Canadian street youth: Who are they? What are their needs?

Abstract

‘Homeless youth’, ‘out-of-the-mainstream youth’ and ‘street youth’ are some of the many terms that are used to describe a heterogeneous group of young people who live and work on the streets of urban centres across Canada (1–3). The actual number of street youth in Canada is unknown, and estimates vary from 45,000 to 150,000 youths, depending on the source (4). The youth come from rural, suburban and urban areas, are from all socioeconomic classes and have diverse cultural backgrounds. For different reasons, these adolescents are thrown out of their homes or run away to inner city streets in search of identity, independence or a better life. Many have suffered emotional, physical and/or sexual trauma or parental neglect during their childhood (5–7). Others have underlying behavioural, emotional or mental health problems, which are often undiagnosed and exacerbated by substance misuse that began in early adolescence (2,7,8). Over time, these teens become increasingly detached from their families, the educational system and society, and adopt a street-involved lifestyle that compromises their personal development, and physical and mental well-being. Many street youth become involved in illicit drug use, survival sex and criminal activities, which further alienate them socially and legally (2,5,7). In Canada, 12% to 26% of street youth have exchanged sex for money, shelter, drugs or other needs, and 17% to 36% of them have injected drugs (9,10). Living on the streets in an unstable and predatory environment puts these young people at risk of developing many health problems (2,3,7,9–14). Studies carried out among Canadian street youth report high rates of sexually transmitted diseases and blood borne infections; for example, chlamydia infection was found in more than 20% (12), hepatitis B markers in 7% to 9% (9,13), hepatitis C infection in more than 12% (9) and human immunodeficiency virus infection in 1.8% to 2.2% (5,10) of street youth. For many youth, alcohol and/or drug dependency, and mental health problems lead to increased morbidity and premature death. In a cohort of Montreal street youth, severe depression, attempted suicides and drug overdoses were frequent (15). The mortality rate among these youths was 12 times higher than that of other young people their age; suicides and drug and/or alcohol problems were the leading causes of death (15).