Service utilization among homeless and runaway youth in Los Angeles, California: Rates and reasons

Purpose: To describe the service utilization patterns of homeless and runaw ay youth in a "service-rich" area (Los Angeles, California); identify demog raphic and other correlates of utilization; and contextualize the findings with qualitative data. Method: During Phase 1 of this study, survey data were collected from an et hnically diverse sample of 296 youth aged 13-23 years, recruited from both service and natural "hang-out" sites using systematic sampling methods. Dur ing Phase 2, qualitative data were collected from 46 youth of varying ethni cities and lengths of time homeless. Results: Drop-in centers and shelters were the most commonly used services (reported by 78% and 40%, respectively). Other services were used less freq uently [e.g., medical services (28%) and substance abuse treatment (10%) an d mental health services (9%)]. Utilization rates differed by ethnicity, le ngth of time in Los Angeles, and city of first homeless episode (Los Angele s vs. all others). Shelter use was strongly associated with use-of all othe r services. Despite youths' generally positive reactions to services, barri ers were described including restrictive rules, confidentiality and reporti ng problems, and negative interactions with staff members. Youth suggested improvements including more targeted services, more long-term services, rev ised age restrictions, and mote and/or better job training and transitional services to get them off the streets. Conclusions: Because shelters and drop-in centers act as gateways to other services and offer intervention potential for these hard-to-reach youth, it is vital that barriers to use of these services are eliminated. (C) Societ y for Adolescent Medicine, 1999.