Patterns of service needs and use by subgroups of youth experiencing homelessness

ABSTRACT

Service use predicts exit from homelessness and improvements in physical and mental health among youth experiencing homelessness (YEH). However, service use among YEH remains low. This study uniquely examined youths’ reported needs and patterns of service use during and after the COVID-19 pandemic. Baseline data were examined from a large opioid prevention project conducted in a midwestern, service-rich metropolitan area. YEH (n = 240), between the ages of 18–24 years, were recruited from a drop-in center and other non-service locations. Youth completed self-report questionnaires about their service needs and utilization over the prior three months. The most common services YEH needed were housing (n = 233, 97.5%), drop-in center (n = 194, 81.2%), identification and birth certificates (n = 118, 49.6%), medical care (n = 110, 46.0%), dental care (n = 106, 44.4%), employment counseling (n = 97, 40.6%) and mental health and emotional life counseling (n = 91, 38.1%). Most service needs were unfulfilled. Youth showed extreme service need overall, but other than drop-in centers, the youth reported limited use of most services. The limited use of needed services underscores the importance of future efforts toward improving service use for those in need.

KEYWORDS:

• Youth homelessness
• service use
• service need
• COVID-19 pandemic
• service pattern‌

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by the National Institutes of Health through the NIH HEAL Initiative under award number UH3DA050174. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or its NIH HEAL Initiative.

Notes on contributors

Natasha Slesnick

Natasha Slesnick, MPI, PhD, is a professor of human development and family science in the department of human sciences at The Ohio State University. She is also the Associate Dean for Research and Administration in the College of Education and Human Ecology. She is a licensed clinical psychologist and has focused her attention on substance-using runaway and homeless youth since 1998. Much of this work included engaging homeless youth through drop-in centers, shelters, and the streets.

Brittany Brakenhoff

Brittany Brakenhoff, PhD, is a Research Assistant Professor at the University of Nebraska-Lincoln Center on Children, Families, and the Law. Her research focuses on homelessness and marginalized populations.

Alicia Bunger

Alicia Bunger, MSW, PhD, is an associate professor in the Division of General Internal Medicine in 2024 after serving on the faculty at OSU's College of Social Work for 11 years. Her interdisciplinary research program focuses on implementing interventions that require linkage or integration of services delivered by health and human service organizations. She is trained as a behavioral health services researcher and social worker.

Laura J. Chavez

Laura J. Chavez, PhD, MPH, is a senior research scientist at Nationwide Children's Hospital. She is a health services researcher with expertise in mixed-methods analyses, as well as management of large and complex datasets.

Caleb L. Cuthberton

Caleb L. Cuthberton, MS, is a Human Development and Family Sciences doctoral student in the College of Education and Human Ecology at Ohio State University. He is a licensed Couple (Marriage) and Family Therapist with clinical and research interests related to mental health outcomes for survivors and their families of gun violence and other traumatic injuries.

Ruri Famelia

Ruri Famelia received her PhD from the department of human sciences in the College of Education and Human Ecology, Ohio State University. She has worked as a data specialist, instrument developer, and program evaluator in research with children from disadvantaged families.

Xin Feng

Xin Feng, PhD, is an associate professor of Human Development and Family Science in the department of human sciences at The Ohio State University. Her areas of expertise include statistical methods, with an emphasis on multilevel modeling and the analysis of nonlinear outcomes as well as secondary analysis of large-scale databases.

Margaret M. Fitzpatrick

Margaret M. Fitzpatrick is a PhD candidate at the Ohio State University College of Nursing. She graduated with her Bachelor of Science in Nursing in 2020 from the University of Connecticut as an Honors Scholar. Under the mentorship of Dr. Jodi Ford and supported by a T32 fellowship, her dissertation will explore patterns of adversity among youth experiencing homelessness, their relationships with psychological distress and physiological stress, and the role of social support as potential buffers.

Jodi Ford

Jodi Ford, PhD, is an associate professor in the College of Nursing at The Ohio State University. Dr. Ford studies social determinants of health and health care, the effects of social context on psychosocial and biological health, and biomeasures of chronic stress, with a particular interest in adolescent and young adult health.

Eugene Holowacz

Eugene Holowacz, PhD has been working with individuals who are homeless since May 2015. He has had many roles such as an advocate, recruiter, and housing liaison. He received his PhD in December 2016 in Human Development and Family Science with a specialization in Couple and Family Therapy.

