View in EDS HTML Full Text PDF Full Text

Homeless Youth with Intellectual Disabilities: Precarious Lives and Health Inequalities

Saved in:
Bibliographic Details
Title: Homeless Youth with Intellectual Disabilities: Precarious Lives and Health Inequalities
Language: English
Authors: Ann Fudge Schormans, Stephanie Baker Collins, Heather Allan, D. O'Neil Allen, Nathan Gray
Source: British Journal of Learning Disabilities. 2024 52(3):477-488.
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 12
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Descriptors: Intellectual Disability, Youth, Homeless People, Incidence, At Risk Persons, Health, Well Being, Health Needs, Access to Health Care
DOI: 10.1111/bld.12588
ISSN: 1354-4187
1468-3156
Abstract: Background: Youth with intellectual disabilities experiencing homelessness are invisible within multiple service sectors. We know little about their experiences of homelessness, or the impacts of such on the social and physical health and well-being. Methods: We used quantitative and qualitative methods to measure prevalence and learn from key informants and homeless youth with intellectual disabilities about factors leading to and sustaining homelessness, and the implications of such on their social, physical, and mental health and well-being. The project involved seven co-researchers with intellectual disabilities and experience of youth homelessness in research design, data collection, analysis, and dissemination. We created Forum Theatre scenes that creatively represent the findings of the project. In this paper we share one of those scenes, as well as the recommendations three co-researchers with intellectual disabilities have for improving support to homeless youth with intellectual disabilities. Findings: Lack of awareness of and about homeless youth with intellectual disabilities, combined with siloed ways of working by involved sectors, results in significant disadvantage and health inequities for youth. Also revealed was the likelihood this would continue given existing obstacles to accessing appropriate housing and supports to exit homelessness. Conclusion: Services providers, policy makers and representatives of the involved sectors need to recognize and acknowledge homeless youth with intellectual disabilities and take responsibility for learning and working together to develop integrated and responsive approaches to effectively supporting them.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1431976
Database: ERIC
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
    Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwEDB_pPmWNS93LsMbgb6NRQAAAA4zCB4AYJKoZIhvcNAQcGoIHSMIHPAgEAMIHJBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDJJsQCAe1Z_DvCHVAgIBEICBmyhGrCVeCHiu2yUKbMDZGgmNj-3E6UtOMJwfgePkNHrfsrJyD1ChOb9H72qAyyX0i9G-Qz9xV3bnpvzH_GcxV1HUVYEQaRG_pTftrKMuFRRE46chtGLqK6BhpXInNxHCT6QEbY1whU97JlTweJ4akzcEAJuXMll4iWOXPMnixXsKiO2GuU__GCWCeeXmMdn72CEx3h1H1hewRCs_
Text:
  Availability: 1
  Value: <anid>AN0178558297;f0401sep.24;2024Jul24.05:11;v2.2.500</anid> <title id="AN0178558297-1">Homeless youth with intellectual disabilities: Precarious lives and health inequalities </title> <p>Background: Youth with intellectual disabilities experiencing homelessness are invisible within multiple service sectors. We know little about their experiences of homelessness, or the impacts of such on the social and physical health and well‐being. Methods: We used quantitative and qualitative methods to measure prevalence and learn from key informants and homeless youth with intellectual disabilities about factors leading to and sustaining homelessness, and the implications of such on their social, physical, and mental health and well‐being. The project involved seven co‐researchers with intellectual disabilities and experience of youth homelessness in research design, data collection, analysis, and dissemination. We created Forum Theatre scenes that creatively represent the findings of the project. In this paper we share one of those scenes, as well as the recommendations three co‐researchers with intellectual disabilities have for improving support to homeless youth with intellectual disabilities. Findings: Lack of awareness of and about homeless youth with intellectual disabilities, combined with siloed ways of working by involved sectors, results in significant disadvantage and health inequities for youth. Also revealed was the likelihood this would continue given existing obstacles to accessing appropriate housing and supports to exit homelessness. Conclusion: Services providers, policy makers and representatives of the involved sectors need to recognize and acknowledge homeless youth with intellectual disabilities and take responsibility for learning and working together to develop integrated and responsive approaches to effectively supporting them.