Street-involved youth Flashcards
What is the difference between absolute homeless and relative homeless?
Absolute homeless: live outdoors, in abandoned buildings or use emergency shelters/hostels
Relative homeless: live in unsafe, inadequate or insecure housing, including a rented hotel/motel room, cough surfing.
These are UN definitions
What are some of the causes of homelessness
Poverty Dysfunctional family life violence Sexual and physical abuse (2.5-4x higher) Underlying medical illness Parental drug use Curiosity Mental health problems
What are some of the risks of being homeless?
Lack of money, food, shelter Early sexual activity Dependency on street economy Psychological harm Substance use STI Abuse
What is street economy?
Sex, drugs and panhandling
What are some of the individual barriers to accessing health care?
Lack of money Lack of transportation Lack of knowledge Concerns regarding privacy and rust Legal problems - wanting to avoid getting caught
What are some of the system and environmental barriers to accessing health care?
Lack of a health card
No permanent address
Perceived need for adult consent
Poorly coordinated services
If a SIY had pharyngitis and no money, what treatment could you often them?
1 x IM dose of benzathine penicillin (equivalent to 10 days of oral penicillin)
What are some of the physical problems specific to SIY?
Increased respiratory problems, especially TB and asthma
Dental disease - lack of oral care, smoking, poor hydride, alcohol
Derm - lice, scabies, acne, atopic dermatitis, impetigo and infections (MRSA_
Foot problems - wet conditions and limited clean socks and footwear
Malnutrition secondary to food insecurities.
Injuries and burns
Lack of immunisations
STIs
Substance use
What are some of the mental health problems of SIY?
How does the incidence in SIY compare to the general population?
Disruption of healthy development of self esteem Mood disorders, self harm and suicide Bipolar disorders Conduct disorders PTSD Addiction to substances
Incidence = much higher. You need to screen for these problems.
IVDU increases the risk of which infections?
Hepatitis B, C, HIV
What are some of the factors that affect SIY’s ability to take medication
Money - need to understand if medication can be purchased
Loosing medication
Theft
When taking a history from a SIY, what are important features about the homelessness to consider (not HEADSS and not associated risk behaviours)
Do you consider yourself homeless? Where do you sleep? Where do you get food from? Do you feel safe? Is there an adult you can depend on? How do you get your money? Involvement with the justice system? Do you go to school?
Why don’t SIY just go to adult homeless facilities?
They believe they are not “that bad off”
They do not feel they meet their needs (i.e. adolescent needs)
If you were treating a SIY who might have chlamydia, is there anything you would do differently in them, than in a normal teen?
What about HIV?
You might treat them prior to waiting for test results because follow up can be challenging in their unpredictable lives. 9 x higher risk of clhlamydia
HIV: test at the initial visit, don’t treat until the results are available, and education about need for follow up and risk of ongoing transmission if positive.
What should the government do to help with the health and lives of SIY?
Fund vaccines (esp HPV) and outreach/catch-up programs Create integrated mental health services Target societal issues that increase the risk of running away: poverty, mental health services, family support Fund evidence based programs: Foyer Model Support community interventions
