positively correlated with “skin andrespiratory diseases, such as asthma and pneumonia” (Edidin, Ganim, Hunter & Karnik, 2012, p. 360).
In addition studies point to the implications ofhomelessness in relation to youth’s sexual and reproductive health. Manyunsheltered youth, both males and females as young as 13-14, are more likely toengage in dangerous sexual relations (National Network for Youth, n.d.). In fact, 25% ofunsheltered youth have been involved in prostitution, also referred to assurvival sex in which youth trade sex for necessities (i.
e., food, shelter, ordrugs) (Hwang, 2001). Gonorrhea and chlamydia, which is linked to experiencing “multiplesexual partners, inconsistent use of condoms and injection drug use” (Hwang,2001, p. 231), are more common among homeless youth. In addition, pregnancy is far from uncommon; moreover,”about 50% of street youth have had a pregnancy experience compared to about33% living in shelters” (National Network for Youth, n.d.
, p. 4-5). Thisfurther complicates their current situation, due to the various needs ofexpecting mothers. Moreover, the infant is also at-risk from the impendingexposure to violence, drugs/alcohol, inconsistent attainment of basic needs,and the overbearing theme of survival mode embedded in street culture (NationalNetwork for Youth, n.
d). RationalTwo:Mental health consequencesThe impact ofhomelessness has numerous adverse implications with regard to mental health(Edidin, Ganim, Hunter & Karnik, 2012). In a study conducted by Oppong Asante, Meyer-Weitz &Petersen (2016), results indicated that “of the 227 participants in the study, 199 (87.6 %)exhibited moderate to severe psychological problems” (p. 433), concluding thatthe mental health of homeless youth is twice more severe than their housedpeers. Among homelessyouth, there are disproportionately higher rates of mental health problems, aswell as suicidal ideations and attempts (Martin & Howe, 2016).
In fact,street-involved/homeless youth are 27-46% more likely to attempt or commitsuicide (Frederick, Kirst & Erickson,2012). Unfortunately, suicide is unarguably theleading cause of death among homeless youth in comparison to their housed peers(Martin & Howe, 2016). Furthermore, high risk of mood disorders ispositively correlated with distinctively “high rates of suicidal ideation,attempts, and completed suicide” (Edidin, Ganim, Hunter & Karnik, 2012, p.363).In terms ofneurocognitive implications and mental health, although “some of these problemsmay be short-lived, the chronic stress and deprivation associated withhomelessness may have long-term effects on development and functioning”(Edidin, Ganim, Hunter & Karnik, 2012, p. 354). Compared to their housedpeers, “the lifetime prevalence of psychiatric disorders depression, anxiety,substance use, posttraumatic stress disorder, and psychosis is almost as twiceas high for homeless youth” Edidin, Ganim, Hunter & Karnik, 2012, p. 362).
From a systemic and ecological point of view, it isimperative to assess the reason a youth is experiencing homelessness and subsequentmental health implications. Edidin, Ganim, Hunter & Karnik (2012) assertthat “homeless youth experience high rates of trauma and abuse prior to their experienceof homelessness, such as abuse by family and non-family members, rape, andassault” (p. 356).
Additionally, “there is evidence that suggests that therelation between trauma, including abuse, and homelessness may be bidirectionalin nature. That is, homelessness may precipitate, or be a consequence of,trauma” (Edidin, Ganim,Hunter & Karnik, 2012, p. 356). The abuse, however, does not end afterleaving the home. Many youth experience re-victimization; albeit at the mercyof a different perpetrator (Edidin, Ganim, Hunter & Karnik, 2012). Withoutproper management and treatment of the neurocognitive implications sustained bya debilitating home environment, symptoms continue onto the streets. Specifically,symptoms “such as separation anxiety, hyperactivity, and irritability, andproblems with cognitive control or executive functions, including poorexecutive attention and inhibitory control”(Herbers, Cutuli, Monn, Narayan & Masten, 2014, p.
1167), further complicatethe experience of being homeless. As aresult, the risk of acquired traumatic brain injury is far more pronounced in comparisonto their housed peers.Adolescent andearly adulthood in and of itself is a difficult transition.
Additionally, it isalso a critical developmental stage where social, psychosocial, and physicalchanges are undergoing (Edidin, Ganim, Hunter & Karnik, 2012). Morespecifically, significant maturation of the prefrontal cortex, the part of thebrain accountable for executive functions, transpires during this time (Edidin,Ganim, Hunter & Karnik, 2012). The executive function is responsible of decisionmaking, reasoning, organization, inhibition, and behaviour and emotionregulation (Edidin, Ganim, Hunter & Karnik, 2012).