</p> <p>Accessible Summaries: Many youths with intellectual disabilities are homeless, but we do not know very much about them. We do not know how they became homeless, what their lives are like when they are homeless or how being homeless affects their health.The (name withheld) research project included academic researchers and co‐researchers with intellectual disabilities, who had experience of being homeless. They spoke to service providers and to homeless youth without intellectual disabilities about these things.They learned that most homeless youth with intellectual disabilities have had very difficult lives. They face many challenges every day. They don't have access to health care, mental health supports, food and nutrition or physical safety. Attending school or having a job is harder to do when you are homeless.Many different services are involved in the lives of people with intellectual disabilities who are homeless. However, these services don't know about each other or work together to support homeless youth with intellectual disabilities.Service providers, governments and policy makers need to take responsibility to learn about the lives of homeless youth with intellectual disabilities. They must work together, and with homeless youth with intellectual disabilities, to develop better supports for this group of youth.</p> <p>Keywords: forum theatre; health inequalities; intellectual disability; precarity; youth homelessness</p> <hd id="AN0178558297-2">INTRODUCTION</hd> <p>In Canada, it is estimated that 35,000–40,000 youth per year are homeless (Gaetz et al., [<reflink idref="bib10" id="ref1">10</reflink>]). Youth homelessness is a recognized significant concern, one requiring dedicated attention from all levels of government, service systems and the public (Kulik et al., [<reflink idref="bib11" id="ref2">11</reflink>]). Youth homelessness has been defined as 'people younger than 25 years of age who are 'living in extreme poverty, and whose lives are characterized by the inadequacy of housing, income, health care supports and, importantly, social supports that we typically deem necessary for the successful transition from childhood to adulthood' (Gaetz, 2009, as cited in Kulik et al., [<reflink idref="bib11" id="ref3">11</reflink>]: e43). As youth become homeless for many reasons, homelessness takes different forms, including youth living on the streets, runaways, youth leaving home without permission or forced out of home by their parents, as well as youth aging out of child welfare care or the juvenile justice system with nowhere to go (Gaetz et al., [<reflink idref="bib9" id="ref4">9</reflink>]). Structural and social determinants of health inequities such as family conflict; parental criminality, addictions, psychiatric involvement; poverty; abuse and neglect, and involvement with child welfare often precipitate youth homelessness (Embleton et al., [<reflink idref="bib7" id="ref5">7</reflink>]; Kulik et al., [<reflink idref="bib11" id="ref6">11</reflink>]). The effects of these precursors to homelessness on physical, emotional and psychological health are exacerbated by homelessness. The experience of homelessness negatively impacts youth across multiple domains: access to stable, secure and supportive housing, education, employment, income, social connections and safety are all threatened (Gaetz et al., [<reflink idref="bib10" id="ref7">10</reflink>]; Kulik et al., [<reflink idref="bib11" id="ref8">11</reflink>]). Impacts may include preventable physical and mental health issues, increased risk of HIV and sexually transmitted infections, and premature death; substance misuse; incarceration and involvement with criminal justice systems; physical and sexual violence; and malnutrition, poverty, and food insecurity (Gaetz et al., [<reflink idref="bib10" id="ref9">10</reflink>]; Kulik et al., [<reflink idref="bib11" id="ref10">11</reflink>]). The deleterious effects on youths' physical, mental and social health and well‐being are further exacerbated the earlier they become homeless and the longer they remain so (Embleton et al., [<reflink idref="bib7" id="ref11">7</reflink>]; Gaetz et al., [<reflink idref="bib10" id="ref12">10</reflink>]).</p> <p>Despite this awareness, homeless youth with intellectual disabilities remain largely invisible (Baker Collins et al., [<reflink idref="bib2" id="ref13">2</reflink>]). Research has emerged demonstrating the overrepresentation of adults with cognitive disabilities experiencing homelessness. Reported rates vary widely, and are dependent upon sample sizes, sampling strategies, and measure used to assess cognitive ability. For example, figures range from 12%–39% (Durbin et al., [<reflink idref="bib6" id="ref14">6</reflink>]) to 30%–40% (Spence et al., [<reflink idref="bib18" id="ref15">18</reflink>]). This variability complicates an understanding of prevalence. Research also identifies particular and additional challenges facing homeless adults with disabilities related to ableism and disability discrimination across multiple sectors and resultant failures to meaningfully incorporate access into health, employment, education, income and other necessary systems (Durbin et al., [<reflink idref="bib6" id="ref16">6</reflink>]; Woolley, [<reflink idref="bib19" id="ref17">19</reflink>]).