In May 2013, Lotus House convened a gathering of public and social policy leaders, community providers, philanthropists and stakeholders to raise awareness of youth homelessness in our community and trauma informed best practices to foster positive youth development. Building on research at the national level and years of direct experience successfully sheltering youth, Lotus House officially launched a program exclusively for youth experiencing homelessness, including both single unaccompanied youth and parenting youth and their infants and toddlers. This summit sparked a broader movement in our community to end youth homelessness which continues to this day. Today in Lotus Village, Lotus House is the largest provider of youth shelter in the State of Florida, offering enriched resources, educational supports, job readiness training and deep protective factors that foster positive youth development. Lotus House now has over 15 years successfully guiding youth in transition to their new homes and brighter futures
According to the data in this study, youth at greater risk of experiencing homelessness include:
83% HIGHER RISK
Black or African American youth to report homelessness
33% HIGHER RISK
Hispanic, non-White youth to report homelessness
200% HIGHER RISK
Unmarried parenting youth to report homelessness
162% HIGHER RISK
Youth reporting annual household income of less than $24,000 to report homelessness
120% HIGHER RISK
LGBT to report homelessness
346% HIGHER RISK
Youth with less than a high school diploma or GED than their peers who completed high school
Other national-level information offers critical insight into who these vulnerable young people are and their unique needs:
- Most homeless youth have experienced trauma, both before and during homelessness[ii], including child physical and sexual abuse and neglect, removal from home by child protective services, and harassment or violence due to homelessness, sexual orientation and/or gender identity, among others[iii]. It is estimated that 17% – 35% of homeless youth have experienced sexual abuse and 40% – 60% have experienced physical abuse.[iv]
- Two of the primary causes of youth homelessness are (1) family breakdown, including being locked/kicked out, abused, and neglected/abandoned; and (2) “systems failure” through which those aging out of foster care or exiting juvenile detention lack critical support and become homeless.[v] Twenty-five percent of former foster youth report being homeless for at least one night within four years after leaving the foster care system.[vi]
- Homeless youth are particularly vulnerable and face tragic consequences if they do not receive the services and interventions they need. They are at a higher risk for further physical and sexual assault or abuse, physical illness including HIV/AIDS, anxiety disorders, depression, post-traumatic stress disorder, drug abuse, suicide, and becoming involved in prostitution.[vii] An estimated 5,000 unaccompanied homeless youth die each year as a result of assault, illness or suicide.[viii]
- Adolescent women are among the most vulnerable and medically underserved groups of homeless individuals.[ix] Homeless female youth are at a high risk for early pregnancy, sexually transmitted diseases, and HIV due to poor access to health care, survival sex (trading sex for basic needs such as housing and food), substance abuse and other challenges.[x]
- Youth homelessness also disrupts critical educational development. The experience of homelessness, with its instability and associated traumas, often disrupts schooling[xi] and makes finishing high school very challenging. One study of 18‐21 year‐old homeless youth found that two‐thirds had not obtained a high school diploma or a GED.[xii]
- Yet staying in school can be a life-line for homeless youth. “Young people who are able to stay in the same community or in the same schools as before they became homeless have a better chance of avoiding the dangerous consequences for youth who do not have familiar (sic) support.”[xiii]
- The consequences of not obtaining a high school education are demonstrably more grave for women. We know that:
- A woman without a high school diploma earns an average of $15,520 per year—over $6,000 less annually than women with a high school diploma.[xiv]
- Nearly one of every two female high school dropouts ages 25-64 is unemployed.[xv]
- A female high school graduate is 68% less likely to receive any type of welfare assistance.[xvi]
- Dropping out of high school is an intergenerational issue. Those who drop out of high school not only have lower lifetime income and worse overall health, but their children are also more likely to drop out of high school as well.[xvii]
- A significant number of young women “cite pregnancy or parenting as a reason for dropping out.”[xviii]
Forty-four percent of the young women experiencing homelessness in the Youth Count study, ages 18 to 25, were pregnant or a parent. Ten percent of the 13- to 17- year-old females reported being pregnant or a parent.[xix]
Miami-Dade County ranks first in sex trafficking in Florida, which in turn ranks third in the nation. About 40% of victims are children and most of the rest are youth between 18 and 23 years old. Federal statistics show that some victims are sold for sex up to 20 times a day.[xx] The number of human trafficking cases reported in Florida more than doubled from 2015 to 2019.[xxi] Victims experience problems ranging from psychological trauma, psychiatric disorders and physical illnesses.[xxii]Lotus House has served such victims for many years, in some cases arranging for relocation to other states where they have support systems.
