Nature of the Problem
The homelessness rate in Hawaii and the Waianae beach area, in particular, has grown in recent years and it continues to be a significant public concern because of multiple negative consequences of the problem on the state economy and the community welfare. Notably, the number of homeless youth is high in the state as well. They have unique needs and are exposed to risks that differ from those faced by adults living on the streets.
Many young homeless people frequently locate themselves on a distance from the adult population, lack awareness of existing support resources or are afraid to approach them (National Network for Youth [NNY] 2015).
Additionally, they are more likely to be involved in street violence and sex trafficking because they do not possess the necessary resources and social connections (Blair 2018). Regardless of this, there are currently not enough support services and programs that would address these unique interests in the target population and reduce the threats to their well-being. The policy should strive to challenge the status quo by offering comprehensive solutions aimed to decrease the number of homeless youth and facilitate their transition into adulthood.
Literature Review
Before plunging into the exploration of factors contributing to youth homelessness and discussing risks and problems they face, it is appropriate to define the term “homeless youth.” According to the Runaway and Homeless Youth Act, the homeless youth is defined as “individuals under age 18 (or some older age if permitted by state or local law) who are unable to live in a safe environment with a relative and lack safe alternative living arrangements” (Fernandes-Alcantara 2013, p. 2).
Evidence from various studies suggests that primary barriers to safe living environment encountered by children and teenagers in the United States include family dysfunction, housing instability, and a wide range of societal and health problems, including poverty, substance abuse, and other (NNY 2015; Fermantez 2012; Blair 2018). It is worth noticing that the rate of domestic violence, drug abuse, unfavorable financial conditions, and incarceration is particularly increased among the members of the Native Hawaiian community (Fermantez 2012). Due to this and because youngsters may have nobody to refer to, they run away from their homes seeing this solution as the only available option.
Homelessness among youth poses significant threats to their healthy and happy future and decreases the chance of success in adulthood. Besides the absence of housing, researchers identify such related risks as poor access to healthcare and propensity to infectious and other diseases, involvement in the justice system, inability to pursue academic and professional goals, engagement in crime and sex trafficking (Blair 2018; NNY 2015; Withy et al. 2008; Snyder et al. 2016).
The latter happens because homeless teenagers and children may either steal or engage in survival sex to get resources needed for meeting needs, such as food and shelter (Blair 2018). It is apparent that if youth’s basic needs are not met, they are also not able to satisfy their higher order interests and, therefore, homelessness interventions should primarily aim to provide the necessary resources to individuals living in the streets.
Another critical issue pertaining to youth homelessness in Hawaii discussed in the literature is related to their cultural background. For example, McDonell (2014) notes that a lot of homeless Native Hawaiians are attracted to specific areas, such as beaches, and prefer to stay there because they have certain cultural significance. Additionally, Fermantez (2012) states that to meet the needs of Native Hawaiians more efficiently, local authorities should understand their worldviews, values, and interests. These findings indicate that homelessness prevention initiatives in Hawaii should be culturally sensitive.
Policy Goals
Goal One: To Decrease the Homelessness Rate
Reduction of the incidence of homelessness among the Waianae youth is the primary goal of the proposed policy. To achieve this, it is essential to challenge the status quo pertaining to the problem by addressing the needs of the vulnerable population that have not been properly met so far and developing a favorable environment for the attainment of positive outcomes.
It is apparent that a preliminary comprehensive analysis of the current situation, including main issues, risk, and factors leading to homelessness in the region, is required to design effective strategies and methods to fulfill the formulated objective. The review of evidence provided in reliable academic, peer-reviewed, and professional resources will help in this to a significant extent. Nevertheless, active engagement in the community and collection of empirical data will allow targeting the problem even better.
Goal Two: To Minimize Dangers to the Well-Being of Homeless and At-Risk Youth
As the findings of the literature review revealed, homeless youth in Hawaii and other regions of the United States is exposed to multiple threats to both psychological and physical health. Additionally, certain risks increasing the chance for young individuals to flee their homes can be present in home environments. These types of threats undermine individuals’ possibility to lead healthy lifestyles, as well as perform and function well in various spheres across the lifespan. Therefore, there is a need to find solutions that would allow eliminating all potential risks in the community and provide the local youth with alternatives, enabling them to cope with adverse situations better.