</p> <p>Information pertaining to homeless youth with intellectual disabilities, their numbers, precipitating circumstances, experiences of homelessness and needs for support is notably limited (Baker Collins et al., [<reflink idref="bib2" id="ref18">2</reflink>]; Collins & Schormans, [<reflink idref="bib3" id="ref19">3</reflink>]). Systematic reviews of studies of children and youth experiencing homelessness that address the broader category of cognitive function, suggest youth experiencing homelessness appear to have lower cognitive functioning at higher rates than their housed peers; however, reported rates vary so widely as to be inconclusive. As with studies of homeless adults with disabilities, the variability in methods, sample sizes, sampling strategies, diagnostic labels and measures across these studies prohibit a clear understanding (see, Fry et al., [<reflink idref="bib8" id="ref20">8</reflink>]; Parks et al., [<reflink idref="bib14" id="ref21">14</reflink>]). Disability has been recognized as a precursor and consequence of homelessness for youth and adults with disabilities (Decter, [<reflink idref="bib4" id="ref22">4</reflink>]; Dinning & Smit, [<reflink idref="bib5" id="ref23">5</reflink>]). A recent study (Shoemaker et al., [<reflink idref="bib17" id="ref24">17</reflink>]) identified both 'youth' and 'people with intellectual disabilities' as priority areas for homelessness research, policy and supports to address physical and social health inequities, but did not consider youth with intellectual disabilities. This matters – without such knowledge and awareness youth with intellectual disabilities will remain invisible, their health and other needs unmet, their lives and futures increasingly precarious, with the inevitable likelihood that they will experience multiple forms of harm.</p> <p>In this study, we share information about an inclusive research project—Partnering for Change—which sought to learn more about youth homelessness and intellectual disability. Following a description of the project, we identify a key finding—the ways systems failures and disjunctures work to disadvantage youth with intellectual disabilities experiencing homelessness. We share as well how project co‐researchers with intellectual disabilities used Forum Theatre as a means of data analysis and dissemination. A co‐produced forum theatre scene is included, and then discussed. We conclude the paper with co‐researchers' recommendations for ways to work towards change.</p> <hd id="AN0178558297-3">THE PARTNERING FOR CHANGE PROJECT</hd> <p>Partnering for Change is a multiyear, multimethod research project focused on homeless youth with intellectual, developmental and learning disabilities, who became homeless and experienced homelessness in the various ways identified in the introduction to this paper. Bringing together academics, youth with intellectual disabilities having experience of homelessness and partners from the youth‐serving homelessness, disability, education and employment sectors, the project aims to map the intersections between intellectual disability, education and employment among homeless youth to identify system‐wide gaps, develop interventions, inform policy and advance research. Partnering with agencies in three sites in the province of Ontario, Canada, representing a mixed urban and rural municipality (Niagara), a medium‐sized city (Hamilton) and a large urban centre (Toronto), we collected three streams of data. To determine prevalence of intellectual disability among homeless youth, quantitative data were collected at six participating shelters through the addition of a one‐page questionnaire focused on intellectual, developmental and learning disability to their intake process (567 questionnaires were completed). An environmental scan involving 47 key informant interviews in the homelessness, disability, child welfare, education and youth employment sectors let us map connections and identify service gaps. We conducted qualitative interviews with frontline staff working with youth to learn about their concerns, as well as 38 qualitative interviews and 11 mapping interviews with homeless youth with intellectual disability to learn about their day‐to‐day experiences and attempts to secure supports. Interviews were all talk based. Although recruitment materials were written in easy‐read formats, no participants requested alternative forms to complete the interview (for additional information, see Baker Collins et al., [<reflink idref="bib2" id="ref25">2</reflink>]; Collins & Schormans, [<reflink idref="bib3" id="ref26">3</reflink>]).