As previously eluded to,”it is due to the relative immaturity of these regions of the brain that youthare more likely to engage in reckless and risky behaviours” Edidin, Ganim,Hunter & Karnik, 2012, p. 358). Without the support of strong and effectivecaregivers, youth are at risk of partaking in careless decisions driven by impulseand external environmental pressures—further asserting their adaption to anunstable environment and survival-like behaviour. Consequently, anxiety, mood disorders(bipolar disorder or major depressive disorder), and posttraumatic stressdisorder (PTSD) are exceeding more common (Edidin, Ganim, Hunter & Karnik,2012; Perlman, Willard, Herbers, Cutuli& Garg, 2014). the overall street-lifeenvironment, mental health challenges exacerbate homelessness, and is linked tohigher levels of aggression, substance abuse, difficulty with self-regulation,and risky behaviour (Oppong Asante, Meyer-Weitz & Petersen, 2016). NEED SOMETHING TO TIE THIS UP.Rationale 3:SocialimplicationsCommonly describedsocial consequences of youth homelessness, such as stigma, lack of socialsupports and job prospects, only touch the surface of this deep-rooted issue. Homelessnessis very challenging to come out of, and our social climate is the primaryculprit (Frederick,Kirst & Erickson, 2012).
Our societypredicates success on materialism and economic status, while simultaneously makingit difficult for many to advance despite the amount of effort put in. This, of course, contradicts the very dilemmahomeless youth find themselves in: “becominghomeless further reinforces the cycle of inadequate schooling, lack ofemployment and early delinquent involvements” (Frederick,Kirst & Erickson, 2012, p. 9). This is furtherenhanced by the social stigma surrounding homeless youth, such as the beliefthat they are dangerous, outcasts, worthless, lazy, and addicts (OppongAsante, Meyer-Weitz & Petersen, 2016). A study completed by Oppong Asante, Meyer-Weitz & Petersen (2016) found that “themajority of the participants indicated that they were beaten, wrongly accusedof stealing, and called derogative names” (p.
442). Kidd (2007) suggestthat many youths feel alienated and have internalized the adverse stereotypesthe larger society holds against them. In the study conducted by Knight et al., (2017), youth described feeling intimated in “normalcrowds”; in fact, when comparing university and jail, jail was deemed to beless intimating. It could be argued that homeless youth have identified andinternalized an “us versus them” dichotomy. Inaddition, intersectional feminists would assert that feelings of alienation andisolation are exponentially higher “dependingon ethnicity, sexual orientation, subsistence activity, and total time on thestreets” (Kidd, 2007, p. 296). More specifically, those who are in the LGBTQcommunity, involved in the sex trade, and ethnic minority groups are subject togreater frequency of stigmatization, negative public perception, self-blame,and guilt (Kidd, 2007).
These feelings and emotions not only take a toll onone’s self perception, but they also hinder self-efficacy. Thus, it may pose asa hindrance to some youth who accepted their predicament and do not plan to doanything about it (Kidd, 2007). From a social constructionism perspective, itis clear how the social context and interactions play a critical role in notonly how they interpret their situation, but also their impending future.Although some youth accepted a fixed future based ontheir current situation, many express a strong desire to get permanently offthe streets (Knight, Fast, DeBeck, Shoveller& Small, 2017). In terms of securing legal employment and reducingreliance on illegal income sources, Knight et al.
, (2017) found that many “found themselvesill-equipped for the job-hunting process, including being unable to answerconventional interview questions” (p. 5). In addition, many youths describebeing inept to prepare a proper resume, had limited computer literacy skills, andlacked professional attire (Knight, Fast, DeBeck, Shoveller & Small, 2017).Although there are social supports available for youth, many explain their”distrust towards ‘the system'” (Knight, Fast,DeBeck, Shoveller & Small, 2017, p. 5) due to negative previous experiences,especially among those who were in the foster care system. With regardto social and symbolic capital, many youths describe deficiencies in being ableto successfully communicate their needs (Knight,Fast, DeBeck, Shoveller & Small, 2017). Social learning theorysuggests that exposure to the streets causes many to use aggression and impulseto drive their interactions, and many are “cognizant of the mismatch betweenthe kinds of traits (e.g.
, toughness, aggression, independence) they hadcultivated to survive” (Knight, Fast, DeBeck,Shoveller & Small, 2017, p. 6). These beliefs translate into thework youth can secure for themselves, which are often low waged, low skilled,and temporary (Knight, Fast, DeBeck, Shoveller& Small, 2017).
