Researchers with the Southwest Institute for Research on Women have spent years studying the unmet needs of southern Arizona youth and young adults who are homeless and lesbian, gay, bisexual, transgender and questioning.
The University of Arizona institute, also known as SIROW, which also has provided programs to address those needs is launching a new initiative.
The project, "i-TEAM: A Treatment Enhancement for Adolescents on the Move," has just earned the institute a five-year Substance Abuse and Mental Health Services Administration grant totaling $1.75 million. The collaborative project will focus on some of population's most pressing needs, particularly those involving mental health support and substance use prevention.
"This is great for the University and really connects the UA and our community," said Sally Stevens, the institute's executive director.
While some services exist for this population, for the most part their needs are largely unmet, Stevens said.
"These services are difficult to find funding for and it is getting tougher and tougher with the economic times," she said. "There are some services available, but they are not at a level where we need to be" she said, speaking specifically about resources for homeless LGBTQ youth and young adults."
"Also, programs don't always know what to do with these youth, and there are a lot of biases that they are dealing with," said Stevens, also the principal investigator on the grant.
SIROW's grant proposal cited a 2005 study conducted by LeCroy & Milligan Associates, Inc. on Tucson-area homeless youth and young adults. The study estimated that between 20 and 40 percent of those between the ages of 18 and 24 who report being homeless identified as LGBTQ. Of their more pressing needs, the agency found that housing, education and employment were among them.
Stevens noted that SIROW and its community-based partners would also be working to reduce discrimination and stigma when working with the youth and young adults. And over the course of the project, the UA-led team also will evaluate the program's effectiveness.
The UA institute's collaborators are Our Family Services, Open Inn, Wingspan, CODAC Behavioral Health Services and the Southern Arizona AIDS Foundation, also know as SAAF. Our Family Services and Open Inn are offering housing and case management, CODAC will provide the substance abuse and mental health treatment and SAAF will offer an HIV prevention curriculum and testing. SIROW will take the administrative lead on the project and facilitate the research component.
The i-TEAM project will target 300 homeless LGBTQ youth and young adults, enrolling 60 individuals each year during the funding period.
Those enrolled will be engaged in an intensive program for six months, which will include the case management, housing and mental health treatment. Other services to be provided include voluntary HIV education and testing, links to community services and training to provide life skills. The UA-led team will then follow up with each participant for another six-month period.
The project comes after SIROW concluded the Prism Project, a research initiative that gleaned a tremendous amount of insight about the needs of young LGBTQ homeless individuals, Stevens said. The Prism Project also offered workshops to the youth on topics such as healthy relationships, sexuality, empowerment, and LGBTQ history.
In preparing for i-TEAM, SIROW will begin reaching out in January to LGBTQ youth and young adults who are homeless and between the ages of 15 and 23, targeting shelters, local streets and areas the population tends to frequent. Those admitted into the substance abuse treatemnt component must meet the American Society for Addiction Medicine's qualifications for outpatient substance abuse treatment.
The project is critically important, as it will provide much needed services for one of the most underserved populations, Stevens said. It is especially important that the new project builds upon years of research about the population.
During the five-year Prism Project, SIROW investigated the sexual health histories and substance abuse use among about 200 participants, aged 13 to 23.
The Prism project was funded at $2.5 million through a grant from the Substance Abuse and Mental Health Services Administration. The program operated at Wingspan's EON Youth Center which was then located in downtown Tucson. Collaborators on that project included the Pima County Health Department, CODAC, SAAF, and Wingspan.
"We had expected this population would be heavily involved in substance abuse and engaged in a lot of risky behaviors for contracting HIV," Stevens said.
But the team found that while that was true for a "smaller segment of the population," it was not true for most.
"They weren't really involved in the criminal justice system either," Stevens said. "Yet, we found that there was a greater need for mental health services than we had expected."
The research team also found that the young, homeless LGBTQ are dealing with serious stressors, such as stigma, harassment, discrimination and depression, which was "higher than we thought compared to when we set out on the research."
Another key issue, of course, is housing.
"These were youth who were between the ages of 15 and 23 who oftentimes did not have a stable place to live," Stevens said, adding that a large portion of individuals SIROW was following lived in shelters or tended to "couch hop," living on the sofas of extended family or friends.
"It goes back to what research has shown: Just ending treatment is not a good idea; not an effective approach," Stevens said. "Our approach is to make sure they are connected in the community in healthy ways after formal treatment ends."
Substance abuse treatment is somewhat complicated, she said, noting challenges with location, enrollment requirements, and stigma associated with treatment. Still, one of the major challenges is that treatment tends to stop abruptly, rather than taper off, as the iTEAM program is designed.
"We're examining how we can provide effective recovery services and follow up treatment," Stevens said. "That is where the field needs to move because people may be helpful for a while but when the treatment stops, there must be support there."
By La Monica Everett-Haynes, University Communications January 8, 2010