The Housing First for Youth (HF4Y) program model – a youth-focused adaption of the successful Housing First intervention – is a promising example of how to prevent and support sustainable exits from homelessness for young people, by providing them with housing and well-being supports. But what happens when HF4Y services end? And how can HF4Y programs ensure young people are supported in the immediate and longer-term?

Challenges and barriers for youth transitioning from services:

A common challenge of Housing First programs is when individuals are discharged (sometimes not voluntarily) before they have had the opportunity to achieve and practice skills that promote long-term housing stability. For young people who are transitioning out of homelessness and into adulthood, this can create particular barriers.  

  • There may be a steep drop from receiving intensive wrap-around supports to being on their own with no one around.  In most cases, communications with the HF program ceases, and contact is often lost. While some young people move on, others struggle and often say that they were not ready to have their support end.
  • They are more likely to be learning independence when their peers still enjoy the shelter and protection of their parents.  In Canada, most young adults continue to receive support from family, and many will return to live with their parents. This is not generally the case for young people experiencing homelessness or who have recently exited homelessness. The lack of support can make them vulnerable to setbacks, including returns to homelessness
  • Every day that their needs go unmet represent missed opportunities to support their healthy transition into adulthood. Changing economic and social realities, the unpredictability of life, and unsafe living environments can create situations that limit the conditions and opportunities young people need to succeed and thrive once they are stably housed and living independently. All young people need stable homes and the space to grow, fail, and succeed, as is the case with housed youth

The role of aftercare supports in H4FY program delivery:

Most studies highlight negative outcomes of transitions from services, but a few studies have consulted with youth directly to ascertain possible services that may assist in their transition. From those studies, aftercare supports were a desired and recommended service component for addressing these challenges.

Aftercare is defined as a kind of support that allows young people to stay connected to their program, based on their needs and desires. The types of supports offered within an aftercare program can vary but typically provide individuals with continued access to social and health supports, including Housing, counseling, regular check-ins, mentoring, and connections to a range of resources and services they can access within their community.

In preparing to graduate or exit a program, young people should be assessed to determine their ongoing needs and then be offered aftercare supports when they leave the program.  And in accordance with the HF4Y core principles, care planning decisions should focus on meeting the needs of individual care leavers rather than being based on age or legal status. The model of support is not as extensive as the case management they receive in an HF4Y program. The supports are intended to help young people experience problems or crises once they have moved on. 

While the assumption behind aftercare service interventions is logical and sound in theory, to date, there is limited evidence to support the key features, evidence-based practices, or expected outcomes of aftercare programs, particularly for young people. The absence of formal assessment, along with inconsistent practices across service and interventions, severely inhibits information sharing, replicability, and scalability of successful models and practices.

Making the case for HF4Y aftercare supports:

Effective decision-making requires a solid evidence base. And so, to enhance the current evidence base, the Making the Shift Youth Homelessness Demonstration Lab (MtS DEMS) is prototyping and testing an aftercare support program for young people who have recently exited HF4Y programs at our demonstration sites – starting with young people from the HF4Y site in Ottawa. The program will involve one full-time Support Coach who will determine their ongoing needs and assist young people in larger systems navigation. Supports offered will include:

  • Systems navigation, referrals, and planning advice.
  • Housing support and eviction prevention.  
  • Short-term financial assistance through Aftercare Financial Supports if the young person is in a situation where lack of money could lead to a return to homelessness.
  • Providing general advice and support based on the needs of the young person.
  • Help in reconnecting with family.

 

The methodology and research design for the project will consist of both a developmental and outcomes evaluation.  The developmental evaluation will document the prototyping and implementation of aftercare supports at the program and community levels. Of particular interest will be working with young people to identify the critical components of the aftercare model and what modifications are needed to address the specific needs of different groups and sub-populations.  The outcomes evaluation will test the impact of the aftercare supports once young people have exited the HF4Y Ottawa program. Survey instruments assessing program participants' psychosocial and health needs will be completed at different time points during participation to monitor and track any changes. Interviews and focus groups with young people, are also being used to understand better what they like and dislike about the program, how it compares to other programs they took part in, and how their lives change across the project.

By evaluating the development and outcomes of programs in this way, the project team can respond to stakeholder feedback in real-time through actual changes to the program structure, research design, and communication strategy as the project progresses. Together, this collaboration will enhance the current evidence base through engagement with community stakeholders and program research and evaluation (developmental and outcomes) that will improve our understanding of how effectively deliver aftercare supports and the kinds of outcomes to be expected.  In the end, the goal is to understand and support an approach that promotes better outcomes for youth.