1.1 A Blueprint for Ending Youth Homelessness

A Blueprint for Ending Youth Homelessness: Recent Research to Help Guide

Policy

Paul A. Toro, Ph.D., Dept. of Psychology, Wayne State University, Detroit, MI

National Conference on Ending Family and Youth HomelessnessLos Angeles, February 9, 2012

This powerpoint presentation will be available on the website of the National Alliance to End Homelessness.

What We’ve Learned in the Past 3 Decades

1 - Defining Homelessness Among Youth       Age range (minors only, up to 25)

Range of sampling sites (streets, etc.)2 - Estimating Prevalence (up to 15% before age 18)3 - Obtaining Representative Samples  Characteristics of Homeless Youth4 – At-risk groups: Youth “aging out” of foster care,

leaving institutional settings, in troubled families

For a recent review, see Toro, Dworsky, & Fowler (2007). Homeless youth in the United States: Recent research findings and intervention approaches. In D. Dennis, G. Locke, & J. Khadduri (Eds.), Toward understanding homelessness: The 2007 National Symposium on Homelessness Research,. Washington DC: U.S. Department of Housing and Urban Development and U.S. Department of Health and Human Services. Available at http://aspe.hhs.gov/hsp/homelessness/symposium07/.

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Research on Homeless Youth: Some New Frontiers

1 - Longitudinal Course 2 - Effective Interventions3 - Understanding Causes

Comparison Group (Case Control) Designs Preventing Homelessness Cross-cultural Comparisons

The Housing, Adolescence, and Life Outcomes (HALO) Project:

A longitudinal study of 250 homeless and 148 matched housed adolescents

This research was supported by grants from the National Institute of Alcohol Abuse and Alcoholism.

Baseline Probability Sample of 250 Homeless Youth

• Adolescents (ages 13-17) were sampled from throughout the 8-county Detroit metro area in 1997-2000

• Mostly, they came from youth shelters, but also from out-patient and residential programs, and other sites

Baseline Matched Sample of 148 Housed Adolescents

• Homeless adolescents nominated 5 to 10 peers from their neighborhood

• Housed sample was matched on race, gender, age, and neighborhood income

Measures: Family, Peers, & Context

  Inventory of Childhood Events (ICE)   Parental Monitoring Scale (PMS)   Perceived Competence Scales (PCS)   Social Network Interview (SNI)   Family Environment Scale (FES)   Revised Conflict Tactics Scales (CTS2)  Modified Life Events Interview (MLEI)

Measures: Outcomes

• Diagnostic Interview Schedule for Children (DISC): Substance abuse, conduct, and mood disorders (and symptom counts)

• Brief Symptom Inventory (BSI) • Risky Sexual Behaviors (RSBs) Survey• Physical Health Symptoms Checklist

Housed-Homeless Differences at Baseline

Groups differed significantly on a wide range of variables, including:

• Family and community violence, parenting, housing moves, etc.

• Diagnoses/symptoms: conduct, mania, depression, substance abuse, etc.

• School and sexual behavior, etc.

Methods of Longitudinal Follow-up

Initial Project: Full-length interviews attempted at 3 time points

• 6 months (N=231, 58% of total 398 from baseline; 115 homeless, 116 housed)

• 1 year (N=150, 38% of 398)• 2 years (N=235, 59% of 398)

Continuation Project: 3 more annual full-length interviews

• 5 years (N=327, 82% of 398)  6 years (N=296; 74% of 398) 7 years (N=330, 83% of 398) 388 (97%) have at least 1 of 6 possible

follow-up interviews 368 (92%) have at least 2

Procedures to improve follow-up:

• Positive "human encounter" with interviewer • Keeping in regular contact between

interviews• Use of “collateral contacts,” such as parents

and close friends• $20-$50 payment at each interview• 1-800 number • Persistent tracking and “dropping in” on

residences• Use of web-based services and other “public”

data (e.g., from drivers’ licenses) 

Attrition Effects:

 Greater attrition for homeless vs. housed early on (e.g., 54% vs. 21% at 6 months)

 This difference “washed out” in last 3 interviews (19% vs. 15% at 5 years)

 Use of Hierarchical Linear Modeling (HLM) allows inclusion of youth with any follow-up data and modeling time as a continuum

