Drug Involvement and Experience of Violence in Street Youth

1. Drug Involvement and Experience of Violence in Street Youth A Report on the Youth Pathways Project Patricia G. Erickson, Ph.D. Senior Scientist, CAMH

2. P G Erickson Feb 2008 2 YPP Team PRINCIPAL INVESTIGATOR Patricia Erickson, CAMH Co-Investigators/Collaborators Edward Adlaf Jennifer Butters Deborah Goodman Andy Hathaway Paul Links Lori Ross Carol Strike Chris Wekerle Bruce Leslie COMMUNITY PARTNERS Toronto Children�s Aid Society Catholic Children�s Aid Society SHOUT Clinic Research/Dissemination Staff Katharine King Tara Fidler Tyler Frederick Maritt Kirst Nora Ottaway Christine Wong-Chong A multi-disciplinary team of researchers, plus community partners Funding from two agencies, health and social research, for basically two pilot projectsA multi-disciplinary team of researchers, plus community partners Funding from two agencies, health and social research, for basically two pilot projects

3. P G Erickson Feb 2008 3 Financial Support provided by: Girls � SSHRC ��Homelessness and Diversity Strategic Grant� Boys � CIHR - �Pilot Project Grant from IGH� Dissemination - SSHRC � �Innovative Approaches for the Diversity Competition�

4. P G Erickson Feb 2008 4 Youth as a special population? Youth: a vulnerable stage of life course: Needs for autonomy combined with potentially undeveloped decision making skills Age- specific risks and harms Consider both population and high-risk subgroups How well do policies and programs target youth? (Poulin, 2006: www.ccsa.ca)

5. P G Erickson Feb 2008 5 High-Risk Youth:  Gender, Violence & Health A Conceptual Framework: Mainstream vs. Marginalized Youth

7. P G Erickson Feb 2008 7 Homeless youth: A vulnerable population Background dysfunctional families; school dropout histories of physical and sexual abuse Physical and Mental Health mortality and morbidity � high depression, suicide attempts Criminal activities and victimization High Rates of drug use and problems Overdose, injection drug use a major risk

8. P G Erickson Feb 2008 8 Posters were displayed on 40 recycling bins located on street corners in the targeted zone. Posters were displayed on 40 recycling bins located on street corners in the targeted zone.

9. P G Erickson Feb 2008 9 From the Youth�s Perspective Living on the street is hard But both positive and negative aspects Leaving is difficult But many do succeed Both young women and men live in a climate of fear and vulnerability on the streets

10. P G Erickson Feb 2008 10 Living on the street �It should be harder to get on the street because once we are here it is really hard to get off; it�s easy to stay on.� (Male) �It�s not easy living in a shelter. (You are) dealing with people who are unclean or don�t care. It�s easier to get through if you have support, someone who�s positive.� (Female)

11. P G Erickson Feb 2008 11 Positive aspects of street life - females �I live by my own rules� �Street life is an advantage. I may not be smart in school but I�m smart in other ways. I know how to survive� �I�ve bettered myself by it. I�ve learned a lot and I�m young�and I got support systems and I�m ready to follow rules and I�m young, not like older people on the streets�

12. P G Erickson Feb 2008 12 Positive aspects of street life -males �Being on street is a whole different world- you see more than someone else that went to private school- we see what is around us- we don�t make plans, just live day by day. This path has been made for us so you are going to do what is on your mind.� �Food and shelter in Toronto and you can look for a job and you can take time for yourself to figure out what you want to do. No parents too�.

13. P G Erickson Feb 2008 13 Negative aspects of street life - females �It sucks a lot to be on the street. It�s like you don�t feel like a part of society. I was blown away by how disgusting it is.� �I would tell kids not to get kicked out. Listen to your parents. No one wants to go without eating. I try to scare spoiled kids at shelters so they go home and don�t get into stupid shit. If you can go home, go home.�

14. P G Erickson Feb 2008 14 Negative aspects- Males �In shelters your stuff goes missing and you can catch a disease- you get sick really easy in those places.� �I lived with my mother in a shelter when I was younger- I have uncomfortable memories.� �I am worried about not getting a future- I am worried about getting off the streets. �

