Data from a new report suggests many young people are moving from state-funded inpatient mental health care into homelessness or unstable housing, shining a light on gaps between systems that are supposed to care for and stabilize Washington’s youth.
The report, produced by public-private partnership A Way Home Washington, found that of the roughly 1,800 young people who became homeless or unstably housed after leaving the state’s care in fiscal year 2015, two-thirds came from inpatient mental health treatment programs.
That means that young people who received help with their mental health or substance abuse disorders returned to situations that threaten their progress, said Jim Theofelis, executive director of A Way Home Washington.
“The amount of staff time, money, energy and courage it takes for a young person to agree to go into mental health treatment — to have them be discharged into a shelter, homelessness or unstable housing, it’s a failure,” Theofelis said.
There are many reasons young people become homeless after a stay in a mental health facility.
They may have lost connection with family due to their illness. Long distances between their homes and the limited number of behavioral health facilities in the state mean parents lose contact. Children as young as 13 can consent to inpatient mental health and substance abuse treatment, potentially cutting their parents or guardians out of discharge plans. Families sometimes feel that they’re not ready to support a young person with behavioral issues, or don’t want to bring them back into their homes.
The level of support offered to young people after discharge can also vary based on insurance. A program like Wraparound with Intensive Services (WISe) is available to patients with Medicaid coverage. Young people whose families use private coverage have difficulty accessing the same kinds of help, according to the report.
As one service provider quoted in the report put it, “Some young people may not be discharged from treatment directly to the streets, but it certainly is to the curb.”
Transitioning into homelessness after putting in the work to improve mental health or to get a substance abuse disorder under control can undo the advances a young person has made in treatment. People lose track of medications needed to manage mental health conditions or risk their sobriety by returning to an environment with alcohol or drugs.
Stabilizing youth and young adults requires a two-pronged solution: more mental health beds that meet the unique needs of young people and more housing that does the same.
There are moves at the state level to do both.
Gov. Jay Inslee announced a plan to overhaul the state’s mental health system when he unveiled his budget proposal in December. It would pump $675 million into the mental health system to increase the number of community-based treatment options and support rental assistance.
Services for youth and young adults must be explicitly called out, Theofelis said. Services for adults do not always translate for young people.
Modern neuroscience shows the brain is still developing until a person is roughly 25 years old. Young people who experience “adverse childhood experiences” such as mental illness in a caregiver or physical or emotional abuse early in life carry that trauma in their bodies and brains. These issues can be compounded by societal factors such as racism that create a “fight or flight” response that also negatively impacts the brain, according to the Harvard Center on the Developing Child.
Black and Native youth are disproportionately caught up in the mental health, foster and juvenile detention systems.
Despite the fact that 3.7 percent of Washington residents are Black and 1.3 percent are Native American or Alaskan Natives, young people from these communities make up 18 and 16 percent of those who become homeless after time in those systems.
Improved care for young people should be identified as a unique problem with a tailored solution, Theofelis said.
Inslee’s plan still requires approval at the state legislature. The budget he offered to lawmakers in December was 20 percent bigger than the 2017-2019 proposal, and hinged on larger taxes, including a capital gains tax that the legislature has so far been loathe to pass.
The legislature has endorsed a stronger pipeline for housing for youth as a goal.
State lawmakers passed a law in 2018 that guaranteed unaccompanied youth discharged from publicly funded systems of care would receive safe housing by Dec. 31, 2020. The Department of Children, Youth & Their Families and the Office of Homeless Youth has been tasked with developing that plan, which is due to the governor and legislature by the end of 2019.
“The fact that we would be releasing them after these great services potentially directly into homelessness is unconscionable and definitely counterproductive,” said Rep. Tana Senn (D-Bellevue) at a working session of the House Human Services & Early Learning Committee. “It’s not something that the state should be doing.”
Ashley Archibald is a Staff Reporter covering local government, policy and equity. Have a story idea? She can be can reached at ashleya (at) realchangenews (dot) org. Follow Ashley on Twitter @AshleyA_RC
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