The system-of-care for homeless youth: perceptions of service providers

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Abstract

Service providers' perceptions of the system of care for homeless youth are described. Face-to-face structured interviews were conducted with staff at homeless youth agencies in Los Angeles County (L.A. County) regarding organizational and staff characteristics, issues affecting youth, types of available services, gaps in services, and barriers to service delivery.

Overall, agencies were large, well established, and provided multiple services. Most agencies (62%) were concentrated in Hollywood, a cruise area of L.A. County. Clear distinctions emerged between large and small agencies; large agencies had more resources, more professional staff, were established longer, and were policy advocates. Typical of other US metropolitan areas, services for homeless youth in L.A. County are located in cruise areas, and are not as readily available in other geographic areas. Such geographic barriers to providing a comprehensive and coordinated system of care can affect youth's pathways out of homelessness.

Section snippets

Setting

Los Angeles County is a large urban region measuring 4061 square miles, and this study encompassed all of L.A. County. In L.A. County, a large subgroup of agencies serving homeless youth form the Coordinating Council of Children's Hospital of Los Angeles (Children's Hospital) with funding provided by the California State Office of Criminal Justice (California Homeless Act of 1985). In the Hollywood area of L.A. County, a primary destination for homeless youth, Children's Hospital and 10 other

Characteristics of the service system

A key characteristic of the service system was the concentration of agencies in or around the cruise area of Hollywood. Over half the agencies (62%) were located within an 8-mile radius of Children's Hospital located in Hollywood: 18 within 8 miles, 6 between 9 and 16 miles, and 5 were 17 miles or more away from Children's Hospital (See Fig. 1). Thirteen of the Hollywood agencies had overlapping geographic service areas and several of these agencies were located within walking distance of each

Discussion

The L.A. County system of care for homeless youth attempts to provide comprehensive services, but the system is limited by the concentration of services in one geographic area. There appear to be two main reasons for the location of services in one area. First, Children's Hospital of Los Angeles has organized the service providers in the Hollywood area for over 20 years; consequently, most of the services have evolved within geographic proximity to Children's Hospital. Second, social,

Lessons learned

A number of valuable lessons were learned while conducting this study. Most importantly, the service sector for homeless youth is fluid and ever changing and must be revisited continuously. Therefore, it is important for service providers to be a part of the process of developing and implementing a comprehensive service system for homeless youth in any setting. The following lessons learned are specific to a large metropolitan area with diverse populations.

  • 1.

    This study shed light on some of the

Study limitations

This study has a number of limitations that should be considered when interpreting results. First, it was not an evaluation of the system of care for homeless youth in L.A. County. It was a descriptive study of service providers' understanding of the service sector. Second, staff were not randomly sampled across all programs. Instead, key informant staff were selected to provide a comprehensive overview of the programs. These key informants included senior and line staff. Because we did not

Acknowledgements

This research was supported by grant MH61185 from the National Institute of Mental Health.

References (48)

  • P. Mundy et al.

    The prevalence of psychotic symptoms in homeless adolescents

    Journal of the American Academy of Child and Adolescent Psychiatry

    (1990)
  • J.N. Pennbridge et al.

    Runaway and homeless youth in Los Angeles County, California

    Journal of Adolescent Health Care

    (1990)
  • A. Schneir et al.

    Children's Hospital of Los Angeles, a model of integrated care for HIV-positive and very high-risk youth

    Journal of Adolescent Health

    (1998)
  • L.M. Takahashi

    The socio-spatial stigmatization of homelessness and HIV/AIDS: toward an explanation of the NIMBY syndrome

    Social Science and medicine

    (1997)
  • S.M. Taylor et al.

    Attitudes toward the mentally ill and reactions to mental health facilities

    Medicine and Geography

    (1979)
  • A.D. Tenner et al.

    Seattle youth care's prevention, intervention and education program

    Journal of Adolescent Health

    (1998)
  • J.L. Athey

    HIV infection and homeless adolescents

    Child Welfare

    (1991)
  • S.W. Baron

    Street youths and substance use: the role of background, street lifestyle, and economic factors

    Youth and Society

    (1999)
  • M.A. Barwick et al.

    Learning difficulties in adolescent clients of a shelter for runaway and homeless street youths

    Journal of Research on Adolescence

    (1996)
  • D.S. Bass

    Helping vulnerable youths: runaway and homeless adolescents in the United States

    (1992)
  • R.E. Booth et al.

    Severe aggression and related conduct problems among runaway and homeless adolescents

    Psychiatric Services

    (1996)
  • A.M. Cauce et al.

    The characteristics and mental health of homeless adolescents: age and gender differences

    Journal of Emotional and Behavioral Disorders

    (2000)
  • J. Constantine et al.

    The impact of organizational characteristics on runaway and homeless youth services

    Association for Health Services Research

    (1999)
  • T.K. Craig et al.

    Homeless youth in London: II. Accommodation, employment and health outcomes at 1 year

    Psychology and Medicine

    (2000)
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