Youth come to Lotus House from the streets through word of mouth and by referral from an array of sources, including the homeless outreach teams of the Miami-Dade Homeless Trust and the City of Miami, staff of the Miami-Dade Public Schools system’s Homeless Assistance Program as mandated by the McKinney-Vento Education Assistance Act, family and drug court judges, foster care agencies, and other temporary shelters. Other sources of referrals include treatment programs, domestic violence shelters, social workers from Jackson Hospital, police and local providers of services to runaway and homeless youth – any of whom may be seeking residential program space for homeless youth. Youth (16-24) and their children comprise approximately 35 percent of the women and children served by Lotus House on an annual basis.
What Research Tells Us About The Most Effective Strategies To Serve Youth
Fortunately, there are solutions for these special young people who lack basic supports such as stable, safe shelter and food, and the care of a parent or guardian. Due to the unique needs of homeless youth, these solutions must be “distinct from an approach to ending homelessness for adults.”[xxiii] The Framework to End Youth Homelessness calls for a two-prong approach to effectively serving homeless youth: (1) trauma-informed care, which emphasizes settings and relationships in which youth can heal; and (2) positive youth development, which emphasizes settings and relationships in which youth can thrive.[xxiv] Through positive youth development, youth are given the opportunity to “develop transferable skills and competencies through positive interactions” with others.[xxv] Preventing and Ending Homelessness – A Coordinated Community Response goes further and calls for a community coordinated approach which includes tailored services and longer-term housing supports.[xxvi]
Researchers also recognize that the special needs of homeless youth—such as mental and physical health needs, substance abuse, and lack of self-sufficiency skills and sustainable financial resources—require multiple levels of intervention[xxvii] to address “housing, education, mental health, physical health, substance abuse, and other family and community supports.”[xxviii] Specifically, interventions should provide safe, stable housing, “essential to enabling functioning across a range of activities,”[xxix] and educational support which can provide a long term solution to homelessness, “increas[ing] a youth’s capacity to support . . . herself and avoid future homelessness.”[xxx]
Mental and emotional support are also imperative, so youth can develop “key competencies, attitudes, and behaviors that equip a young person experiencing homelessness to avoid unhealthy risks and to succeed . . . in school, work, relationships and the community.”[xxxi] To that end, evidence-based and evidence-informed modalities aimed at assisting youth in achieving positive outcomes, and reliable screening and assessment for trauma, social-emotional functioning, health and other behavioral needs are critical to effectively serving homeless youth.[xxxii]
A 2019 review of evidence-based programs for youth was reported by Chapin Hall at the University of Chicago: Comprehensive Evidence Review of Programs and Practices Addressing Youth Homelessness Can Now Inform Decision Making notes that Cognitive Behavioral Therapy (CBT), particularly trauma-focused modalities, had particular effectiveness in youth populations.[xxxiii], [xxxiv] Case management is also found to have value of significance.[xxxv]
Lotus House Evidence-Informed Program Design
Lotus House provides a safe, trauma-informed environment with multi-faceted support, tools and resources that allow homeless youth to heal, thrive, and become who they are truly meant to be. Guided by the Framework to End Youth Homelessness, the Lotus House Youth Program offers:
- support services that foster positive youth development to assure youth can thrive and develop transferable skills and competencies through positive interactions with others. Lotus House offers a multi-faceted, comprehensive and coordinated support system for homeless youth that addresses their basic needs from food and clothing to health care and mental health treatment, ensures appropriate educational support, builds life and work skills, and encourages their social and emotional development
- trauma informed shelter and comprehensive, wrap around support services in which youth can heal, find safety, and enjoy stable housing for the duration of their high school and/or vocational training, thereby preserving social relationships with teachers, guidance counselors and friends at school, together with evidence-based and informed, trauma-focused therapies provided by Lotus House counselors.