</p> <p>As we report in (Collins & Schormans, [<reflink idref="bib3" id="ref27">3</reflink>]), we found a disproportionate number of youths with intellectual disability among homeless youth compared to population means. Sixteen percent of our sample identified with intellectual disability and developmental disability. When learning disability was added, the figure rose to 36%. Data for this study are based on self‐identification—there was no clinical verification of intellectual/developmental disability. Homeless youth may not know or have access to assessment records. They were not always clear on definitions of different types of disability. The stigma associated with disability, as well as fear that being labelled with disability might result in violence against them, led some youth not to disclose. In addition, prevalence data includes only youth in contact with shelter and/or support services. Youth with other experiences of homelessness were not included; thus, our figures are likely an underestimation. All of these factors point to the vulnerability of homeless youth with intellectual disabilities.</p> <hd id="AN0178558297-4">SYSTEMS FAILURES AND DISJUNCTURES</hd> <p>Our analysis of qualitative interview data made plain that youth with intellectually disability typically are involved with several different sectors, including intellectual disability, education, homelessness, child welfare, mental health and medicine. For homeless youth with intellectual disabilities, numerous systems disjunctures were documented, that is gaps that originate not necessarily in a failure of service delivery in any one sector but due to siloed ways of working and a lack of coordination between sectors (Nichols, [<reflink idref="bib13" id="ref28">13</reflink>]). Our data also demonstrated systems failure resulting from inadequate planning for youth (Gaetz et al., [<reflink idref="bib9" id="ref29">9</reflink>]) on the part of sectors supporting people with intellectual disabilities. Drawing on Scully's ([<reflink idref="bib15" id="ref30">15</reflink>]) conceptualization of vulnerability, we found that both systems disjunctures and systems failure are implicated in making youth with intellectual disabilities vulnerable in the shelter system and after finding housing, moreso than vulnerability that may stem from intellectual disability. Precarity ensues from this inadequacy of necessary social and economic supports, with (in this instance) youth with intellectual disabilities being 'differentially exposed to injury, violence and death) (Butler, 2009:ii, as cited in Shildrick, [<reflink idref="bib16" id="ref31">16</reflink>], p.601).</p> <hd id="AN0178558297-5">FORUM THEATRE</hd> <p>Designed as an inclusive, participatory action project, seven co‐researchers with intellectual disabilities, six with lived experience of homelessness, worked alongside academic researchers and community partners in project and site team meetings (project design, developing interview guides, troubleshooting), data collection and analysis (qualitative interviews with youth with intellectual disabilities), knowledge mobilization and dissemination. Recognizing the importance of making service providers, policy makers, and representatives from involved sectors aware of the numbers of youth with intellectual disabilities experiencing homelessness, the pathways into and impacts of homelessness on their lives, co‐researchers with intellectual disabilities chose forum theatre scenes as one way to share knowledge generated by the project and engage sectors in critical and collaborative conversation about the key findings of the project that point towards alternative practices and outcomes.</p> <p>Emerging from Augusto Boal's 'theatre of the oppressed' framework for popular education and social change, forum theatre turns 'the practice of theatre into an effective tool for the comprehension of social and personal problems and the search for their solutions' (Boal, [<reflink idref="bib1" id="ref32">1</reflink>], pp.14–15). Working with Ann Fudge Schormans and Lisa Watts (project manager), five co‐researchers led and participated in the co‐creation of two forum theatre scenes by drawing on qualitative interview data from youth with intellectual disabilities experiencing homelessness and their own lived experiences. At the co‐researchers' request, Watts and Fudge Schormans worked with the transcripts, identifying themes, quotes and examples, and bringing these back to the co‐researchers. Co‐researchers chose the theme of systems disjunctures and systems failures as the focus of the first forum theatre scene. They had been involved in interviews with homeless youth as peer researchers and brought this knowledge and their own experiences to extensive discussion of the data pertaining to this theme. Through multiple meetings at the university, co‐researchers and academic researchers collaborated in the development of a script (setting, focus, characters, dialogue that articulates the key elements of the theme), narrowing the focus to 'Systems Disjunctures = Overlooked Youth = Precarious Lives'. Co‐researchers then chose the role they wish to play, and the scene was produced in a format most accessible for each co‐researcher. In practices and performances, all researchers had the choice of memorizing or reading their parts.