Goal Three: To Decrease Costs Associated with Homelessness
The phenomenon of homelessness is associated with significant expenditures in public services. It is observed that homelessness increases the costs for healthcare and criminal justice systems (Crisis 2018). It is also worth noticing that most of the homeless people experience difficulties in finding jobs and their low level of financial productivity has a negative impact on the economy in general. While incomprehensive interventions, such as the provision of temporary accommodation may be costly, a successful intervention aimed at the prevention of the problem may allow reducing costs at all possible levels: individual, community, state and national (Crisis 2018). Therefore, the policy will have a purpose of implementing cost-efficient solutions and alternatives.
Alternatives
Alternative One: Youth Outreach
Awareness of available support resources is key to connecting individuals to services. According to the NNY (2015), many young people struggle to enter existing programs because they “do not identify themselves in the same category as the older adult homeless population” and frequently lack knowledge of services targeted at helping their age group (p. 10).
The youth outreach program should comprise various activities aimed at locating and meetings with homeless youth on the streets and at-risk individuals, crisis counseling, provision of all the necessary information, and referring them to relevant services. Therefore, the number of community organizations specialized in youth care and family advocacy, as well as the number of outreach workers, should be increased to ensure these prevention practices are performed well.
Alternative Two: Family Engagement and Intervention
The improvement of domestic environments may become a crucial step in minimizing the risk of homelessness, as well as addressing the needs of already homeless youth. The NNY (2015) indicates that programs with a primary purpose of providing services to families can include such activities as counseling for young people and their caregivers and other practices that allow directly addressing various problems faced by them. Not only can they help manage psycho-emotional issues of family members and strengthen their relationships through the enhancement of parent-child interactions but also assist caregivers in developing parenting skills and connect them to resources that would enable further family sustainability.
Alternative Three: Permanent Housing Programs
Self-sufficiency skills are essential for maintaining a proper level of personal well-being throughout adulthood. Many children and teenagers develop them when interacting with their caregivers and other adults who serve as positive role models for them. Thus, homeless youth may often fail to acquire those skills, and it increases the chance that they will have the homeless status in the long term.
Besides providing transitional shelter, the youth-appropriate housing programs specifically aim to address this risk by training young homeless people, increasing their job readiness, improving financial literacy, providing mentorship and psychological counseling, and facilitating their transition to adulthood (NNY 2015). With well-developed self-sufficiency skills, such as housekeeping, self-care, and cooking, it will be easier for youth to adapt to the social environment. Thus, housing programs may be highly effective in addressing current needs of homeless children and teenagers and preventing the risks of adult homelessness.
Alternative Four: Culturally Sensitive Support Services and Cultural Competence Training for Social Service Workers
Cultural minorities and representatives of sexual minority groups are frequently overrepresented in the homeless population. Therefore, it is particularly essential to ensure that services are in line with their values and worldviews and that they also meet their unique interests and needs. As stated by the NNY (2015), it is pivotal to ensure that workers interacting with diverse, vulnerable populations can understand them and possess the necessary cross-cultural skills because cultural sensitivity may substantially define intervention outcomes in their case.
Cultural competence initiatives are important when striving to resolve the problem of homelessness in the Waianae area since many of the local homeless people are Native Hawaiians and have a special emotional attachment to the place where they dwell. Additional, it is crucial to understand the specific needs and problems of the youth in the indigenous community. Thus, organizations offering culturally sensitive services should provide them with an opportunity to be heard and feel accepted, and respond to their needs by using appropriate methods.
Alternative Five: Targeted Healthcare Programs
Young individuals cannot access healthcare services and benefits without parental consent, yet homeless people often face increased health risks, including various communicable diseases, injuries, substance abuse, and so forth. As stated by Julianelle (2008), such a situation increases the homeless youth’s exposure to stress and limits their ability to focus on the improvement of adverse life circumstances.
In Hawaii, only individuals aged 14-22 are eligible for receiving medical services while younger people will likely be denied services when unaccompanied by caregivers (Waikiki Health n.d.). Thus, there is a need to ensure that all homeless minors can receive medical care on a permanent basis and are also aware of the services that exist.