15. P G Erickson Feb 2008 15 OVERALL PURPOSE of STUDY To examine the factors which influence the trajectories of homeless young women and men Specifically, to understand what factors contribute to violence, particularly drug problems & selling How? To combine quantitative and qualitative methods in a multidisciplinary team of researchers TODAY: Present baseline data for 150 street-involved youth (women n=75; men n=75)

16. P G Erickson Feb 2008 16 METHODS of YPP Design: baseline, then short follow-up Data collection: Interviewers went to the youth and conducted one-on-one interviews Recruitment: Young women and men aged 16 to 21 from agencies serving street-involved youth Interviews from Dec 2004 to August 2006 Data collection: survey and open-ended Follow-up: about 50% success rate CAS are youth in care, many in foster homes or in Extended Care and Maintenance, living on their own and receiving an allowanceCAS are youth in care, many in foster homes or in Extended Care and Maintenance, living on their own and receiving an allowance

17. P G Erickson Feb 2008 17 DEFINITIONS Homeless street-involved youth: �Young people up to age 24 who are absolutely, periodically, or temporarily without shelter�or at substantial risk of being on the street in the near future�(Daly) �In past 12 mos. used services for street youth regularly and/or needed a place to stay >once� (Roy) Key aspect: instability of housing

18. P G Erickson Feb 2008 18 OUTLINE of Talk: PROFILES Demographic Housing Safety and Stability Mental Health Violence Drug use/Problems Predicting Violent Outcomes Their Own Words: www.tyss.org

19. Sample Characteristics Women more likely to report being bisexual; men hetero or gay: a defence for females?Women more likely to report being bisexual; men hetero or gay: a defence for females?

20. Diversity- continued Not a lot of immigrants or refugees in the street youth pop of either sex; limits diversity analysis Non-English at home is typical of TorontoNot a lot of immigrants or refugees in the street youth pop of either sex; limits diversity analysis Non-English at home is typical of Toronto

21. Moves in the past 4 months A mobile group, but number of moves very similar for both men and womenA mobile group, but number of moves very similar for both men and women

22. Place stayed the longest Again, very similar; most in hostel or shelter, or rented accommodations.Again, very similar; most in hostel or shelter, or rented accommodations.

23. Safety - place currently staying Majority of about 80% of both males and females feel safe Females more likely to feel current place is somewhat or quite unsafe. Since very little difference in places stayed, more likely related to a gender perception of safety?Majority of about 80% of both males and females feel safe Females more likely to feel current place is somewhat or quite unsafe. Since very little difference in places stayed, more likely related to a gender perception of safety?

24. Sources of income - past 4 months Females more likely to get $ from family or agency; males from illegal activitiesFemales more likely to get $ from family or agency; males from illegal activities

25. Mental Health Self-rated Diagnosis Suicide

26. Mental Health M and F same for excellent rating Women have more self ratings in the fair or poor categories � double the men Same in ever diagnosed with a mental health illness, but F higher in perceiving they have oneM and F same for excellent rating Women have more self ratings in the fair or poor categories � double the men Same in ever diagnosed with a mental health illness, but F higher in perceiving they have one

27. Mental Health M and F same for excellent rating Women have more self ratings in the fair or poor categories � double the men Same in ever diagnosed with a mental health illness, but F higher in perceiving they have oneM and F same for excellent rating Women have more self ratings in the fair or poor categories � double the men Same in ever diagnosed with a mental health illness, but F higher in perceiving they have one

28. Violence & Criminal History Victimization & Perpetration

29. Victimization � Past 12 months M and F similar in physical assaults F higher in sexual assaultsM and F similar in physical assaults F higher in sexual assaults

30. Weapon related victimization � past 12 months

31. Weapon related victimization � past 12 months

32. Assault perpetration - Past 12 months

33. Criminal activity � last 12 mos. Girls higher on hurting partner and minor theft Boys higher on everything else Half of boys and 1/3 of girls have sold drugs.Girls higher on hurting partner and minor theft Boys higher on everything else Half of boys and 1/3 of girls have sold drugs.