</p> <p>Forum theatre's power lies in the engagement of audiences in transforming the scene; inviting audience members to join the scene, shift what is happening by introducing alternative actions as a means of changing the outcome (Boal, [<reflink idref="bib1" id="ref33">1</reflink>]). Each new audience thus brings potential for additional possibilities for change. With each audience, co‐researchers, academic researchers and (when required) student volunteers present the scene in its entirety once to the audience. The scene is then started again. At different points in the scene (varying dependent upon the audience), the scene is paused and audience members are invited to replace one of the characters or to add a new character to the scene. As each new element is added to the scene, the scene shifts, necessitating that performers improvise to keep the scene going. Before public presentations, co‐researchers and academic researchers had drawn in volunteers to facilitate the development of improvisation skills.</p> <p>Academic researchers and co‐researchers have performed the scenes for local, national and international audiences, engaging representatives of a broad range of sectors. To share project findings related to social and health inequities, we present the forum theatre scene focused on the impact of system disjunctures and systems failures on homeless youth with intellectual disabilities. <ephtml> <math altimg="urn:x-wiley:13544187:media:bld12588:bld12588-math-0001" display="block" xmlns="http://www.w3.org/1998/Math/MathML"><semantics><mrow><mtext>Systems</mtext><mspace width=".25em" /><mtext>Disjunctures</mtext><mspace width=".25em" /><mo>=</mo><mtext>Overlooked</mtext><mspace width=".25em" /><mtext>Youth</mtext><mo>=</mo><mspace width=".25em" /><mtext>Precarious</mtext><mspace width=".25em" /><mtext>Lives</mtext></mrow><annotation encoding="application/x-tex"> $\text{Systems}\,\text{Disjunctures}\,=\text{Overlooked}\,\text{Youth}=\,\text{Precarious}\,\text{Lives}$</annotation></semantics></math> </ephtml></p> <hd id="AN0178558297-6">Setting: Case conference at a homeless shelter</hd> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/F04/01sep24/bld12588-gra-0001.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="bld12588-gra-0001.jpg" title="." /> </p> <p></p> <p>Characters:</p> <p></p> <ulist> <item> Chris (shelter worker)</item> <p></p> <item> Ms. Eagleton (teacher)</item> <p></p> <item> Katherine (child welfare [CAS] worker)</item> <p></p> <item> Audrey (mental health worker)</item> <p></p> <item> Megan (Developmental Services Ontario [DSO] worker)</item> </ulist> <p>Purpose: Planning for Francois, a 17‐year‐old homeless disabled youth who grew up in child welfare care, who is about to be discharged from the shelter with nowhere to go but the street.</p> <p>Shelter worker:</p> <p>Thank you everyone for coming. We're here today to determine our options to best help Francois, to make a plan that will support him to become more independent. I've talked to almost everyone on the phone and I know you all have ideas as to what is best for him.</p> <p>CAS worker:</p> <p>Hi Francois. I looked everywhere for you. I called all the shelters around the group home, asking for you!</p> <p>I even called your parents, thinking you may have gone back to them. Even the police couldn't find you! Thank goodness that Chris called me!</p> <p>Now that you've stayed at the shelter and have been on your own for a while, don't you think it would be better to be at the group home? It's not easy to live on the streets, or in a shelter, right?</p> <p>The group home will take you back. You can stay there till you're 18, and then get yourself ready to look for your own place.</p> <p>Francois:</p> <p>I'm almost 18, I am not going back to that group home. I don't like it there; the staff was not nice to me!</p> <p>CAS worker:</p> <p>[becoming frustrated]</p> <p>I remember last time I visited you, you said everything was fine there—that you liked that home better than the other foster and group homes you've stayed in! Didn't you?</p> <p>Francois:</p> <p>[getting upset]</p> <p>No, well... I did, but that was before staff put me in a 1 hr restraint and was aggressive with me! That staff didn't even know me, and he pinned me down on the floor! I don't even remember what it was about!</p> <p>I'm not staying there! I ain't putting up with that shit no more.</p> <p>It's like every placement I ever had—none of them is any good. I hated this group home, the home before this one, and the one before that—I hated them all!</p> <p>CAS never believes me, and nothing gets done—nothing changes! So, I ran away. Fuck that!!</p> <p>Shelter worker:</p> <p>[looking alarmed]</p> <p>Hold on everyone, let's not let our emotions get in the way, let's talk this through calmly.</p> <p>But first, I don't think everyone knows each other yet. Let's introduce ourselves and state why you are here.</p> <p>I'll start: My name is Chris. I'm a case worker here at the shelter. I've been working with Francois for about 6 weeks to set up some goals and directions for his future. I called this meeting.