Introduction in hopes to reform and ameliorate the

Introduction

Every year an estimated number of 40,000 Canadian youth
(ages 13-24) experience rooflessness (living rough), homelessness, and insecure
and inadequate housing due to a multitude of factors that have unfortunately
pushed 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 health
increased the risk of homelessness” (p. 1015). Equally as concerning are the 25
000 to 30 000 of youth who age out of foster care each year and remain the
largest group at risk (Dworsky, Napolitano &
Courtney, 2013). Among these numbers is an inconsistent, invariable, and
ambiguous amount of youth temporarily living with relatives, friends, or
in-and-out of cars—also referred to as hidden homelessness (Rodrigue, 2016). The
growing recognition and understanding of youth homelessness has brought
attention to the importance of further acknowledging this unjust social
challenge. This paper will explore why this issue is important to address; more
specifically, the impact of youth homeless in areas related to the physical,
mental, and social implications. In addition, this paper will also explore
areas of future research in hopes to reform and ameliorate the adversity
associated with youth homelessness.

Rationale One:

Physical health implications

Youth homelessness is associated with severe health
implications, 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 the
physical health risks imposed by homelessness, unsheltered youth face varying
barriers to accessing health care (Hwang, 2001). This may come to surprise due
to Canada’s affluent system of universal health insurance; however, many homeless
youths misplaced their identification, had it stolen, or left their home with
nothing to their name (Hwang, 2001). As a result, the risk of acquiring more
advanced illnesses, coupled with minimal access to resources may lead to more
complicated—if not fatal—health challenges (Edidin, Ganim, Hunter & Karnik, 2012).

Of greatest concern is the average life expectancy
among homeless youth: 39 (Eva’s Initiatives for Homeless Youth, n.d). In Quebec
alone, mortality rates among street youth in Montreal are 9 times higher for
males and 31 times higher for females” (Hwang, 2001, p. 230). Studies suggest
that exposure to the elements, street violence, or overuse of drugs and/or
alcohol are relevant contributors to high rates of mortality associated with
youth homelessness (Hwang, 2001) In addition, risk of disease and illness
remains higher for street youth due to “extreme poverty, delays in seeking
care, nonadherence to therapy, cognitive impairment and the adverse health
effects of homelessness itself” (Hwang, 2001, p. 230). Although homeless
shelters provide many with short-term assistance, crowded shelter conditions
pose significant health risks. Studies demonstrate how poor conditions may
result “in exposure to tuberculosis or infestations with scabies and lice, and
long periods of walking and standing and prolonged exposure of the feet to
moisture 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 and
overpopulated homeless shelters are positively correlated with “skin and
respiratory diseases, such as asthma and pneumonia” (Edidin, Ganim, Hunter & Karnik, 2012, p. 360).

In addition studies point to the implications of
homelessness in relation to youth’s sexual and reproductive health. Many
unsheltered youth, both males and females as young as 13-14, are more likely to
engage in dangerous sexual relations (National Network for Youth, n.d.). In fact, 25% of
unsheltered youth have been involved in prostitution, also referred to as
survival sex in which youth trade sex for necessities (i.e., food, shelter, or
drugs) (Hwang, 2001). Gonorrhea and chlamydia, which is linked to experiencing “multiple
sexual 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 about
33% living in shelters” (National Network for Youth, n.d., p. 4-5). This
further complicates their current situation, due to the various needs of
expecting mothers. Moreover, the infant is also at-risk from the impending
exposure to violence, drugs/alcohol, inconsistent attainment of basic needs,
and the overbearing theme of survival mode embedded in street culture (National
Network for Youth, n.d).

Rational
Two:

Mental health consequences

The impact of
homelessness 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 that
the mental health of homeless youth is twice more severe than their housed
peers. Among homeless
youth, there are disproportionately higher rates of mental health problems, as
well as suicidal ideations and attempts (Martin & Howe, 2016). In fact,
street-involved/homeless youth are 27-46% more likely to attempt or commit
suicide (Frederick, Kirst & Erickson,
2012). Unfortunately, suicide is unarguably the
leading cause of death among homeless youth in comparison to their housed peers
(Martin & Howe, 2016). Furthermore, high risk of mood disorders is
positively correlated with distinctively “high rates of suicidal ideation,
attempts, and completed suicide” (Edidin, Ganim, Hunter & Karnik, 2012, p.
363).

