Michelle Solomon, MScN Thesis Defense Supervised by: Dr. Cheryl Forchuk and Dr. Mickey Kerr University of Western Ontario

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Barriers to Education in Homeless Youth Michelle Solomon, MScN Thesis Defense Supervised by: Dr. Cheryl Forchuk and Dr. Mickey Kerr University of Western Ontario

Purpose of the Study Many homeless youth have not completed high school or postsecondary education, a health risk factor that has not been extensively investigated in the homeless youth population! (Evenson & Barr, 2009; Rachlis, Wood, Zhang, Montaner, & Kerr, 2009) To test relationships between multiple ecological factors and their affect on the academic achievement of homeless youth who have a mental health disorder. Which factor is most predictive of academic achievement?

Methodology A quantitative secondary analysis from The Youth Matters in London: Mental Health, Addiction and Homelessness study. Data were collected from the first interviews of 187 youth. Variable selection guided by Bronfenbrenner s 1979 ecological developmental model, and the literature review

Background Length of time housed (Hyman et al., 2011) Mobility (Davey et al., 2000; Murphy, 2011; Rafferty 1995; Rafferty et al., 2004; Whitman et al., 1990) Victimization exposure (Kennedy, 2007) Family relations (Aviles de Bradley 2011, Dupper & Halter, 1994) Social competence (Davey et al., 2000; Yamaguchi et al., 1998) Health and social service use (Hyman et al., 2011) Access to care (Hyman et al., 2011)

Ecological Model Figure 1. The effects of microsystem and mesosystem variables on academic achievement.

Data Collection & Measures Variable Questionnaire Measurement Length of time housed The Housing History Survey Summary of time spent not on the streets, in a hostel, or shelter over the past two years Number of times moved Count of the number of moves The Housing History Survey to unique residences lived in over the past two years During the past six months, did Victimization exposure Health, Social, Justice Service anyone: (threaten; attack; Use attempt to force unwanted sexual activity)? Satisfaction with family relations Social competence Health and social service use Access to care High school completion Quality of Life Inventory 20 Multnomah Community Ability Scale Health, Social, Justice Service Use Access Demographics, Service and Housing History Family satisfaction subscale Social competence subscale Visits to/by: health provider; crisis team; ambulance; drop in centres; food banks (past six months) Do you have a regular medical doctor? A place you usually go to when sick? Available care? Level of education completed Current enrollment in school Demographics, Service and Housing History One or more registered hours per week

Hypotheses Microsystem Predictors of academic achievement 1. Longer length of time housed 2. Less moves 3. Less victimization 4. Less satisfaction with family relations 5. Social competence (no relationship) Mesosystem Predictors of academic achievement 6. Health and social service use (no relationship) 7. Access to care (no relationship) Overall, housing stability will be the strongest predictor of academic achievement

Sample and Setting 187 youth between the ages of 16-25 Non-probability sampling London and surrounding areas, both urban and rural Inclusion Criteria 1. Absolute homelessness or precariously housed 2. A serious mental disorder with or without a co-existing substance use disorder

Results

Descriptive Statistics Variables Frequency Percent Mean (S.D.) Age 20.4 (2.5) Sex Male 122 65.2 Female 62 33.2 Other 3 1.6 Level of education Attended University not completed 4 2.1 Completed High School 27 14.4 Attended High School not completed 137 73.3 Attended business, trade, technical school 7 3.7 Completed Gr5 to 8 12 6.4 Years of school completed a 10.39 (1.6) 7 11 years 146 78.1 12-16 years 41 21.9 Primary diagnosis Substance-related disorder 64 34.2 Mood disorder 59 31.6 Disorder of childhood/adolescence 25 13.4 Anxiety disorder 22 11.8 Unknown 9 4.8 Schizophrenia 5 2.7 Other 2 1.1 Developmental disorder 1 0.5

