The Youth Risk Behavior Survey (YRBS) was first developed by the Centers for Disease Control and Prevention (CDC) in 1990 to assess the health risk behaviors of youth and adults in the United States. For the first time since the survey has been widely administered, the 2017 YRBS optional question list included two questions pertaining to homelessness. Using this YRBS data from 17 states (Alaska, Arkansas, California, Colorado, Delaware, Hawaii, Idaho, Illinois, Kansas, Kentucky, Maine, Montana, New Hampshire, North Carolina, Pennsylvania, Virginia, and Wisconsin), we conducted an analysis of differences in seven self-reported risk factors and health outcomes between high school students experiencing homelessness and those not experiencing homelessness. The results were striking and heartbreaking.

Broadly, our findings demonstrate that young people experience homelessness at an even higher rate than currently measured by the United States Department of Education. The YRBS indicates that 4.9% of students surveyed in the 17 states experienced homelessness at some point during the 2016-2017 school year, while public schools reported only 2.57% of their students as experiencing homelessness. The significant under-identification indicated by the YRBS means as many as one million students experiencing homelessness are not receiving the services that are their right under federal law.

Additionally, young people who experience homelessness engage in a wide variety of health risk behaviors at significantly higher rates than their housed peers. Youth experiencing homelessness were:

• 5.23 times more likely to miss school due to safety concerns
• 5.03 times more likely to be victims of sexual dating violence
• 5.88 times more likely to be victims of physical dating violence
• 4.63 times more likely to misuse prescription pain medicine
• 3.21 times more likely to make a suicide plan
• 7.19 times more likely to attempt suicide

We supplemented our analysis of YRBS data with qualitative data gathered from youth who had experienced homelessness, including their recommendations for policy and practice. Of the 49 surveyed from SchoolHouse Connection’s Youth Leadership and Scholarship Program and the National Network for Youth’s National Youth Advisory Council:

• 24.48% missed school due to safety concerns
• 18.36% misused prescription pain medicine
• 36.74% experienced sexual dating violence
• 20.41% experienced physical dating violence
• 59.18% made a suicide plan
• 24.49% attempted suicide

Policies and practices to improve implementation of the protections and supports provided to homeless children and youth by federal law:

Identification:

• Ensure that McKinney-Vento liaisons, which the McKinney-Vento requires every LEA to designate, have adequate capacity to conduct adequate identification. The McKinney-Vento requires that liaisons be “able to carry out the duties described” in the law.
• Adopt LEA policies requiring school personnel—including such front-line staff as bus drivers, office secretaries, registrars, and security officers—to receive annual training on the definition of homelessness, signs of potential homelessness, and how to respond to such indicators.
  • Training should include trauma-informed practices to cultivate an environment that encourages students experiencing homelessness to self-identify.
  • “Students experiencing homelessness are more likely to seek and ask for help from those they trust.”

Engagement and participation in school:

• Adopt LEA policies to ensure students receive credit for full and partial coursework completed at prior schools, as required by federal law.
  • Especially during times of acute crisis, youth noted that it would be helpful to have flexible course loads with built-in opportunities to earn missed credits or request extensions or complete credits online. Youth also requested increased classroom staff and support to help them succeed in alternative programs.
• Support parenting students. Recent research found having a child to be the second greatest risk factor for young adult homelessness.
  • Parenting youth stated that transportation to day care for their children would support their own goals for graduation.
• Ensure consistent, safe transportation to school.
  • Young people noted that gas cards and carpools were welcome resources.
  • Young people frequently commented that the most significant barrier to accessing safe transportation services provided by districts was uncertainty.
  • “Arranging safe transportation would have helped me not miss so much school. If we needed to sleep in emergency shelters, we would not know where we’d be staying until the day before, and the shelters we stayed in were up to an hour and a half drive away from my high school. Though my district said they could offer help with transportation, it was nearly impossible to arrange because we didn’t know where we would be staying.”