In terms of
neurocognitive implications and mental health, although “some of these problems
may be short-lived, the chronic stress and deprivation associated with
homelessness may have long-term effects on development and functioning”
(Edidin, Ganim, Hunter & Karnik, 2012, p. 354). Compared to their housed
peers, “the lifetime prevalence of psychiatric disorders depression, anxiety,
substance use, posttraumatic stress disorder, and psychosis is almost as twice
as high for homeless youth” Edidin, Ganim, Hunter & Karnik, 2012, p. 362). From a systemic and ecological point of view, it is
imperative to assess the reason a youth is experiencing homelessness and subsequent
mental health implications. Edidin, Ganim, Hunter & Karnik (2012) assert
that “homeless youth experience high rates of trauma and abuse prior to their experience
of homelessness, such as abuse by family and non-family members, rape, and
assault” (p. 356). Additionally, “there is evidence that suggests that the
relation between trauma, including abuse, and homelessness may be bidirectional
in 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 after
leaving the home. Many youth experience re-victimization; albeit at the mercy
of a different perpetrator (Edidin, Ganim, Hunter & Karnik, 2012). Without
proper management and treatment of the neurocognitive implications sustained by
a debilitating home environment, symptoms continue onto the streets. Specifically,
symptoms “such as separation anxiety, hyperactivity, and irritability, and
problems with cognitive control or executive functions, including poor
executive attention and inhibitory control”(
Herbers, Cutuli, Monn, Narayan & Masten, 2014, p. 1167), further complicate
the experience of being homeless. As a
result, the risk of acquired traumatic brain injury is far more pronounced in comparison
to their housed peers.

Adolescent and
early adulthood in and of itself is a difficult transition. Additionally, it is
also a critical developmental stage where social, psychosocial, and physical
changes are undergoing (Edidin, Ganim, Hunter & Karnik, 2012). More
specifically, significant maturation of the prefrontal cortex, the part of the
brain accountable for executive functions, transpires during this time (Edidin,
Ganim, Hunter & Karnik, 2012). The executive function is responsible of decision
making, reasoning, organization, inhibition, and behaviour and emotion
regulation (Edidin, Ganim, Hunter & Karnik, 2012). As previously eluded to,
“it is due to the relative immaturity of these regions of the brain that youth
are more likely to engage in reckless and risky behaviours” Edidin, Ganim,
Hunter & Karnik, 2012, p. 358). Without the support of strong and effective
caregivers, youth are at risk of partaking in careless decisions driven by impulse
and external environmental pressures—further asserting their adaption to an
unstable environment and survival-like behaviour. Consequently, anxiety, mood disorders
(bipolar disorder or major depressive disorder), and posttraumatic stress
disorder (PTSD) are exceeding more common (Edidin, Ganim, Hunter & Karnik,
2012; Perlman, Willard, Herbers, Cutuli
& Garg, 2014). the overall street-life
environment, mental health challenges exacerbate homelessness, and is linked to
higher 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:

Social
implications

Commonly described
social consequences of youth homelessness, such as stigma, lack of social
supports and job prospects, only touch the surface of this deep-rooted issue. Homelessness
is very challenging to come out of, and our social climate is the primary
culprit (Frederick,
Kirst & Erickson, 2012). Our society
predicates success on materialism and economic status, while simultaneously making
it difficult for many to advance despite the amount of effort put in. This, of course, contradicts the very dilemma
homeless youth find themselves in: “becoming
homeless further reinforces the cycle of inadequate schooling, lack of
employment and early delinquent involvements” (Frederick,
Kirst & Erickson, 2012, p. 9). This is further
enhanced by the social stigma surrounding homeless youth, such as the belief
that they are dangerous, outcasts, worthless, lazy, and addicts (Oppong
Asante, Meyer-Weitz & Petersen, 2016). A study completed by Oppong Asante, Meyer-Weitz & Petersen (2016) found that “the
majority of the participants indicated that they were beaten, wrongly accused
of stealing, and called derogative names” (p. 442).

Kidd (2007) suggest
that many youths feel alienated and have internalized the adverse stereotypes
the larger society holds against them. In the study conducted by Knight et al., (2017), youth described feeling intimated in “normal
crowds”; in fact, when comparing university and jail, jail was deemed to be
less intimating. It could be argued that homeless youth have identified and
internalized an “us versus them” dichotomy. In
addition, intersectional feminists would assert that feelings of alienation and
isolation are exponentially higher “depending
on ethnicity, sexual orientation, subsistence activity, and total time on the
streets” (Kidd, 2007, p. 296). More specifically, those who are in the LGBTQ
community, involved in the sex trade, and ethnic minority groups are subject to
greater frequency of stigmatization, negative public perception, self-blame,
and guilt (Kidd, 2007). These feelings and emotions not only take a toll on
one’s self perception, but they also hinder self-efficacy. Thus, it may pose as
a hindrance to some youth who accepted their predicament and do not plan to do
anything about it (Kidd, 2007). From a social constructionism perspective, it
is clear how the social context and interactions play a critical role in not
only how they interpret their situation, but also their impending future.