Fostering Positive Youth Development
Lotus House works to foster positive youth development via a campus-like setting in which youth can thrive and develop transferable skills and competencies through positive interactions with others. Lotus House offers a multi-faceted, comprehensive and coordinated support system for homeless youth that addresses their basic needs from food and clothing to health care and mental health treatment, ensures appropriate educational support, builds life and work skills, and encourages their social and emotional development.
At move-in, each youth participates in identifying their needs and develops an individual action plan with the steps, services and supports requisite to accomplishing her health, therapeutic, educational, vocational, and life goals. Thereafter, they meet weekly with their counselor and resource coordinator who assist in accessing the requisite supports and achieving their goals. At regular progress reviews, there are opportunities to adjust their action plans and identify additional supports that may be helpful. Youth at Lotus House also receive individualized support for education, employment training, life skill-building and other activities that foster their growth and development.
For those in high school, Lotus House counselors coordinate with the Miami-Dade County School Board Homeless Student Program to ensure they are enrolled in school, have transportation to and from school and activities, school uniforms, supplies and other assistance needed to complete their education. Tutors are available to meet weekly one-on-one with those who may benefit from more intensive instruction in specific areas and catch up for lost time. We are committed to providing as close to “normal” high school experience as possible, including support for youth participation in after school programming, field trips, and senior activities, from prom dresses to graduation. For those not in high school, Lotus House provides access to GED courses and tutors to assist in obtaining their GED certificates.
In addition to educational support, Lotus House assists youth in pursuing their higher educational, vocational and career dreams and goals, such as help with college testing, applications and tuition waivers for admission, entering our country’s service, and achieving vocational training and employment income before move-out. An array of job training programs provides youth with critical skills needed to obtain and succeed in employment now and in the future. These include the Lotus House Thrift: Basic Job Readiness, Retail Job and Barista Training, and job searches. Additional certifications and trainings are also arranged for those who want to develop careers in areas such as security, the medical field, or day care for example. Our employment coaches meet one on one with each youth to assist with resumes, practice interviews, interview and work attire, job search strategies, and to help in learning to juggle their new responsibilities in the work world.
Counselors, health coordinators, employment specialists, resident managers and a cadre of volunteers all assist youth in developing a wide range of basic life skills from preventive health care and housing resources to computers and financial literacy. In a residential setting with a shared community environment such as Lotus House, responsibilities for upkeep and chores assigned to youth and teams are an opportunity to build both life and social skills. From the kitchen to the laundry room, as with any family, everyone pitches in at Lotus House, and Lotus House staff and other participants become an extended “family” for these special youth, who find mentors and build friendships lasting long after their transition. Youth who find refuge in Lotus House while completing high school have are able to preserve relationships with teachers, friends and guidance counselors that will transcend graduation and contribute to lifelong success.
With a coordinated, comprehensive and multi-faceted approach, Lotus House offers the wrap around support, tools and resources needed to empower and uplift these very special, courageous youth to achieve their promise of a brighter future.