Study Variable Statistics Microsystem variables Variables Frequency Percent Mean (S.D.) Length of time housed in 2 years a 163.47 (234.14) Up to 2 years 107 57.2 More than 2 years but less than 4 52 27.8 years More than 4 years but less than 6 13 7.0 years 6 years or more 15 8.0 Number of times moved in the last 2 3.7 (2.2) years Victimization exposure Less than 2 exposures 76 40.6 2 or more exposures 111 59.4 Satisfaction with family relations Unhappy with family relations 88 47.8 Pleased with family relations 96 52.2 Social competence Less than effective, low 84 44.9 Effective to extensive, high 103 55.1

Study Variable Statistics Mesosystem variables Variables Frequency Percent Health and social service use Up to 9 visits 46 25.0 10 to 29 visits 45 24.5 30 to 112 visits 47 25.5 113 to 513 visits 46 25.0 Access to care Less than two points of access 69 36.9 Two or more points of access 118 63.1 Academic achievement Variables Frequency Percent High school completion No 120 80 Yes 30 20 Currently enrolled in school No 152 81.3 Yes 35 18.7

Relationships Between Independent Variables Relationship between satisfaction with family relations and access to care Variable Less than 2 points Mean (SD) 2 or more points Mean (SD) Difference in means Number of times moved 3.93 (2.25) 3.57 (2.19) 0.36 Victimization exposure 2.03 (1.42) 1.77 (1.4) 0.26 Satisfaction with family relations 3.4 (1.3) 4.0 (1.6) -0.60* Social competence 3.85 (0.72) 3.9 (0.77) -0.05

Relationships Between Independent Variables Relationship r Victimization exposure and number of times moved 0.187 Victimization exposure and satisfaction with family relations -0.154 Victimization exposure and length of time housed -0.145

Summary of Hypotheses Testing Hypothesis Variable Difference between completing high school or not Difference between enrolled in school or not Hypothesis supported 1. Length of time housed Yes* No Yes 2. Number of times moved No No No 3. Victimization exposure No No No 4. Satisfaction with family relations No No No 5. Social competence No No Yes 6. Health and social service use No No Yes 7. Access to care No No Yes

Summary of Hypotheses Testing Mann-Whitney Test between Length of Time Housed and Academic Achievement Variable No high school High school Mann-Whitney U z Sig Length of time housed 71.95 89.68 1374.500* -2.00.046 Variable Not enrolled Enrolled Mann-Whitney U z Sig Length of time housed 93.72 95.20 2618.000 -.146.850

Predicting High School Completion Logistic Regression Model: Predicting High School Completion, n=132 95% CI Predictor OR LL UL Length of time housed Up to two years housed Reference group Two to four years housed 1.314.423 4.082 Four to six years housed 10.569* 1.950 57.290 Six years or more housed 1.436.219 9.414 Number of times moved 1.045.835 1.307 Victimization exposure No victimization exposures Reference group One victimization exposure.460.067 3.174 Two or more victimization exposures 1.035.295 3.626 Satisfaction with family relations.791.555 1.126 Social competence 1.203.611 2.367 Health and social service use Up to 9 visits to health and social services Reference group 10 to 29 visits to health and social services 1.334.274 6.490 30 to 112 visits to health and social services 1.940.454 8.302 113 to 513 visits to health and social services 2.831.683 11.735 2 or more points of access to care.576.206 1.614 *p<.05

Predicting Current Enrollment in School Logistic Regression Model: Predicting Current Enrollment in School, n=167 95% CI Predictor OR LL UL Length of time housed Up to two years housed Reference group Two to four years housed.465.140 1.546 Four to six years housed 3.991.636 25.055 Six years or more housed.914.194 4.317 Number of times moved.768*.609.969 Victimization exposure No victimization exposures Reference group One victimization exposure 1.195.255 5.602 Two or more victimization exposures 1.639.511 5.256 Satisfaction with family relations.952.686 1.321 Social competence 1.398.717 2.724 Health and social service use Up to 9 visits to health and social services Reference group 10 to 29 visits to health and social services 1.086.251 4.699 30 to 112 visits to health and social services 2.559.692 9.469 113 to 513 visits to health and social services 1.721.452 6.554 2 or more points of access to care.984.358 2.701 *p<.05

