Supportive relationships drive change for youth experiencing homelessness

31 March 2022

We face a growing problem of youth homelessness. Every year in Minnesota, approximately 7,500 young people aged 16 to 24 who live apart from parents or guardians experience homelessness. Do effective solutions exist?

Youth homelessness results from many interrelated problems: extreme poverty, structural racism, families in crisis or separated, mental health issues and chemical dependency.

One resource we offer these youth is drop-in centers supported by taxpayers, foundations, and individual donors. An example is YouthLink in downtown Minneapolis, where about 2,000 youth come annually to meet their basic needs—a hot meal, a shower, and toiletries—before returning to the street.

There is little evidence about whether these organizations work and, if so, what makes them effective. Is it the building and these basic services? Is it human connections that happen there?

YouthLink, like other drop-ins, is staffed by specially trained case managers, including some who have endured homelessness themselves. They engage youth and offer a supportive adult relationship.

The underlying premise for case management in this as in other areas of social work and psychology is that a human relationship is healing and promotes positive developmental outcomes. Appealing as this premise may be, little evidence exists that such relationships help youth experiencing homelessness surmount the monumental challenges they face.

We conducted research to test this premise and assess whether case managers help such youth move forward in their lives. Funded by The Kresge Foundation, our team studied long-term outcomes for 1,229 youth who visited YouthLink and analyzed 60,000 case notes written by YouthLink case managers following their interactions with them. We investigated outcomes over six years (before the pandemic) in housing, education, court involvement and use of taxpayer-funded economic support programs, using integrated data securely maintained at Minn-LInK, in the University of Minnesota Center for Advanced Studies in Child Welfare.

We found that youth who developed substantial relationships with case managers did better. They were more than four times as likely as those who did not develop such relationships to use permanent supportive housing, and to stay housed far longer. They were nearly twice as likely to earn a high school diploma.

In addition to creating supportive relationships, case managers offer youth experiencing homelessness what we call transformative services, including focused assistance with education, employment, housing, mental health counseling and other services that potentially help them transform their lives to achieve their goals and become financially self-sufficient. We asked, do these efforts make a difference?

We found that youth whose case managers worked more intensively with them on transformative services were twice as likely to use temporary shelters and 2.5 times as likely to use permanent supportive housing, and to stay housed much longer. They were 2.6 times as likely to earn a GED.

Case managers also support youth by encouraging behaviors that help them avoid negative outcomes. The behaviors that case managers encourage span many topics, including managing school, substance use, living arrangements, emotionally charged situations and behavior in the drop-in. Sometimes case managers focus on life choices, helping youth navigate the potential consequences of their decisions. They try to help youth, many of whom have experienced serious life traumas, to achieve maturity and self-sufficiency, avoid imminent violations of implicit or explicit social norms and resolve legal problems.

We found that youth whose case managers more often encouraged such behaviors did better. They were 2.5 times more likely to use temporary shelters and four times more likely to use permanent supportive housing, and to stay housed much longer. A substantial focus on these behaviors by case managers reduced by two-thirds the likelihood of a youth’s conviction for a felony.

Finally, we found that case management had a very limited influence on the overall cost of taxpayer-funded economic support during our observation period.

Our research demonstrates that the dedicated people who work in drop-ins do make a difference with youth experiencing homelessness. The positive outcomes we found resulted from intentional efforts by specially trained case managers. Overcoming homelessness requires tremendous determination by youth, but case managers can help them make it. Supportive adult relationships—coupled with needed services—are essential to addressing youth homelessness and deserve our financial support.

Steven Foldes, Ph.D. is principal of Foldes Consulting LLC and an adjunct associate professor of Epidemiology and Community Health at the University of Minnesota. Kirsten Hall Long, Ph.D. is president of K. Long Health Economics Consulting, LLC. Kristine Piescher, Ph.D. is the director of Research and Evaluation at the Center for Advanced Studies in Child Welfare at the University of Minnesota. Katelyn Warburton, M.A. is a homeless programs administrator at the Office of Economic Opportunity in the Minnesota Department of Human Services. Saahoon Hong, Ph.D. is an assistant research professor at the Indiana Division of Mental Health and Addiction at Indiana University. Nina L. Alesci, Ph.D., M.P.H. is an epidemiologist and independent research consultant. A more detailed summary of study results is available at https://z.umn.edu/ml_youthhomelessness.

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