With limited legal job opportunities, non-precarioushousing, and available support, many youths who attempt to transition out ofhomelessness find that its often temporary and partial (Knight, Fast, DeBeck,Shoveller & Small, 2017). Overall, Nott & Vuchinich (2016) state that:The bioecological model holds that the settings,places, and people that impact youth are necessary for activating and nurturingthe innate capacity to develop basic physical, psychological, moral, and socialcapacities. The ecological resources, such as food, shelter, family andsupportive institutional structures, however, are often lacking for homelessadolescents. Thus, the myriad of experiences within family, socialinstitutions, and the broader culture that distinguish the lives of homelessyouth compared to resident youth may lead to different conceptualizations of strengthsand optimal development for homeless adolescents (p.866).Areasfor future researchResearch on youth homelessness has remained stagnant,focusing little on how to effectively ameliorate this deep-rooted,multi-layered, complex social injustice. As Kidd (2012) states, there is oneconsistent truth: “contemporary social responses are failing” (p.
534), whichreinforces the need for policy makers, social services, and the larger societyto change their response. Though the great body of research focuses attentionto risk factors and the lack of service delivery, little research illustrateshow to uphold a more strategic response that bridges across “research, service,and policy domains … to generate coordinated and effective solutions” (Kidd,2012, p. 533). In addition, minimal research exists on prevention, effectiveand long-term interventions, and a thorough understanding of exiting streetlife (Brown & Amundson, 2010). To createlong-lasting change, it is important to revolutionize our collectiveunderstanding of preventing youth homelessness. To conceptualize this, it is fourimpactful institutions must be addressed: “child protection, criminal justice, …education” (Kidd, 2012, p. 539), and mental health. Given that these points ofcontact are commonly linked to youth homelessness, there is an unequivocal needto look further into their impact and areas of influence.
This could beaddressed through community outreach, educating parents, and improved healthcare facilities, such as connecting runaway/”throwaway” youth to theirfamilies, teaching parents how to effectively cope with conflict/emotions, andimproving follow-up care with those experiencing mental health challenges.Studies that point to at-risk groups allow governments to allocate funds to vulnerablecommunities, in order to implement service provisions that effectively respondto their needs in a proactive matter. It is also important to be mindfulthat due to the problem’s complex nature, ameliorating youth homelessness”requires the involvement of a wide range of stakeholders, including all levelsof government, service providers, health professionals, biomedical/socialscience researchers, community groups, and homeless people themselves” (Frankish,Hwang & Quantz, 2005, p. S27). This could be met through the development “of institutes or commissions that have strongconnections with policy makers at all levels, strong public relations andadvocacy arms, and influence over federal funders of research” (Kidd, 2012, p.541).
Additionally, strengthening interagency functions allows for youth toaccess the necessary services without jumping from “one service to another andsometimes finding it difficult to have to tell their story endlessly, and moreimportantly establish meaningful relationships with new support workers” (Quilgars, Fitzpatrick & Pleace, 2011, p.51), also referred to as “‘single gateways'” (Quilgars,Fitzpatrick & Pleace, 2011, p. 51)In response to this need, a combinationof housing strategies, job prospects, and longitudinal studies exploring youthexiting homelessness can provide a wealth of information on what works and whatdoes not work (Brown & Amundson, 2010). This is especially important tonote because many homeless youths are resilient and successfully exit homelessness.Understanding what factors contribute or disempower resiliency would bebeneficial, if not crucial, to theorizing an effective, accessible and relevantremedy. In addition, improving transitional accommodations such as by followingexiting youth and understanding what hinders or enhances their chances ofremaining housed. This includes, but is not limited to, assisting youth withstrengthening social supports, acquiring stable housing, returning to school,and distancing oneself from street culture (Gaetz, O’Grady, Buccieri, Karabanow& Marsolais, 2013).
Thus, research should not only aim to provide an enhancedunderstanding of how youth came out of homelessness, but also apply thisknowledge to policy and practice (Frankish, Hwang & Quantz, 2005).Conclusion Youthexperiencing homelessness are subject to varying physical, mental and socialimplications that further contribute to the preservation and prominence of thissocial matter. To compound the presenting issue, “the longer youth are homeless,the more they are exposed to the risks of sexual and economic exploitation andthe more likely they are to experience trauma, declining health, nutritionalvulnerability, and addictions” (Eva’sInitiatives for Homeless Youth, n.d, para. 15).As a result, it is increasingly evident that contemporary responses to youthhomelessness are failing to address this social injustice in its entirety.Future areas of research look to this gap in knowledge, such as by improvingpreventive measures, strengthening the integrationof diverse service providers, and reinforcing the implementation of strategies thatassist youth with exiting homelessness.
These integral areas of research shedlight on “many programs and services offering highly innovative andeffective strategies that address youth homelessness …. If specific,tangible, and promising solutions can be offered, rather than simplyreiterating accounts of risk that cultivate a collective helplessness” (Kidd, 2012,p. 541), then a more effective response to eradicating youth homelessness can beachieved.