Strongest Predictors of Academic Achievement Length of time housed Housed between 4 to 6 years were 10 x more likely to complete high school than participants who were housed for <2 years. 143 participants (76.5%) housed for <2 years Number of times moved For every move, participants were 23% less likely to be enrolled in school 91 participants (48.7%) made 4 or more moves in the past two years 4 moves= 65% less likely to be enrolled in school

Limitations Limited to using variables that were in the Youth Matters study Self report measures Generalizability is limited to homeless youth with a mental health disorder Not a random sample Recall bias Health and social service use, victimization, and access to care variables not tested for psychometric properties

Implications Practice implications: needs assessment for housing stability Housing policy: long term funding from Federal government to support affordable housing for youth Educational system: consider barriers to enrollment, attending, and participating in school Research: Needs assessment of what assists participation in school; participation action research

Conclusions More points of access to care is significantly related to being happy with family relations, although literature presents otherwise Increased victimization exposure is significantly related to less time housed, increased mobility, and less satisfaction with family relations Overall housing stability is the strongest predictor of academic achievement in homeless youth who have a mental health issue

Thank You

References Aviles de Bradley, A. M. (2011). Unaccompanied homeless youth: Intersections of homelessness, school experiences and educational policy. Child & Youth Services, 32, 155 172. doi:10.1080/0145935x.2011.583176 Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, Mass: Harvard University Press. Davey, T. L., Penuel, W. R., Allison-Tant, E., & Rosner, A. M. (2000). The HERO program: A case for school social work services. Social Work in Education, 22(3), 177 191. Retrieved from http://web.ebscohost.com/ehost/detail?sid=b7699757-ee7f-48ef-8696-0d8f61bd8244%40sessionmgr11&vid=4&hid=126&bdata=jnnpdgu9zwhvc3qtbgl2zq%3d%3d#d b=a9h&an=3421373 Evenson, J., & Barr, C. (2009). Youth homelessness in Canada: The road to solution. Retrieved from http://www.raisingtheroof.org/raisingtheroof/media/raisingtheroofmedia/documents/roadto Solutions_fullrept_english.pdf Hallett, R. E. (2012). Living doubled-up: Influence of residential environment on educational participation. Education and Urban Society, 44, 371 391. doi: 10.1177/0013124510392778 Hyman, S., Aubry, T., & Klodawsky, F. (2011). Resilient educational outcomes: Participation in school by youth with histories of homelessness. Youth & Society, 43, 253 273. doi: 10.1177/0044118X10365354 Kennedy, A. C. (2007). Homelessness, violence exposure, and school participation among urban adolescent mothers. Journal of Community Psychology, 35, 639 654. doi:10.1002/jcop.20169

References Murphy, J. (2011). Homeless children and youth at risk: The educational impact of displacement. Journal of Education for Students Placed at Risk, 16, 38 55. doi:10.1080/10824669.2011.554143 Rachlis, B. S., Wood, E., Zhang, R., Montaner, J. S. G., & Kerr, T. (2009). High rates of homelessness among a cohort of street-involved youth. Health & Place, 15, 10 17. doi:10.1016/j.healthplace.2008.01.008 Rafferty, Y. (1995). The legal rights and educational problems of homeless children and youth. Educational Evaluation and Policy Analysis, 17(1), 39 61. Retrieved from http://www.jstor.org/openurl?volume=17&date=1995&spage=39&issn=01623737&is sue=1 Rafferty, Y., Shinn, M., & Weitzman, B. C. (2004). Academic achievement among formerly homeless adolescents and their continuously housed peers. Journal of School Psychology, 42, 179 199. doi:10.1016/j.jsp.2004.02.002 Whitman B.Y., Accardo, P., Boyert. M., & Kendagor, R. (1990). Homelessness and cognitive performance in children: A positive link. Social Work, 35(6), 516 519. Retrieved from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=3&sid=f88a4e6e-b024-4c4b-b253-0eda26e99a83%40sessionmgr11&hid=10 Yamaguchi, B. J., Strawser, S., & Higgins, K. (1998). Children who are homeless: Implications for educational diagnosticians. Special Services in the Schools, 13(1/2), 63 83. Retrieved from http://www.tandfonline.com/doi/pdf/10.1300/j008v13n01_04