Soren Jaderlund

Soren Jaderlund currently works for Ohio State University in the College of Education and Human Ecology and has spent six years working on research projects regarding homeless youth. He received a bachelor's degree in History from Ohio State University. He is interested in Cultural Anthropology and Human welfare.

Kelly Kelleher

Kelly Kelleher, MD, PhD, is the ADS Professor of Pediatrics, Psychiatry and Public Health at Nationwide Children's Hospital and The Ohio State University. Dr. Kelleher focuses on the effectiveness of policy and practice in behavioral health service delivery in primary care, justice, and foster care settings. In addition, he has an extensive background in clinical research, developing and participating in new studies that directly examine behavioral health outcomes including those related to the introduction of new technology to improve access.

Ellison Luthy

Ellison Luthy is a graduate student at The Ohio State University working towards a PhD in Human Development and Family Science. She earned a bachelor's degree in psychology at Miami University and worked as a Marriage and Family Therapist for 3 years. Her current research placement is with Dr. Natasha Slesnick focused on homeless youth and substance use interventions. As a researcher, she is interested in family planning, mental health, and LGBTQ+ experiences.

Allen B. Mallory

Allen B. Mallory, Ph.D. is an assistant professor of Human Development in the Department of Human Sciences at The Ohio State University. His research has two primary foci; (1) Understanding the intersectional risk and protective factors for the health and well-being of LGBTQ+ youth and adults; and (2) risk and protective factors for individuals and couples' sexual well-being.

Jared K. Martin

Jared K. Martin, PhD, is a postdoctoral scholar at the Center for Vulnerable Populations at the University of California, San Francisco. He received his doctorate from Ohio State University in Human Development and Family Science. His research covers housing and related supportive interventions for youth and families experiencing homelessness and housing instability and implementation science in human service organizations. He has also researched youth attitudes toward service providers, a tailored Housing First approach for youth populations, and the implementation of a cross-system intervention to support vulnerable families with co-occurring needs.

Alexis Pizzulo

Alexis Pizzulo is a PhD student in Human Development and Family Science specializing in Couple and Family Therapy at The Ohio State University. She is a licensed marriage and family therapist in the state of Ohio. Her research foci include alcohol and substance use, cognitions, emotional expression, problem-solving, and Systems Theory. Clinically, Alexis is interested in utilizing a systemic perspective to treat individuals, couples, families, and groups through symbolic experiential and cognitive behavioral therapy models.

Steven Stone-Sabali

Dr. Steven Stone-Sabali's research places investigative attention on the voices and experiences of Black and African American young adults in the educational and well-being contexts. Dr. Stone-Sabali's research also examines non-Black individuals who interact with Black and African American individuals, such as educators, practitioners, and service providers. To this end, research inquiries are designed to illuminate factors that contribute to productive cross-racial interactions and illuminate aspects of racial ally development. Ultimately, empirical findings are used to illuminate the experiences of Black and African American individuals and guide having more productive interactions with Black and African American individuals.

Tatiana D. Slesnick

Tatiana D. Slesnick is a master's student at The Ohio State University in the School of Environment and Natural Resources. The Ohio State University at Columbus, Ohio, USA. Her research interest is surrounding the exploration of environmental injustices faced by youth experiencing homelessness.

Qiong Wu

Qiong Wu, PhD, is currently an assistant professor in the Department of Human Development & Family Science at Florida State University. Her research focuses on how maternal depression affects young children's socioemotional development through a framework of emotional socialization. As an applied researcher and clinician, she is also interested in process-oriented research in family therapy interventions aimed at improving emotional interactions among family members.

Jing Zhang

Jing Zhang, PhD, is an assistant professor of Human Development and Family Studies at Kent State University. Dr. Zhang's scholarly emphasis is on interdisciplinary research across the domains of family science and public health. Grounded in the ecological and life course perspectives, her work contributes to the understanding of crucial targets for preventive interventions that benefit socially and economically disadvantaged individuals and families.

Tansel Yilmazer

Dr. Tansel Yilmazer is an associate professor of Consumer Sciences in the Department of Human Sciences at The Ohio State University. Dr. Yilmazer is an economist specializing in applied microeconomics and health policy. Her research focuses on health economics, household economics, family finances and access to financial services. In particular, she studies the relationship between socioeconomic status (SES) and health outcomes.