Trauma-Informed Services to Promote Healing
All of the homeless youth at Lotus House have survived traumatic childhoods, including abuse, neglect and untimely loss of parents and caretakers, among others. In addition to providing safe, stable housing with wrap around support services for these special youth for the duration of their high school and/or vocational training, the enriched programming at Lotus House includes evidence-based and informed mental health services focused on trauma resolution, individual and group therapy. Services also include psychosocial education to address the impact of past experiences of violence and trauma during the window of opportunity presented while youth are with us and help them build resilience for life’s future challenges. Upon entry, each young person is matched with one of our full time counselors, who have master’s degrees in mental health counseling or social work or a doctorate in psychology, with whom they will meet every week for individual therapy. They will also participate in an array of evidence-based assessments and interventions specifically selected to address the unique needs of those we serve. These include the evidence-based group counseling modalities of Seeking Safety, a trauma focused-modality to promote healing, and Say It Straight, designed to help youth develop coping strategies and behavior and communication skills to handle adverse situations. Individual counseling, when indicated, utilizes evidence-based Cognitive Behavioral Therapy. For those with a history of substance abuse, there are weekly recovery meetings at the shelter for specialized support. For our youth in high school who are pregnant or have children, additional supports and resources essential to becoming nurturing parents to the children of youth while they are finishing school are provided by our Children and Families Program.
Lotus House has adopted enriched, gender-specific, programming incorporating evidence-based and informed mental health services focused on trauma resolution, individual and group therapy, and psychosocial education to promote healing and build resilience, including:
Early Screenings for total health and well-being, with follow up medical care, comprehensive mental health assessments, and assistance with medications as needed.
Cognitive Behavioral Therapy (CBT) is a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, and so change the way they feel. It is used to help treat a wide range of issues in a person’s life, from sleeping difficulties or relationship problems, to drug and alcohol abuse or anxiety and depression. CBT works by changing people’s attitudes and their behavior by focusing on the thoughts, images, beliefs and attitudes that are held (a person’s cognitive processes) and how these processes relate to the way a person behaves, as a way of dealing with emotional problems. There are trauma-focused modalities which are utilized when appropriate.
Seeking Safety, an evidence-based, present-focused treatment for persons with a history of trauma and substance abuse. Seeking Safety focuses on coping skills and psychoeducation and incorporates four key principles: 1) safety as the overarching goal (helping youth attain safety in their relationships, thinking, behavior and emotions); 2) integrated treatment (working on both PTSD and substance abuse); 3) a focus on ideals to counteract the loss of ideals in both PTSD and substance abuse; and 4) four content areas: cognitive, behavioral, interpersonal, and resource coordination. This counseling framework helps youth build protective factors to moderate the impact of past and future trauma experiences and increase coping skills.
Say It Straight, an evidence-based communication training program, designed to help youth develop empowering communication skills and behaviors and increase self-awareness, self-efficacy and personal and social responsibility – while reducing risky behaviors such as substance abuse, bullying violence, precocious sexual behavior and behaviors that can result in HIV infection. SIS emphasizes values such as resiliency, courage, compassion and integrity, and builds protective factors. It is designed to include high-risk youth and the homeless and youth ages 18-25.
Pre- and Post-testing to gauge the effectiveness of and improve our services. Pre- and post-testing assessments include: PTSD Checklist Civilian version. (PCL-C). The PCL is a 17-item self-report measure reflecting DSM-IV symptoms of PTSD. The PCL has a variety of clinical and research purposes, including:
- screening individuals for PTSD
- aiding in diagnostic assessment of PTSD
- monitoring change in PTSD symptoms
Our Youth Program is carefully designed on every level to assist youth heal and reclaim their lives, build the foundation for a safe, secure and better way of life, and truly break the cycle of homelessness. With a trauma-informed and nurturing environment, evidence-based and informed therapies, education, and comprehensive support services, Lotus House addresses the special needs of these courageous youth and helps them achieve their goals for a safe, secure and brighter future. Your support saves lives. Thank you!
[i] Morton, M.H., Dworsky, A., & Samuels, G.M. (2017). Missed opportunities: Youth homelessness in America. National estimates. Chicago, IL: Chapin Hall at the University of Chicago. https://voicesofyouthcount.org/wp-content/uploads/2017/11/VoYC-National-Estimates-Brief-Chapin-Hall-2017.pdf.