Alternative Six: Services to Respond to Victims of Sexual Exploitation
The findings of the literature review revealed that homeless youth often fall victim to sexual abuse and exploitation. Besides universal social needs that each homeless individual has, those who faced the problem of sex trafficking while living on the streets have a unique set of psycho-emotional needs as well. The program targeted at this homeless population sub-group should provide mental health counseling and relevant linkages to healthcare services and social support resources.
According to the NNY (2015), the model for responding to victims of sexual abuse can include three basic steps: crisis intervention (housing, medical exam, and counseling), stabilization (individual therapy and weekly meetings with multi-professional specialists), and long-term support (family reunification, education, employment, and so forth). As such, this continuum of services is similar to the one provided to all homeless youth, yet it works with problems faced by sex trafficking victims more thoroughly and on a deeper level.
Alternative Seven: Individual Case Management and Mentorship
Although different community-based organizations may offer a wide range of high-quality services and linkages for homeless youth, most of them are unable to establish trustful, one-to-one relationship with them due to multiple factors, including a high level of workload and lack of resources. Nevertheless, an individual approach is a major prerequisite for meaningful communication, youth commitment to change, and better outcomes.
It is observed that those young people who were exposed to individualized, intense case management interventions showed “less aggression, fewer externalized behaviors, and more satisfaction with their quality of life than youth under the regular case management model” (NNY 2015, p. 19). Thus, the increase in the availability of case managers and mentors who would build long-term relationships with homeless and at-risk individuals and work together with them towards the achievement of their goals may be a promising solution in the homelessness prevention efforts.
Analysis of Alternatives
Youth Outreach
The main purpose of this solution is to connect youth living in the streets to various programs and management resources. Outreach may also imply the engagement of youth in crisis management by meeting youngsters’ basic needs such as hygiene supply, free meals, temporary shelter, and other. However, these activities are not part of a long-term intervention and are related to a preliminary stage of the stabilization and intervention processes.
Additionally, the success of this solution implementation is dependent on the degree to which outreach services are integrated with other services in the community infrastructure. Since this particular alternative is not comprehensive enough, it may be not sufficient to minimize all risks to the well-being of homeless young people and reduce the volume of public and social costs related to homelessness (although the alternative itself can be relatively cheap). Still, it may contribute to the reduction of homelessness rate in Hawaii by addressing some needs of individuals both directly and indirectly and linking them to required services.
Family Engagement and Intervention
The initiative allows reducing homelessness by one of its primary causes – unfavorable domestic environment and poor family ties. It received mid-high scores the number of threats and vital needs addressed because the improvement of housing status, social connections, psycho-emotional condition, and family functioning are its expected, direct outcomes. The alternative can also potentially lead to the enhancement of educational performance and employment opportunities even without targeting these areas directly.
Nevertheless, to achieve significant positive outcomes through family engagement, strategies should be evidence-based, involve highly trained personnel, and ensure continuous monitoring of individual cases. For this reason, Pergamit et al. (2016) state that they may be too costly and not feasible to implement. Additionally, this type of services cannot be applied to cases with a high level of child abuse, neglect, and so forth because it will likely not lead to positive results and may endanger a child or a teenager even more.
Permanent Housing Programs
The permanent housing initiative is the most comprehensive among the proposed alternatives as it addresses multiple risks and individuals’ needs at once and is future-oriented. According to the National Academies of Sciences, Engineering, and Medicine et al. (2018), it has the potential to affect health, socioeconomic status, quality of life, and other outcomes. Although the implementation of the initiative may require substantial investments in staff training, transitional placement of youths in shelters, and obtainment of other resources, its favorable and profound impact on public services and individual lives justifies it. For this reason, the alternative received high scores in all impact categories.
Culturally Sensitive Support Services
Similarly to youth outreach initiatives, the success of culturally sensitive programs depends on many infrastructure factors. However, they allow addressing the needs of Native Hawaiian homeless youth well by linking them to culturally relevant resources. Although the initiative can potentially minimize risks to youth’s well-being, it may be difficult to ensure that all support services are rendered by culturally competent workers. For this, either significant investments in the training of existing staff are required or the creation of a new entity that would integrate a great variety of services. Since both the best and worst scenarios may take place, the alternative received medium scores.
Targeted Healthcare Programs
The initiative addresses a specific set of needs and risks pertaining to healthcare, and therefore its impact is not sufficiently high. For example, although access to healthcare is important for better performance in various spheres of life and prevention of illness, it does not eliminate factors that make individual homeless. However, the main advantage linked to the realization of such healthcare programs for homeless youth is that they may be relatively cheap, while the entailed reduction of healthcare costs may be significant.