Access to mental health services:

• Revise mandatory child protective services reporting requirements to allow youth to request and receive services without involving the child welfare system.
  • “Again, I would emphasize confidential, non-reporting counseling options. Having experienced this kind of violence post-homelessness as an adult, I again never sought the therapy that could have helped me cope or provided me with strategies to better my situation for fear of legal reporting requirements.”
• Locate services on school campuses and ensure youth experiencing homelessness can access them.
  • Many youth surveyed felt that mental health, substance abuse, and intimate partner violence services and supports should be sited in the schools themselves—and, due to transportation issues, they noted that services should be available at a range of times during, before, and after the school day.
• Incorporate education about sexual and physical dating violence and the hidden dangers of prescription drug misuse into existing health classes.
• Offer school office phones to call hotlines or to report violence. Youth experiencing homelessness often struggle to maintain functioning cell phones and cell phone plans.
• Create school-based peer educational training programs to inform young people about depression, suicidality, and dating violence and to support students experiencing these risk behaviors.

Policies and practices to address and mitigate highly prevalent risk behaviors:

Establish a culture of care:

• Talk about mental health openly and often.
  • “Destigmatizing depression, anxiety, and mental illness, in general, would be a big step in the right direction. Nurses and counselors could visit classrooms and discuss the commonality of things like this.”
• Encourage an “open door policy” that facilitates emotional security and trust.
  • Schools need to “have enough staff that students are able to make personal connections, and to help foster informal check-ins.”
• Be clear about cultural norms and immediately address inappropriate behavior and toxic language through conflict resolution strategies. Help perpetrators understand why their behavior hurts others, and let victims know that they are supported.
• Respond immediately to warning signs for drug abuse, suicidality, and intimate partner violence by referring students to health and mental health services, while also taking care to respect students’ health care preferences and avoid police intervention when unnecessary. Within the bounds of confidentiality, alert all relevant personnel when a student is experiencing abuse so that their safety can be preserved on school grounds.
• Review all school policies to ensure they are trauma-informed and specifically include students experiencing homelessness. School policies on a wide range of issues, including absenteeism, school discipline, mental health supports, and professional development, are opportunities to ensure a culture of care in school. These policies must address the particular needs of students experiencing homelessness to ensure those students can access supports and that responses to their needs are trauma-informed.

Empower self-advocacy:

• Equip students with the language to identify abuse.
  • “If people can’t identify that they’re in an abusive relationship, they won’t leave it.”
  • “Educate [students about] what physical and sexual dating violence looks like so they can identify whether they are in a violent relationship. Explain prevention methods, how to de-escalate a physically and sexually violent person, [and] how to leave such a relationship without promoting any more violence. When I was experiencing sexual violence in a relationship, I did not realize right away that it was abuse even though I knew I was being coerced.”
• Respect youth autonomy.
  • “Let students know what resources are available to them. Be clear about the procedure followed when students disclose [feelings of suicidality] so they can make an informed choice about disclosure—don’t force interventions that students don’t want, [and] let them know what they need to do to avoid them. [Not] allowing students to safely disclose suicidal feelings is more dangerous than allowing someone to leave after disclosing.”
• Create targeted resources for female students, male students, victims, perpetrators, and LGBTQ and non-binary youth.
• Make informational resources and peer reporting mechanisms easily available so that young people do not have to wait for formal instruction or school assemblies (although these are also welcome).
  • “Offer information on generational violence/poverty/trauma so they can identify patterns they relate to; offer resources to reduce harm like birth control so they have less to worry about when it happens. Even having a reference system where students can report if they feel like their friends are in an abusive relationship would be helpful. That way those that are being abused do not have to be responsible for making the first move.”

Create physical safe spaces:

• By definition, most students experiencing homelessness do not have access to any kind of physical quiet refuge. Permit before- and after-school use of classrooms, libraries, offices, and other school spaces so that students experiencing homelessness can decompress from the traumas they endure off-campus.
• Fill these spaces with affirming messages and health, mental health, and basic needs resources and make sure that all students know they are available. If possible, offer resources and supplies for art and music expression.
• Be clear about anti-bullying policies and proactively respond to reports or warning signs about bullying or intimate partner violence on campus. Create mechanisms for separating victims and perpetrators in classes, hallways, and cafeterias.