When our children were growing up, like many young people, they faced challenges and struggles that required support from us as parents, their schools and other caring adults. We recognized that their ability to grow into healthy adults hinged upon this vital and collective support. Despite having more resources than many parents, life inevitably brings challenges, and we know how hard it would have been to navigate this journey without a home, access to a broad support network, financial stability, or if one or both parents were struggling. Yet millions of families and young people are attempting to do just that.
Amidst this staggering reality, it’s important to recognize that some issues our nation’s youth are experiencing — mental health and homelessness — are closely related. And philanthropic organizations can be influential in elevating the linkage by how we fund and use our voice to improve outcomes for young people in both areas significantly. We can address these challenges humanely and strategically by fostering public and private partnerships to adapt to and improve end-to-end systems of care.
The relationship between youth public health and wellbeing
The interconnected nature of these crises is made clear through data. Each year more than 4 million young people experience homelessness. At the same time, 1 in 6 U.S. youth aged six through 17 experience a mental health disorder. Surgeon General Dr. Vivek Murthy has called youth mental health “the defining public health crisis of our time.”
Consider that more than 1 in 5 people experiencing homelessness in the U.S. have a serious mental health condition due to the harsh realities they face. In fact, 50% of all lifetime mental illness begins by age 14, and 75% by age 24. According to a recent CDC study, there has been a 50% increase over the last decade in the number of high school students who express persistent feelings of sadness or hopelessness. Alarmingly, nearly 1 in 5 of these teenagers reported seriously considering suicide. For youth experiencing homelessness, it is more severe: Students who experienced homelessness were nearly twice as likely to have seriously considered suicide or made a suicide plan during the past year as compared to their housed peers and more than three times as likely to have attempted suicide during the past year. Accessing adequate mental healthcare resources can be challenging, but it is exponentially harder if you are a young person experiencing homelessness due to issues of availability, access, parental consent and costs.
With this in mind, the link between education attainment and homelessness is alarming. The single biggest correlation to young adult homelessness is a student not graduating or obtaining a GED. Given that high school students with significant symptoms of depression are more than twice as likely to drop out compared to their peers, it is evident that addressing untreated mental health conditions should be a critical priority. Failure to do so builds up yet another barrier for young people on their path to graduation and significantly increases their risk of experiencing homelessness.
No solution will be successful or equitable without recognizing that young people who experience homelessness are disproportionately people of color and/or identify as LGBTQ+. We also know that mental illness can overlap with these forms of marginalization. For instance, although young white people have higher rates of reported mental illness than young people of color, youth of color are more likely to suffer disability stemming from mental illness than their white peers. They are also more likely to be referred to the criminal legal system than they are to receive medical treatment. Disturbingly, 70% of youth in the juvenile legal system have a diagnosable mental health condition.
Bottom line: More dedicated resources are needed for interventions and support for young people in their adolescence — the uniquely formative period between childhood and adulthood. As Surgeon General Murthy reminds us, adolescents are not simply mini-adults. Adolescent brain research confirms that young people ages 10 through 19 are in a distinct developmental period, where failing to address adolescent mental health conditions creates larger societal challenges extending to adulthood, impairing physical and mental health and limiting opportunities to lead fulfilling lives as adults.
Washington State’s Department of Social and Health Services has the nation’s most comprehensive dataset on housing status for adolescents entering and exiting systems of care, such as foster care, the legal system, or inpatient/residential treatment for mental health or substance use disorder. The data reveal that young people are far too likely to experience homelessness when they exit these systems. The risk to youth is intensified by the interconnected nature of mental health challenges, contact with the legal system, and the broader dimensions of racial, economic, educational and health inequality young people face — those affected by one are more likely to be impacted by another. This relationship can lead young people in and out of many different forms of public systems of care, further injuring their stability and security and trapping them in an institutional cycle.
A systems approach
At the Raikes Foundation, we are working to transform the systems young people rely on to help them overcome extraordinary life challenges. Our partners and their efforts have elevated clear and compelling learnings about what it will take to be successful. Our collective approach involves several strategies and tactics to cultivate public partnerships in Washington State.
First and foremost, our work is grounded and guided by the feedback we hear from organizations providing direct support services to young people and young people themselves. This involves staff fostering relationships with key organizations across the state and understanding the areas of success and challenges these leaders and organizations face daily. These connections have led to the development of innovative models, including:
Second, we supported learning by funding reports to help state and federal governments address this intersection, like ones that called for warmer handoffs as young people exit systems or explored how Medicaid could be used to fund the disruption of this pipeline. Those reports were essential to Washington State as it developed its homelessness and prevention strategies.
Third, to get the identified strategies implemented, we provided philanthropic support to co-fund key leaders and efforts at the Washington State Health Care Authority and the Office of Homeless Youth to enable focused attention on the issues. Strategies ultimately identified by the state included:
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Creating a stable location for youth to exit inpatient care
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Improving transition planning as youth exited
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Bringing together state agency leaders to collectively case plan on the most acute cases
In the most recent update to the report outlined above on youth leaving systems of care in Washington State, we saw significant decreases over four years in the number and percentage of youth and young adults who were homeless after leaving a system of care. The numbers had dropped by a quarter — 500 fewer young people were experiencing homelessness in 2021 compared to 2017, demonstrating new evidence that coordinated efforts are making a tangible difference. For youth exiting inpatient behavioral health into homelessness, the results were similarly impressive — in 2017, 19% experienced homelessness within a year. By 2021, it was down to 14%.
It is critical to recognize the leverage points where we in philanthropy can make a difference in the lives of young people. By forging effective partnerships with service providers and public, private and other philanthropic organizations, we can collectively work towards improving the design of these systems of public care.
Philanthropic organizations have a powerful tool: the power of flexible resources to incentivize change. Philanthropists, specifically, can show what is necessary to ensure these systems of public care support young people entering and exiting their care to disrupt this cyclical pattern of instability. Let’s seize this opportunity and take decisive action to bring about meaningful change in the lives of the young people who are counting on us.
Tricia Raikes is a co-founder of the Raikes Foundation, based in Seattle, Washington.
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