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Youth vulnerability index: The TAY Triage Tool

Wed, Apr 30, 2014

How do providers of homeless services prioritize the scarce resource of supportive housing?

For individual homeless adults, “a vulnerability index” looks at factors that would cause their death if they remained on the street, such as multiple chronic illnesses, frequent hospitalizations and length of time homeless. A family vulnerability index has also been developed that looks at the likelihood of family breakup if the parent and child/children do not receive housing.

But since October 2012, when Chicago began to transition to a Central Referral System for people seeking supportive housing, unaccompanied homeless youth were not rising to the top to become eligible, said Maura McCauley, director of homeless prevention policy and planning at the City of Chicago Department of Family and Support Services (DFSS).

“To have multiple chronic illnesses is unlikely for an 18- to 24-year old,” McCauley said. “Also, the length of time they are homeless. Young people are in and out of homelessness, they don’t qualify as long-term homeless.”

Advocates realized that the system was not working for these youth. There had to be a way to modify the index, just as had been done for families, McCauley said in a telephone interview.

The Chicago Coalition for the Homeless (CCH) and the Corporation for Supportive Housing (CSH) worked with Dr. Eric Rice of the University of Southern California to develop a tool that instead measured an individual youth’s likelihood of remaining homeless as an adult or being long-term homeless without intervention. Their efforts received support from the Conrad N. Hilton Foundation and the W.M. Keck Foundation. Data came from a National Institute of Mental Health- (NIMH) Funded survey of 646 homeless youth at Los Angeles drop-in centers in 2011 and 2012. Results were vetted with both advocacy groups.

According to the TAY Triage Report executive summary, the benefit of the tool is that its six “relatively non-invasive” questions can easily identify youth who are suffering from many issues and vulnerable to many problems.

Just over 10 percent of the youth identified with four or more of the questions and were thus termed “high risk;” half of these youth in turn had been part of the foster care system; 43 percent did not have a high school diploma or GED and 88 percent had biological children, compared to only 40 percent who were not identified as high-risk.

High-risk youth also had more mental health issues; 46.7 percent reported posttraumatic stress compared to 30.4 percent of those not identified as high-risk. Among high-risk youth, 64.6 percent reported physical abuse, 46.7 percent said they had been physically molested and 42.6 percent said they had been forced to have sex against their will. Comparatively, among youth not identified as high-risk, only 39.5 percent said they had been abused, 23.3 percent said they had been molested and 19 percent said they had been sexually assaulted.

Fifteen youths scored 5 or 6 on the TAY Triage Tool. Six of them were interviewed for the report and two examples are profiled below:

Case 2
Triage Tool Score: 6
Age: 19
Sex: Male
Ethnicity: White
Sexual Orientation: Heterosexual
Place of Origin: Southern California outside Los Angeles
Education: High School dropout
Foster Care History: Starting age 6, 5-9 placements
Employment: Not working
Total Years Homeless: 4
Current Housing: Sleeping on the streets
Number of Biological Children: O
Mental Illness: Depressed
Substance Use: Daily marijuana user; used heroin, cocaine and methamphetamine in past 30 days, injects drugs
Traumatic Experiences: Experienced physical violence, witnessed violence

Case 4
Triage Tool Score: 5
Age: 23
Sex: Female
Ethnicity: African-American
Sexual Orientation: Undisclosed
Place of Origin: USA outside of California
Education: Trade school certificate
Foster Care History: Starting age 14, 5-9 placements
Employment: Not working
Total Years Homeless: 3
Current Housing: Sleeping on the streets
Number of Biological Children: 2 (not in custody)
Mental Illness: Depressed
Substance Use: Has never used illegal drugs

Traumatic Experiences: experienced physical abuse, experienced sexual abuse, witnessed family violence, witnessed violence, violent death or serious injury of loved one.

Suzanne Hanney
StreetWise Editor-In-Chief


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