Services to Respond to Victims of Sexual Exploitation
The initiative implies a comprehensive approach, and since it can meet a wide range of youth’s needs (housing, access to healthcare, and so forth) and address most of the threats they face, it has a high score regarding first two policy goals. Nevertheless, its main disadvantage is that it is not aimed specifically at providing greater employment opportunities to individuals and increasing their economic engagement (although some programs may include this option as well). Additionally, compared to the permanent housing program, it is targeted at a specific sub-population and, thus, its impact may be limited
Individual Case Management and Mentorship
The initiative is promising in terms of helping homeless youth to improve their current situations and obtain opportunities for better future because an individualized approach implies work with a person based on his/her strengths and weaknesses, as well as aspirations and unique life goals. Thus, individual case management received high scores pertaining to the reduction of homelessness rate and the minimization of immediate threats. It can potentially entail a decrease in public service expenditures and is very likely to help engage homeless people in economic performance. However, a high-intensity, individualized approach is very costly, while the number of homeless teenagers/children exposed to intervention can be rather small. Thus, the costs outweigh potential benefits.
Recommendation
The permanent housing initiative is selected as the best alternative based on the scoring and analysis results. It addresses the widest number of homeless youth’s needs and threats to their welfare and, what is more important, has a potential to contribute to better functionality and quality of life throughout the lifespan of those who participate in it by preparing them for employment and independent living.
The initiative will promote efforts to provide youth with transitional shelter while developing self-sufficiency skills in them and preparing them for employment. By the end of the program, each participant is expected to be able to live independently and sustain an optimal quality of life.
To make it happen, it is pivotal to provide sufficient transitional placement opportunities and an integrated approach to building life skills and professional competence in homeless youth along with helping them to meet their educational goals. Additionally, there is a need to refer youth to mental health counseling and support groups to help them cope with adverse life situations better. Lastly, it is essential to establish optimal timeframes for meeting all the identified objectives without compromising cost-effectiveness of the strategy.
Forward Mapping
In the forward mapping scenario, the initial step will be the environmental analysis that will have a purpose to inform investment decision making pertaining to all required resources and transitional accommodation needs. After that, it is necessary to establish ties across support service organizations or involve workforce that would provide those services on site (in a specially designed establishment).
Along with this, measures should be undertaken to approach homeless and at-risk youth and encourage them to participate in the program. After the initial assessment of an individual case, a recovery and training plan should be designed for each involved person. By the end of the program, homeless teenagers will be provided with assistance towards finding a job and permanent accommodation. To ensure sustainable outcomes, each case will be monitored for at least a year after the completion.
Backward Mapping
In the backward mapping scenario, the achievement of the desired outcome will be facilitated through the establishment of partnerships with local housing authorities that would help accommodate program participants. At the same time, to ensure that homeless youth is eligible for permanent housing it is important to reach a high level of multiple service integration through cross-organizational collaboration and hire a competent and skilled workforce that would assist program participants throughout their education and training. Moreover, to make it easier for youth to pursue their developmental goals, their basic needs, including shelter, food, and hygiene, must be satisfied. And it implies that enough financial resources should be allocated to provide them with all this.
Issues
The primary implementation issue is non-compliance with the policy due to a reduced level of stakeholder involvement in the decision-making. According to Tebele (2016), when “end-users” are activated merely at the implementation stage, they may be unsupportive of the policy and face significant barriers to realizing it in practice (p. 13). Another potential implementation issue is the lack of collaboration between various parties and stakeholders.
Firstly, it means that the public, community-based organizations, and young homeless individuals themselves must contribute to policymaking. Therefore, to achieve better outcomes, it may be recommended to engage stakeholders at the stage of policy development by educating them and gathering useful information and feedback. Secondly, it is pivotal to encourage cross-organizational networking.
Bibliography
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National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Policy and Global Affairs; Science and Technology for Sustainability Program; and Committee on an Evaluation of Permanent Supportive Housing Programs for Homeless Individuals. 2018. Permanent supportive housing: evaluating the evidence for improving health outcomes among people experiencing chronic homelessness. Washington: National Academies Press.
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