34. Number of times arrested Males arrested more and more oftenMales arrested more and more often

35. Profile of Youth Substance use In the general population In the street youth group Problem drug use among street youth

37. P G Erickson Feb 2008 37 Street Youth: Any drug use (%) � past 12 months Levels of past year use not very different Males higher on alcohol, marijuana, powder cocaine and crack, but only significantly higher on amphetamines. Females higher on hallucinogens, heroin, and injection drug use. Levels of past year use not very different Males higher on alcohol, marijuana, powder cocaine and crack, but only significantly higher on amphetamines. Females higher on hallucinogens, heroin, and injection drug use.

38. P G Erickson Feb 2008 38 Mean age at first drug use [SY] Males start alcohol and marijuana younger, but females start crack and heroin at younger ages than males. Little difference in onset overallMales start alcohol and marijuana younger, but females start crack and heroin at younger ages than males. Little difference in onset overall

39. P G Erickson Feb 2008 39 Alcohol problems�past 12 mos. These are indicators of dependency, indicating possibly a more severe drug problem Both M and F have tried to cut down, and with some success, but F more likely to feel dependentThese are indicators of dependency, indicating possibly a more severe drug problem Both M and F have tried to cut down, and with some success, but F more likely to feel dependent

40. P G Erickson Feb 2008 40 Cannabis problems�past 12 mos. These are indicators of dependency, indicating possibly a more severe drug problem Both M and F have tried to cut down, and with some success, but F more likely to feel dependentThese are indicators of dependency, indicating possibly a more severe drug problem Both M and F have tried to cut down, and with some success, but F more likely to feel dependent

41. P G Erickson Feb 2008 41 Hallucinogen problems�past 12 mos. These are indicators of dependency, indicating possibly a more severe drug problem Both M and F have tried to cut down, and with some success, but F more likely to feel dependentThese are indicators of dependency, indicating possibly a more severe drug problem Both M and F have tried to cut down, and with some success, but F more likely to feel dependent

42. P G Erickson Feb 2008 42 Amphetamine problems�past 12 mos. These are indicators of dependency, indicating possibly a more severe drug problem Both M and F have tried to cut down, and with some success, but F more likely to feel dependentThese are indicators of dependency, indicating possibly a more severe drug problem Both M and F have tried to cut down, and with some success, but F more likely to feel dependent

43. P G Erickson Feb 2008 43 Powder cocaine problems�past 12 mos. These are indicators of dependency, indicating possibly a more severe drug problem Both M and F have tried to cut down, and with some success, but F more likely to feel dependentThese are indicators of dependency, indicating possibly a more severe drug problem Both M and F have tried to cut down, and with some success, but F more likely to feel dependent

44. P G Erickson Feb 2008 44 Crack use problems�past 12 mos. Again, large prop of both M and F have tired to cut down, but F seem to have more trouble with crack. Feelings of dependency are about the same for males and femalesAgain, large prop of both M and F have tired to cut down, but F seem to have more trouble with crack. Feelings of dependency are about the same for males and females

45. P G Erickson Feb 2008 45 Heroin use problems�past 12 mos. Females report more problems, and had less success in reducing their use of heroin than malesFemales report more problems, and had less success in reducing their use of heroin than males

46. Health Services High demand for medical services, much less for drug treatment

47. P G Erickson Feb 2008 47 Health service use � past 4 months More males than females accessed substance use treatment, but still low levels, compared to other health services which are more likely to be accessed by females.More males than females accessed substance use treatment, but still low levels, compared to other health services which are more likely to be accessed by females.

48. P G Erickson Feb 2008 48 Service access & Utilization + � [Advantage is] being able to get counseling. Because on street there is better access. A lot of doors open to you. It makes you smart too�you know where to turn� (Female). - �What�s done isn�t touching us. Programs designed to find people who fall between the cracks just create more cracks.� (Female)

49. Violence and Victimization

50. Victimized by a weapon

51. Perpetrated Violence

52. P G Erickson Feb 2008 52 Conclusions: Violence Victimization Drug problems, selling not significant; secure housing is protective; being a male and carrying weapons increase the odds � for protection? Perpetration For more frequent violence, carrying a knife and less frequent drug selling increased the likelihood of violence against others,but only drug selling (any) was significant for less frequent violence most variables not significant

53. P G Erickson Feb 2008 53 Conclusions: Prevention �Treatment of addiction and mental health problems should represent public health priorities to prevent deaths in these young people.� (Elise Roy et al., JAMA, 2004) Housing and other social supports Interventions to help improve quality of life and potential for social re-integration