Perceived Need and Receipt of Behavioral Health Services at Drop-In Centers Among Homeless Youth

Published in: Health Services Research [Epub June 2018]. doi:10.1111/1475-6773.12990

Posted on RAND.org on June 29, 2018

by Eric R. Pedersen, Joan S. Tucker, David J. Klein, Layla Parast

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Research Questions

  1. What proportion of homeless youth who screen positive for behavioral health problems perceive a need for supportive services in the areas of housing, mental health, alcohol or drug use, or case management?
  2. What proportion of homeless youth who perceive a need for services report actual receipt of supportive services in the areas of housing, mental health, alcohol or drug use, or case management?
  3. What characteristics or survey participants are associated with perceived need for services?

Objective

Homeless youth are a population in need of housing assistance and case management, as well as services to address behavioral health problems. This study examines youth's perceived need for and receipt of services through drop-in centers.

Data Source

Surveys of 273 homeless youth.

Study Design

Cross-sectional.

Extraction Methods

Descriptive analyses with bivariate and multivariable regression models.

Principal Findings

About one-third to half of the sample met criteria for behavioral health problems, yet half or less of those meeting criteria reported a need for services targeting the problems. Most youth who perceived a need for services received relevant services through a drop-in center, with the exception of care for substance use problems. Youth with behavioral health problems were more likely to perceive a need for services related to housing and case management than those addressing behavioral health problems more directly. Multivariable regression analyses indicated that the factors most strongly associated with perceived need for services were not behavioral health problems, but rather race/ethnicity, traveler status, trouble meeting basic needs, delinquency, abuse/victimization experiences, and trading sex.

Conclusions

Findings can help to develop outreach and intervention efforts to reach homeless youth and help promote the use of behavioral health services.

Key Findings

  • Among 273 homeless youth (between age 13 and 25) surveyed in Los Angeles, almost 40 percent screened positive for posttraumatic stress disorder (PTSD), nearly half for depression, and 30 percent for a substance use disorder.
  • Half or less of participants screening positive indicated a need for services to help with their problems.
  • Perception of need for care is important because those who do not think they need services are unlikely to pursue them.
  • Of those screening positive for PTSD and depression and perceiving a need for care, about three quarters received services at a homeless drop-in center.
  • Among those reporting a need for services due to alcohol or drug use, the rate of service receipt was much lower, at 57 percent.
  • Participant characteristics such as race/ethnicity, severity of homelessness, and history of abuse or victimization were associated with perception of need, but behavioral health problems were not.

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