Implementing Housing First for Mentally Ill, Homeless Youth

The characteristics of homeless youth with mental illnesses differ from homeless adults with similar conditions, prompting the need for more focused interventions on homeless youth with mental disorders in housing-first programs. The housing-first approach makes housing and mental health services immediately available to people experiencing homelessness without a requirement to meet other conditions first. Using data on 2,255 participants in At Home, a randomized controlled trial of a housing-first model serving youth and adults in five Canadian cities, researchers in Psychiatric Services compared youth with older program participants to understand whether and how the mental health needs of homeless youth differ from other age groups. The study’s participants were people who were homeless or precariously housed and who suffered from a mental disorder. Dividing the sample into two groups by age, the researchers compared people age 24 or younger (youth) with people age 25 or older (adults) by demographics, clinical disorders, and services used.

Key findings:

• High school completion rates for homeless youth with mental disorders were lower than homeless adults with mental illnesses. Youth also experienced higher rates of learning disabilities compared with adults.
• The proportion of youth who experienced drug abuse, recent physical and sexual assault, and arrests were higher than that of adults.
• A smaller percentage of youth had a regular medical doctor.
• Ethnic and racial minorities were more common among youths than adults.
• Despite similar rates of impairment among youth and adults, these disparities in characteristics may reflect different pathways to homelessness for youth and therefore different solutions.