Predictors of Drop-in Center Attendance among Substance-Abusing Homeless Adolescents

Abstract

Homeless youths comprise a vulnerable and disenfranchised group. They experience social exclusion and inadequate access to health and social services and are at risk of sexual assault and other trauma (Gaetz, 2004). Because of the vulnerability of homeless youths, engaging them into reintegration services is a priority. Although surveys have provided important information regarding demographic characteristics and problem behaviors among homeless youths (for example, Rachlis, Wood, Zhang, Montaner, & Kerr, 2009), no study that we are aware of has delineated predictors of drop-in center use among these youths. Such information can inform service providers about what youths are likely to be receptive to drop-in center assistance and what youths might need modified services to increase service engagement. Even though evaluations of the impact of drop-in centers are sparse, one study showed that youths who accessed substance abuse, mental health, and case management services through a drop-in center had significant improvements in mental health and housing stability, as well as reduced substance abuse (Slesnick, Kang, Bonomi, & Prestopnik, 2008). Similarly, adult studies have shown that those with access to a social services worker or those who use community services are more likely to exit homelessness (Zlotnick, Tam, & Robertson, 2003). In sum, drop-in centers might ease the challenge of meeting engagement and, ultimately, reintegration goals. However, more research is needed on factors that inhibit or facilitate the use of drop-in centers among homeless youths. As no studies have examined predictors of drop-in center use, we did not have prior research to guide our hypotheses. Some research indicates that homeless youths who are cut off from their family experience more depression and hopelessness than those who are eventually reunited with their family (Teare, Furst, Peterson, & Authier, 1992). Even in the case of parental abuse or parental problems such as substance use or incarceration, when youths cannot or do not want to return home, the loss of family is still profound (Bowen, 1978). Thus, in the present study, we examined depressive symptoms and unavailability of parents (either through substance use, incarceration, or some other factor) as well as age, gender, length of homelessness, difficulties meeting basic needs, and alcohol and drug use as predictors of drop-in center attendance among homeless youths in Columbus, Ohio. METHOD Participants Data were collected as part of a larger, ongoing study comparing treatment interventions for substance-abusing homeless youths. To be eligible for participation, youths had to meet criteria for homelessness, which was defined as lack of a fixed, regular, or adequate night-time residence (McKinney-Vento Homeless Assistance Act, 2002); being between the ages of 14 and 20 years; and meeting DSM-IV-TR (American Psychiatric Association, 2000) criteria for alcohol or other psychoactive substance use disorder. Participants (n = 82) were recruited from local soup kitchens, parks, and libraries and through referrals from other clients and social service agencies. Youths ranged in age from 15 to 20 years (M = 18.6, SD = 1.4), and the majority of them (63.4%) were male. Youths' ethnic composition was African American (57%), white/non-Hispanic (24.1%), and mixed race/ethnicity or other (18.9%). Procedure Eligible youths signed an assent/consent statement, which was approved by the Ohio State University's institutional review board. Youths who did not meet formal eligibility criteria were provided with referrals within the community and told that they could access the drop-in center even though they were not eligible for the larger study. The baseline assessment battery was administered at the drop-in center, and each youth was compensated with a $25 gift card to a local retail store. Follow-up assessments were completed at three, six, and 12 months. …