Although some youth accepted a fixed future based on
their current situation, many express a strong desire to get permanently off
the streets (Knight, Fast, DeBeck, Shoveller
& Small, 2017). In terms of securing legal employment and reducing
reliance on illegal income sources, Knight et al., (2017) found that many “found themselves
ill-equipped for the job-hunting process, including being unable to answer
conventional interview questions” (p. 5). In addition, many youths describe
being inept to prepare a proper resume, had limited computer literacy skills, and
lacked 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 regard
to social and symbolic capital, many youths describe deficiencies in being able
to successfully communicate their needs (Knight,
Fast, DeBeck, Shoveller & Small, 2017). Social learning theory
suggests that exposure to the streets causes many to use aggression and impulse
to drive their interactions, and many are “cognizant of the mismatch between
the kinds of traits (e.g., toughness, aggression, independence) they had
cultivated to survive” (Knight, Fast, DeBeck,
Shoveller & Small, 2017, p. 6). These beliefs translate into the
work 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-precarious
housing, and available support, many youths who attempt to transition out of
homelessness 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 nurturing
the innate capacity to develop basic physical, psychological, moral, and social
capacities. The ecological resources, such as food, shelter, family and
supportive institutional structures, however, are often lacking for homeless
adolescents. Thus, the myriad of experiences within family, social
institutions, and the broader culture that distinguish the lives of homeless
youth compared to resident youth may lead to different conceptualizations of strengths
and optimal development for homeless adolescents (p.
866).

Areas
for future research

Research 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 one
consistent truth: “contemporary social responses are failing” (p. 534), which
reinforces the need for policy makers, social services, and the larger society
to change their response. Though the great body of research focuses attention
to risk factors and the lack of service delivery, little research illustrates
how 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, effective
and long-term interventions, and a thorough understanding of exiting street
life (Brown & Amundson, 2010). To create
long-lasting change, it is important to revolutionize our collective
understanding of preventing youth homelessness. To conceptualize this, it is four
impactful institutions must be addressed: “child protection, criminal justice, …
education” (Kidd, 2012, p. 539), and mental health. Given that these points of
contact are commonly linked to youth homelessness, there is an unequivocal need
to look further into their impact and areas of influence. This could be
addressed through community outreach, educating parents, and improved health
care facilities, such as connecting runaway/”throwaway” youth to their
families, teaching parents how to effectively cope with conflict/emotions, and
improving follow-up care with those experiencing mental health challenges.
Studies that point to at-risk groups allow governments to allocate funds to vulnerable
communities, in order to implement service provisions that effectively respond
to their needs in a proactive matter.

It is also important to be mindful
that due to the problem’s complex nature, ameliorating youth homelessness
“requires the involvement of a wide range of stakeholders, including all levels
of government, service providers, health professionals, biomedical/social
science 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 strong
connections with policy makers at all levels, strong public relations and
advocacy arms, and influence over federal funders of research” (Kidd, 2012, p.
541). Additionally, strengthening interagency functions allows for youth to
access the necessary services without jumping from “one service to another and
sometimes finding it difficult to have to tell their story endlessly, and more
importantly 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 combination
of housing strategies, job prospects, and longitudinal studies exploring youth
exiting homelessness can provide a wealth of information on what works and what
does not work (Brown & Amundson, 2010). This is especially important to
note because many homeless youths are resilient and successfully exit homelessness.
Understanding what factors contribute or disempower resiliency would be
beneficial, if not crucial, to theorizing an effective, accessible and relevant
remedy. In addition, improving transitional accommodations such as by following
exiting youth and understanding what hinders or enhances their chances of
remaining housed. This includes, but is not limited to, assisting youth with
strengthening 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 enhanced
understanding of how youth came out of homelessness, but also apply this
knowledge to policy and practice (Frankish, Hwang & Quantz, 2005).

Conclusion

            Youth
experiencing homelessness are subject to varying physical, mental and social
implications that further contribute to the preservation and prominence of this
social matter. To compound the presenting issue, “the longer youth are homeless,
the more they are exposed to the risks of sexual and economic exploitation and
the more likely they are to experience trauma, declining health, nutritional
vulnerability, and addictions” (Eva’s
Initiatives for Homeless Youth, n.d, para. 15).
As a result, it is increasingly evident that contemporary responses to youth
homelessness are failing to address this social injustice in its entirety.
Future areas of research look to this gap in knowledge, such as by improving
preventive measures, strengthening the integration
of diverse service providers, and reinforcing the implementation of strategies that
assist youth with exiting homelessness. These integral areas of research shed
light on “many programs and services offering highly innovative and
effective strategies that address youth homelessness …. If specific,
tangible, and promising solutions can be offered, rather than simply
reiterating accounts of risk that cultivate a collective helplessness” (Kidd, 2012,
p. 541), then a more effective response to eradicating youth homelessness can be
achieved.