[ii] PSYCHOLOGICAL FIRST AID FOR YOUTH EXPERIENCING HOMELESSNESS, NATIONAL CHILD TRAUMATIC STRESS NETWORK AND HOLLYWOOD HOMELESS YOUTH PARTNERSHIP, P. 2 (2009). HTTP://WWW.HHYP.ORG/DOWNLOADS/HHYP_PFA_YOUTH.PDF.
[iii] PSYCHOLOGICAL FIRST AID, P.2.
[iv] CULTURE AND TRAUMA BRIEF: TRAUMA AMONG HOMELESS YOUTH (2007). THE NATIONAL CHILD TRAUMATIC STRESS NETWORK, P.3 (CITING ROBERTSON, M. J. & TORO, P.A. (1998) HOMELESS YOUTH. RESEARCH, INTERVENTION AND POLICY. IN. L.B. FOSBURG & D. B. DENNIS (EDS.), PRACTICAL LESSONS: THE 1998 NATIONAL SYMPOSIUM ON HOMELESS RESEARCH. (PP. 3-1 – 3-32). WASHINGTON DC: U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT; JENKS, C. (1994). THE HOMELESS. CAMBRIDGE, MA: HARVARD UNIVERSITY PRESS).
[v] FUNDAMENTAL ISSUES TO PREVENT AND END YOUTH HOMELESSNESS (2006). NATIONAL ALLIANCE TO END HOMELESSNESS YOUTH HOMELESSNESS SERIES, BRIEF NO. 1. P.1-2 (CITING ROBERTSON, M. & TORO, P. (1998). HOMELESS YOUTH, RESEARCH, INTERVENTION AND POLICY, PRACTICAL LESSONS: THE 1998 NATIONAL SYMPOSIUM ON HOMELESSNESS RESEARCH. WASHINGTON, D.C.: US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT; US DEPARTMENT OF HEALTH AND HUMAN SERVICES). https://endhomelessness.org/wp-content/uploads/2016/10/1058_file_youth_brief_one.pdf.
[vi] ID. AT 1 (CITING COOK, R. “A NATIONAL EVALUATION OF TITLE-IV-E FOSTER CARE INDEPENDENT LIVING PROGRAMS FOR YOUTH, PHASE 2.” ROCKVILLE, MD: WESTAT 1991).
[vii] FUNDAMENTAL ISSUES TO PREVENT AND END YOUTH HOMELESSNESS AT P.1 (INTERNAL CITATIONS OMITTED).
[viii] ID. P.1 (CITING NATIONAL LAW CENTER ON HOMELESSNESS AND POVERTY (2004). “LEGAL TOOLS TO END HOMELESSNESS” P. 3)
[ix] ENSIGN, J., FNP, DR.PH, PANKE, A., RN, MN, 2002, “BARRIERS AND BRIDGES TO CARE: VOICES OF HOMELESS FEMALE ADOLESCENT YOUTH IN SEATTLE, WASHINGTON, USA.” JOURNAL OF ADVANCED NURSING 37(2), 166-172 AT P.166. HTTP://WWW.BROWN.UK.COM/HOMELESS/ENSIGN.PDF.
[x] ID. AT 167 (INTERNAL CITATIONS OMITTED).
[xi] SUPPLEMENTAL DOCUMENT TO THE FEDERAL STRATEGIC PLAN TO PREVENT AND END HOMELESSNESS, BACKGROUND PAPER – YOUTH HOMELESSNESS. (2010). U.S. INTERAGENCY COUNCIL ON HOMELESSNESS, P. 2 (CITING U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. (2007). “PROMISING STRATEGIES.”). HTTP://WWW.USICH.GOV/RESOURCeS/UPLOADS/ASSET_LIBRARY/BKGRDPAP_YOUTH.PDF.
