Article by Beatrix Wang

Graphic design by Amy Assabgui

Youth aged 13 to 24 comprise roughly 12% of Canada’s populace, but account for 20% of its homeless population.¹ This disparity underscores youth homelessness as a major concern within Canada, with young people representing one of its fastest growing homeless populations.²

Though a largely overlooked issue in the past, a growing body of research has recently begun to shed light on the complex, intersecting forces that result in young people experiencing homelessness. Dr. Sean Kidd, Clinical Psychologist, Senior Scientist, and Division Chief of Psychology at the Centre for Addiction and Mental Health (CAMH) and Associate Professor in the Department of Psychiatry, is a leading expert within this space.

“We can sometimes think about youth homelessness as this binary sort of thing,” Dr. Kidd says. “Like there’s a bad situation at home … or a young person has a mental health crisis or a justice interaction, then they’re homeless. And that’s really not how it works for the vast majority. For most, it’s a long trajectory of challenge, marginalization, and interacting problems.” These factors include poverty, discrimination, and intergenerational trauma. Consequently, there is an overrepresentation of 2SLGBTQ+ and Indigenous youth among those experiencing homelessness.

The lack of safe, stable housing has far-reaching consequences. Not having an address can prevent individuals from obtaining employment and accessing services. Housing instability can increase the chance of young people being in environments wherein abuse and sex trafficking are risks. Safe housing, furthermore, is a vital determinant of health—both mental and physical—and its absence makes wellness difficult to achieve in innumerable ways.

However, for many, the story does not end when they obtain housing. This was something Dr. Kidd saw firsthand in research performed with colleagues at the University of Dalhousie, which followed the trajectories of 51 youth transitioning out of homelessness for a year.³ The outcomes, to put it mildly, were not good. “It was a very depressing study to run,” Dr. Kidd says. “In that year, we saw about a quarter were street homeless again. And you could count on one hand the number that were flourishing.” For many who retained housing, the team observed continued marginalization, mental health crises, and trouble engaging with work and school.

There was a silver lining to this study, however. These findings, though bleak, demonstrated a need for continued support for youth exiting homelessness, and led Dr. Kidd to embark on a research journey wherein he has worked to develop a critical time intervention called the “Housing Outreach Program Collaboration” (HOP-C).⁴

With HOP-C, Dr. Kidd and his colleagues are asking an essential question: If youth who have experienced homelessness have difficulty succeeding within the current system, even when they do obtain housing, can their chances of success be increased by intervening in the right ways and at the right time?

The key time frame for intervention is when individuals are transitioning out of homelessness and housing insecurity. “You’ve got a moment,” Dr. Kidd says, “when a young person has some housing, some stability. It’s very precarious. But if you can double down on supports at that transition time, you have a chance of improving their outcomes such that they’re keeping their housing and flourishing more.”

HOP-C, a multi-agency collaboration between CAMH, LOFT Community Services, Covenant House, the Wellesley Institute, and others, combines outreach, case management, peer support, and mental health services in a team-based approach that provides programming for youth in this window of time. Initial pilot and feasibility studies in Toronto showed high levels of engagement and improved short-term outcomes in education, employment, and housing. Dr. Kidd and his colleagues next partnered with Lakehead University and Dilico Anishinabek Family Care to co-develop and pilot an extremely successful Indigenous-led HOP-C program in Thunder Bay.

These successes led to a substantial CIHR grant, totalling nearly $1 million, which will fund a fully powered HOP-C randomized control trial in Toronto starting in September 2021. In the largest application of the program yet, over 100 youth will experience the intervention for a year and their outcomes will be followed for six months afterwards.

Part of what has made HOP-C so unique is how it redefines what peer support can be. After seeing the effectiveness of the initial study in Toronto, the team, led by youth with lived experiences of homelessness, wanted to do even more. “Later in the project,” recalls Mardi Daley, a HOP-C peer specialist, “there was the question of, how can we build something? How do we build a product to show what we’ve done in this housing intervention?” With this goal in mind, the team hired HOP-C participants to create something that imparted knowledge that would have helped them at the onsets of their journeys. What resulted was the MY Guide, a 90-page booklet filled with encouragement, tips, recipes, and activities to aid youth transitioning out of homelessness in Toronto and beyond.

This process, which gave participants the opportunity to produce something impactful for their peers, proved to be empowering. “Homelessness is so highly stigmatised, especially for young people, that a lot of them are written off before they’ve even had a chance to try things,” Daley says. “So it’s key to allow them to learn how to be leaders for themselves, to see that they’re capable beyond the stereotypes and limitations of being homeless. Plus, having young people lead younger people shows that you, too, can do this, even if you’ve been homeless; that there’s a future for you after this.”

Owing to such initiatives, significant progress is beginning to be made. Over the course of his career, Dr. Kidd has watched and helped the field shift from its humble beginnings to its current form, which is increasingly rich in policy- and intervention-based research. Much work remains to be done, however. “A whole system’s response is what we need to end ongoing chronic youth homelessness in Canada,” Dr. Kidd says. “And what I’m trying to do is carve out one part of that and really validate, with a good amount of evidence, that one piece of the picture.” The monumental task of ending youth homelessness requires effort on a massive scale to evolve the current system into something less crisis-oriented and more geared towards prevention and continued support for youth. In recent years, this has taken the form of a national coalition called A Way Home Canada, in which dedicated individuals are engaged across a broad range of sectors to make this aim a reality.⁶ It is in this manner that the field is coming together, engaging policymakers, and bringing about system-wide transformation.

The guides have since been distributed worldwide, and this concept—youth empowering other youth—has grown into what is now the “By Youth For Youth” (BYFY) Initiative.⁵ In Thunder Bay, Indigenous young people have developed their own culturally-grounded BYFY guide with consultation from community elders. In Nicaragua, the initiative has taken the form of graffiti art, a hip-hop video, and a theatre piece. More projects are on the horizon as BYFY continues to expand.

References

1. Gaetz S, Gulliver T, Richter T. The State of Homelessness in Canada: 2014. In Toronto: The Homeless Hub Press; 2014.
2. Laird G. Shelter: homelessness in a growth economy : Canada’s 21st century paradox : a report for the Sheldon Chumir Foundation for Ethnics in Leadership [Internet]. Calgary, Alta.: Sheldon Chumir Foundation for Ethics in Leadership; 2007. Available from: http://epe.lac-bac.gc.ca/100/200/300/sheldon_chumir_foundation/shelter/LAIRD_Homelessness_Report.pdf
3. Kidd SA, Frederick T, Karabanow J, et al. A Mixed Methods Study of Recently Homeless Youth Efforts to Sustain Housing and Stability. Child Adolesc Soc Work J. 2016 Jun 1;33(3):207–18.
4. HOP-C: Housing Outreach Program Collaborative [Internet]. The Homeless Hub. [cited 2021 Jun 26]. Available from: https://www.homelesshub.ca/HOP-C
5. By Youth For Youth Initiative [Internet]. The Homeless Hub. [cited 2021 Jun 13]. Available from: https://www.homelesshub.ca/by-youth-for-youth-initiative
6. A Way Home Canada [Internet]. A Way Home Canada. [cited 2021 Jun 26]. Available from: https://awayhome.ca/