Homeless youth: Barriers and facilitators for service referrals
Section snippets
Homeless youth: barriers and facilitators for service referrals
In Australia’s most recent census, 105, 237 people were identified as homeless and 25% of this group were youth aged 12–24 years (Australian Bureau of Statistics, 2012). In those who are homeless, mental health issues are common (Hodgson, Shelton, van den Bree, & Los, 2013; Medlow, Klineberg, & Steinbeck, 2014). In Australia, the lifetime prevalence of psychiatric disorders in homeless youth was found to be 82–85%, with current prevalence varying between 27.6 and 53% (Kamieniecki, 2001).
Design
This was a qualitative research study with a phenomenological approach aiming to explore the lived experience of service referrals through in-depth interviews. A sample size of n = 10 homeless youth was specified a priori, in keeping with Morse’s (2000) suggestion that 6–10 cases are sufficient when large amounts of data are expected per participant, in phenomenological studies employing in-depth interviews. To triangulate this data, samples of mental health clinicians (n = 10) and homelessness
Results
The participating homeless youth included two males and eight females, ranging in age from 17 to 23 years (M = 20.9 years). Three individuals were homeless at the time of the study, and seven had experienced a past episode of homelessness. Interview duration ranged from 44 to 72 min (M = 53.28).
Participating service providers comprised eight males and 12 females (10 from the homelessness sector and 10 from the mental health sector). Years of experience in their given sector ranged from 2.5 to
Discussion
While homeless young people may access a particular service, be it homelessness or mental health, this is no guarantee that they will access other necessary services. The current study aimed to document the factors perceived to support or interfere with successful inter-service referral transitions, from the perspective of both homeless youth and service providers.
Conclusions
The current findings regarding factors influencing successful or unsuccessful inter-service referrals have some overlap with prior literature on factors influencing general service engagement. The relationship young people have with service providers (involving client-centred support), service accessibility, and service collaboration emerged as essential protective factors when assisting vulnerable young people to access the services they require. Chronic resource shortages (funding, allocated
Funding sources
This work was supported by the Australian Government’s Department of Families, Housing, Community Services, and Indigenous Affairs (ID#1-9GN6JN).
Acknowledgements
The authors would like to thank Elizabeth Bassilios for transcribing some of the interviews, and participants for taking the time to share their stories.
The research team would like to dedicate this paper to our co-author, Cheryl Ritter, who is no longer with us.
Dr Emma Black is a Clinical Psychologist who has worked both in clinical practice and research. She was employed as a Research Fellow at the University of Queensland examining mental health outcomes for Indigenous Australians. Another research interest includes self-injury. Prior clinical roles have involved working in public and private adult mental health services.
References (19)
- et al.
Homeless youth’s experiences with shelter and community care services: Differences between service types and the relationship to overall service quality
Children and Youth Services Review
(2014) - et al.
Access to health care among Australian adolescents young people’s perspectives and their sociodemographic distribution
Journal of Adolescent Health
(2004) - et al.
Resilience and suicidality among homeless youth
Journal of Adolescence
(2011) Community factors influencing the prevalence of homeless youth services
Children and Youth Services Review
(2009)- et al.
Adolescents’ views of helping professionals: A review of the literature
Journal of Adolescence
(2007) - et al.
Homeless youths’ perceptions of services and transitions to stable housing
Evaluation and Program Planning
(2008) - et al.
Pathways to youth homelessness
Social Science & Medicine
(2006) - et al.
The health diagnoses of homeless adolescents: A systematic review of the literature
Journal of Adolescence
(2014) - et al.
