Tackling exclusion: A pilot mixed method quasi-experimental identity capital intervention for young people exiting homelessness

Abstract

Background Longitudinal studies examining the life trajectories of young people after they have exited homelessness have identified concerns with persistent social and economic exclusion, struggles to shake off identities of homelessness, and housing instability. This pilot study sought to explore the feasibility of improving socioeconomic inclusion outcomes by bolstering identity capital (sense of purpose and control, self-efficacy and self-esteem) among young people who had experienced homelessness. Methods Nineteen individuals (aged 18–26) who had transitioned out of homelessness within the past three years participated in a six-week, six-session program focused on building identity capital. The study employed a mixed method prospective cohort hybrid design with an intervention group (Group One) and a delayed intervention comparison group (Group Two). Participants were interviewed every three months until nine months post-intervention. Results None of the youth who began the intervention dropped out of the program, with the exception of one participant who moved across the country and was unable to continue. Immediately after participating in the intervention, Group One had statistically significant improvements (p < .05) and large to very large effect sizes in self-esteem (d = 1.16) and physical community integration (d = 1.79) compared to changes in Group Two over the same period, which had not yet begun the intervention. In the pooled analysis, small to moderate effect sizes in hopelessness, physical community integration, and self-esteem were observed at all post-intervention time points. Notably, at six- and nine-months post-intervention, statistically significant improvements (p < .05) and moderate effect sizes in hopelessness (d = -0.73 and d = -0.60 respectively) and self-esteem (d = 0.71 and d = 0.53 respectively) were observed. Youth shared they appreciated the normalizing (vs. pathologizing) of strategies they needed to learn and spoke of the importance of framing new skills as something one needs “to have a better life” vs. “to get better.” Conclusions These early findings signal that targeting identity capital is feasible and may be a promising approach to incorporate into a more complex intervention that includes housing, education, and employment supports to help youth transition out of homelessness. Future research could build on these findings through a sufficiently powered randomized controlled trial.

Effect of Portable Rent Subsidies and Mentorship on Socioeconomic Inclusion for Young People Exiting Homelessness

“…We selected community integration (psychological and physical) and self-esteem-proxy indicators of socioeconomic inclusion-as primary outcomes based on our frontline clinical and research experience with this population. 8,10,28,29 Community integration was measured with the Community Integration Scale, 19,20 with a score range of 1 to 7 for the physical component and 4 to 20 for the psychological component; higher scores indicate higher integration (Table 1). [18][19][20][21][22][23][24][25][26] Self-esteem was…”

“…The annual cost of housing Toronto participants was roughly 6.5 times less expensive than the annual cost of staying in a shelter. Moreover, the sense of personal agency and control that comes from having choice is fundamental to recovery-oriented care, and emerging evidence signals that agency and control could be important mediating factors in outcomes related to mental well-being and housing stability for youths who have experienced homelessness . An unexpected finding was the substantial number of young people who chose to move back home and provide the rent subsidies to their parent(s).…”

“…Moreover, the sense of personal agency and control that comes from having choice is fundamental to recovery-oriented care, 48 and emerging evidence signals that agency and control could be important mediating factors in outcomes related to mental well-being and housing stability for youths who have experienced homelessness. 27,29,49 An unexpected finding was the substantial number of young people who chose to move back home and provide the rent subsidies to their parent(s). Given that most participants in this study indicated at baseline that they maintained contact with family, and the fact that many youths experiencing homelessness come from families with limited finances, 3,5,6 the notion of providing rent subsidies to families warrants further consideration as a strategy to prevent homelessness from (re)occurring.…”

“I feel like I’m in a revolving door, and COVID has made it spin a lot faster”: The impact of the COVID-19 pandemic on youth experiencing homelessness in Toronto, Canada

“…Research has shown that YEH also experience high levels of mental distress, including anxiety, depression, and suicidal ideation, likely the result of trauma and adverse childhood experiences [ 7 ]. They face multiple barriers to social inclusion, including maintaining employment and remaining in school, and often have limited social networks and supports [ 8 ]. The experience of homelessness, particularly when prolonged, can be traumatic in itself, and can lead to worsened mental health, substance use, and exposure to exploitation and victimization [ 9 , 10 ].…”