00.20.40.60.8

11.21.41.61.8

2

Time

Em

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l Dis

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HomelessHoused

Table 1. Homeless vs. housed emotional distress over time

Table 2. Homeless vs. housed substance abuse over time

0

1

2

3

4

5

6

7

Time

Su

bst

an

ce A

bu

se/D

ep

en

de

nce

S

ymp

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HomelessHoused

Table 3. Homeless vs. housed stress over time

0

2

4

6

8

10

12

14

16

Time

Str

ess

ful L

ife E

ven

ts

HomelessHoused

Examining Typologies among Homeless Youth

• The population of homeless youth is heterogeneous

• Early typologies were crude (e.g., runaways vs. throwaways vs. systems kids vs. street kids)

• A full paper presenting these findings appeared in a recent issue of NAEH’s Research Matters.

Typologies among HALO’s Homeless Youth (N=250)

• Latent class analysis at baseline: – 1. transient but connected (n=55), – 2. high-risk (n=46), and – 3. low-risk (n=149)

• Longitudinal outcome differences: – Low-risk showed the most stable

housing over follow-up period– All groups largely housed by 6-7 years

High functioning

60%

Dysfunctional 18%

Transient, but

connected 22%

Conduct Disorder

Depression

Alcohol Use

Drug Use

Number of living sites

Homeless in the past 30 days

Number of schools

Dropped out of school

Number of sexual partners

Abuse history

Days employed

Family cohesion

Self-efficacy

Latent Class Analysis

Low- risk 60%

High- risk 18%

Typologies: Summary

• Need for empirical validation based on representative samples

• Typologies can be based on longitudinal outcomes rather than pre-existing characteristics

• Do certain subgroups do better in certain interventions?

Some Practice/Policy Implications

• Homeless youth are heterogeneous• Some youth will need intensive, long-

term services (esp. street youth)• Some may appear to be doing “OK,”

but still are unstable with housing• About half, with minimal attention,

will do well, even in the short-term• Need for family-based prevention &

treatment programs

Publications from HALO and it’s pilot:• McCaskill, P. A., Toro, P. A., & Wolfe, S. M. (1998). Homeless and

matched housed adolescents: A comparative study of psychopathology. Journal of Clinical Child Psychology, 27, 306-319.

• Wolfe, S. M., Toro, P. A., & McCaskill, P. A. (1999). A comparison of homeless and matched housed adolescents on family environment variables. Journal of Research on Adolescence, 9, 53-66.

• Heinze, H., Toro, P.A., & Urberg, K. A. (2004). Antisocial behavior and affiliation with deviant peers. Journal of Clinical Child and Adolescent Psychology, 33, 336-346.

• Urberg, K., Goldstein, M., & Toro, P.A. (2005). Supportive relationships as a moderator of the effects of parent and peer drinking on adolescent drinking. Journal of Research on Adolescence, 15, 1-19.

• Fowler, P.J., Ahmed, S. R., Tompsett, C. J., Jozefowicz-Simbeni, D. M., & Toro, P.A. (2008). Community violence and externalizing problems: Moderating effects of race and religiosity in emerging adulthood. Journal of Community Psychology, 36, 835-850.

• Tompsett, C.J., Fowler, P.J., & Toro, P.A. (2009). Age differences among homeless individuals: Adolescence through adulthood. Journal of Prevention and Intervention in the Community, 37, 86-99.

• Haber, M., & Toro, P.A. (2009). Parent-adolescent violence and later behavioral health problems among homeless and housed youth. American Journal of Orthopsychiatry, 79, 305-318.

• Tompsett, C.J., & Toro, P.A. (2010). Predicting overt and covert antisocial behaviors: parents, peers, and homelessness. Journal of Community Psychology, 38, 469-485.

• Ahmed, S., Fowler, P.J., & Toro, P. A. (2011). Family, public and private religiousness and psychological well-being over time in at-risk adolescents. Mental Health, Religion & Culture, 14(4), 393-408.

•  Toro, P.A., Lesperance, T.M., & Braciszewski, J.M. (2011, September). The heterogeneity of homeless youth in America: Examining typologies. Research Matters (pp.1-12), Homelessness Research Institute, National Alliance to End Homelessness, Washington, DC.

• Hobden, K.L., Forney, J.C., Durham, K.W., & Toro, P.A. (2012, in press). Limiting attrition in longitudinal research on homeless adolescents: What works best? Journal of Community Psychology.