Static, dynamic, integrated, and contextualized: A framework for understanding mental health service utilization among young adults
Social Science & Medicine
(2012)
Cited by (20)
A rapid evidence assessment of barriers and strategies in service engagement when working with young people with complex needs
2024, Children and Youth Services ReviewKey Mental Health Approaches and Interventions With Young People Experiencing Homelessness
2022, Comprehensive Clinical Psychology, Second EditionBrief report: Youth homelessness, youthful caregiving, and resilience
2021, Children and Youth Services ReviewCitation Excerpt :The participants did mention sources of support, but they also described feeling overwhelmed and experiencing significant challenges in navigating health, legal, and social service bureaucracies on behalf of themselves and their family member (e.g. bail, disability supports, etc.). Further, the interviews demonstrated ways in which the care being provided distracted from and overshadowed the recovery goals of the young people, further adding complexity to already fraught help seeking and service access dynamics for those experiencing homelessness (Black et al., 2018; Dixon et al., 2011). Given the way that services are often siloed, there are few services that are equipped to simultaneously support these young people and their family member.
Access to healthcare among youth experiencing homelessness: Perspectives from healthcare and social service providers
2020, Children and Youth Services ReviewCitation Excerpt :Our study findings also showed that providers encountered challenges with coordinating YEH’s care across facilities, which negatively impacted YEH’s healthcare experience. Consistent with these findings, previous studies have found that YEH become frustrated and sometimes disengaged with services when they had to retell their story every time they met with a new provider due to lack of care coordination in the referral process (Black et al., 2018; Christiani et al., 2008; Darbyshire et al., 2006). YEH-serving systems-of-care should consider implementing strategies aimed to strengthen YEH’s continuity and coordination of care, such as establishing collaborative networks of care, utilizing a multidisciplinary, integrated, or team-based approach to care, offering case management, patient support, and outreach services, and utilizing web-based personal health information systems in which YEH can securely store their health histories and important health documents (Ambresin et al., 2013; Beharry et al., 2018; Dang et al., 2012).
In search of employment: Tackling youth homelessness and unemployment
2020, Children and Youth Services ReviewCitation Excerpt :In addition, there is an opportunity for staff to engage in professional development and to take part in networks that could support their individual growth. This could result in, staff developing even greater expertise, and increasing their ability to provide effective and supportive relationships, and enhancing their ability to develop relevant and meaningful programs for vulnerable youth (Altena, Beijersbergen, & Wolf, 2014; Black et al., 2018; Boden et al., 2016; Community Development Halton, 2007). In striving for continuous improvement in programs focused on youth employment, organizations should consider the following strategies:
“If you're gonna help me, help me”: Barriers to housing among unsheltered homeless adults
2019, Evaluation and Program Planning
Dr Emma Black is a Clinical Psychologist who has worked both in clinical practice and research. She was employed as a Research Fellow at the University of Queensland examining mental health outcomes for Indigenous Australians. Another research interest includes self-injury. Prior clinical roles have involved working in public and private adult mental health services.
Dr Izabela Fedyszyn, PhD, has a background in psychology and currently works as a Research Fellow at the University of Queensland. Her research interests include suicidology, suicide prevention, and mental health. She has previously worked for the Danish government examining and analysing health register data.
Dr Helen Mildred is a Clinical Psychologist and Senior Lecturer at Deakin University. She is Director of the Deakin University Psychology Clinic and supervises provisional psychologists within child and youth mental health. She previously worked in a youth homelessness mental health program, and her research interest is self-injury.
Ms Rhianna Perkin is a psychologist and Program Lead- Practice Methods for EACH Social and Community Health’s Youth and Families program. She has worked in community health and homelessness services for over 15 years.
Mr Richard Lough is the manager for EACH Social and Community Health’s Youth and Family services. Richard is a social worker and outdoor education professional with extensive experience working with young people and adults in mental health, homelessness, and forensic sectors.
Dr Peter Brann is a Senior Clinical Psychologist and the Director of Research and Evaluation at Eastern Health. He has spent many years working in child and youth mental health services, and developing routine outcome measurement. He also occupies a role as an Adjunct Lecturer at Monash University’s School of Clinical Sciences.
Ms Cheryl Ritter was a Senior Clinician who coordinated the Eastern Health Child and Youth Mental Health Community Engagement Program. She has extensive experience in working clinically with a range of marginalised clients, as well as providing consultation and training to a wide range of community organisations.