[xii] ID. AT 3 (CITING BARBER, C., FONAGY, P, FULTZ, J., SIMULINAS, M., & YATES, M. (2005). “HOMELESS NEAR A THOUSAND HOMES: OUTCOMES OF HOMELESS YOUTH IN A CRISIS SHELTER.” AMERICAN JOURNAL OF ORTHOPSYCHIATRY, 75, 347‐355).
[xiii] ID. (CITING NATIONAL ALLIANCE TO END HOMELESSNESS (2006). FUNDAMENTAL ISSUES).
[xiv] “WHEN GIRLS DON’T GRADUATE, WE ALL FAIL” (2007). NATIONAL WOMEN’S LAW CENTER, P. 8. https://www.nwlc.org/wp-content/uploads/2015/08/when_girls_dont_graduate.pdf.
[xv] ID. AT 7.
[xvi] ID. AT 11.
[xvii] ID. AT 10.
[xviii] ID. AT 13.
[xix]Dworsky, A., Morton, M.H., Samuels, G.M. (2018). Missed opportunities: Pregnant and parenting youth experiencing homelessness in America. Chicago, IL: Chapin Hall at the University of Chicago. https://www.chapinhall.org/wp-content/uploads/VoYC-PP-Brief-FINAL.pdf.
[xx] NBC Miami. Anti-Sex Trafficking Effort Launched for Miami Super Bowl. November 6, 2019. https://www.nbcmiami.com/news/local/anti-sex-trafficking-effort-launched-for-miami-super-bowl/2058761/#:~:text=most%20difficult%20cases.%22-,Authorities%20say%20Miami%2DDade%20County%20ranks%20first%20in%20sex%20trafficking,to%2020%20times%20a%20day.
[xxi] WUFT. PBS. 2020 Human Trafficking Summit Highlights Florida’s Ongoing Battle. October 8, 2020.https://www.wuft.org/news/2020/10/06/2020-human-trafficking-summit-highlights-floridas-ongoing-battle/.
[xxii] MIAMI TIMES. Miami-Dade County has a human trafficking problem, numbers show. FEBRUARY 8, 2017. https://www.miamitimesonline.com/news/local/miami-dade-county-has-a-human-trafficking-problem-numbers-show/article_bd6d872a-ee1a-11e6-b608-dfddf8a94191.html.
[xxiii] FRAMEWORK TO END YOUTH HOMELESSNESS (2013). US INTERAGENCY COUNCIL ON HOMELESSNESS, P. 2. HTTP://WWW.USICH.GOV/RESOURCES/UPLOADS/ASSET_LIBRARY/USICH_YOUTH_FRAMEWORK__FINAL_02_13_131.PDF.
[xxiv] ID. AT 18.
[xxvi]the united states interagency council on homelessness. preventing and ending youth homelessness. a coordinated community response. https://www.usich.gov/resources/uploads/asset_library/Ending_Youth_Homelessness_Coordinated_Response.pdf.
[xxvii] FUNDAMENTAL ISSUES TO PREVENT AND END YOUTH HOMELESSNESS AT 2 (INTERNAL CITATIONS OMITTED).
[xxviii] ID. AT 17.
[xxix] FRAMEWORK AT 18-19.
[xxx] ID. AT 19.
[xxxii] ID. AT 16-17.
[xxxiii] Morton, M. H., Kugley, S., Epstein, R. A., & Farrell, A. F. (2019). Missed opportunities: Evidence on interventions for addressing youth homelessness. Chicago, IL: Chapin Hall at the University of Chicago. https://www.chapinhall.org/wp-content/uploads/Evidence-Review-Brief.pdf.
[xxxiv] Evidence Summary Individual Counseling and Related Interventions for Youth Homelessness November 2019. https://www.chapinhall.org/wp-content/uploads/Chapin-Hall_VoYC_Evidence-Review_Individual-Counseling-and-Treatment.pdf.
[xxxv] Evidence Summary Non-housing Case Management and Support for Youth Homelessness November 2019. https://www.chapinhall.org/wp-content/uploads/Chapin-Hall_VoYC_Evidence-Review_Case-Management-and-Support.pdf.