</p> <p>CAS worker:</p> <p>I know everyone here. I'm Katherine, I've been Francois's worker from the Children's Aid Society for the past year. I'm his legal guardian.</p> <p>I just want him to be safe and to be prepared to age out of CAS with a place to go.</p> <p>DSO worker:</p> <p>I'm Megan, the intake access coordinator at Developmental Services Ontario, supporting youth with intellectual disabilities transitioning from youth services, such as CAS, to adult developmental services.</p> <p>CAS referred Francois's file to us 2 years ago: Part of the process of transitioning him out of care. Because youth with disabilities can't always manage to live on their own, they tend to move from CAS straight into adult developmental services.</p> <p>Of course, Francois, the process stalled when you ran away. But we can re‐start it, so long as you remain in CAS care!</p> <p>To receive adult services, we must first make sure you are eligible. CAS provided early developmental assessments in the package they sent 2 years ago. Those assessments are now outdated—you will need new assessments. If you are still eligible, if you still have a developmental disability, we can start working on your transition to adult care.</p> <p>Teacher:</p> <p>[smiling at Francois]</p> <p>I'm Mrs. Eagleton, the alternate education teacher here at the shelter, in the Section 23 school.</p> <p>I've been teaching Francois since he arrived. He has a lot of potential! And I know that he has plans to finish his high school diploma!</p> <p>I'm here to make sure that his education needs are met in any plan that is made for him.</p> <p>Mental health worker:</p> <p>I'm Audrey, a mental health clinician working in the youth shelters here in town. Francois was brought to my attention because he told Chris that he was feeling anxious and in need of some extra support while here at the shelter. A shelter is no place for him—having a safe and stable place of residence will definitely help to improve his mental health.</p> <p>Shelter worker:</p> <p>Thank you everyone. You all have your area of expertise that I hope we can utilize to develop a plan to support Francois.</p> <p>Francois has some thoughts on goals that he would like to achieve that are important for us to address today.</p> <p>The most urgent concern is that Francois has overstayed at this emergency shelter. We don't want to discharge him with nowhere to go, but our hands are tied—we can't keep him much longer. We need to house him quickly!</p> <p>CAS worker:</p> <p>[dismissively]</p> <p>As I said, he can always return to the group home. This is the best solution!</p> <p>Francois:</p> <p>[angry]</p> <p> <bold>NO</bold>! I already told you I don't want to stay there!</p> <p>CAS worker:</p> <p>[ignoring Francois]</p> <p>Or we can work with the DSO to figure out housing.</p> <p>DSO worker:</p> <p>How old are you again, Francois?</p> <p>Francois:</p> <p>I just turned 17.</p> <p>DSO worker:</p> <p>That's a problem. We can't provide services until you're 18. But we can get working on updating your assessments to determine your eligibility.</p> <p>This typically takes some time but if we can do that quickly, then once you're 18, we could have everything in place. It would be easier to get this paperwork finished if you returned to the group home. You won't be able to do it on your own.</p> <p>Francois:</p> <p>[very frustrated]</p> <p>I've already said a thousand times—I don't want to live in a group home anymore! Not a CAS group home or a DSO group home!</p> <p>I've heard about those DSO homes! I feel like I am too high functioning. I don't need to be in those homes!</p> <p>I know of people who end up homeless because they can't stand the ridiculous rules of those homes. Who eats their dinner at 4:30? And if you miss mealtime, you're on your own!</p> <p>I also know you can be shipped anywhere in the province. My friend was moved out of his community; now, he's living up north. He's never been there before, he doesn't know anyone there, and it's too far away for me or his other friends to visit!</p> <p>I don't want to go there. I want to be able to live on my own, have my own place in my own community, finish high school and have a job!</p> <p>I'm done with the system; I want to be independent!</p> <p>CAS worker:</p> <p>[frustrated with Francois]</p> <p>I know you want to live on your own, but it is not as easy as you think. I'm not asking you to stay there forever. In fact, you can only stay till you're 18.</p> <p>If you stay there till then, you have time to learn the skills that you will need to live on your own, and work towards getting your own apartment.</p> <p>Surely, you know it is not just about getting an apartment. You also need to learn how to maintain it! Besides, right now the priority is to get you somewhere to stay, so you don't end up on the streets.</p> <p>Francois:</p> <p>[frustrated, angry, looking at CAS worker]</p> <p>I'm not saying I don't need any supports! I'm saying that I want the opportunity to show you that I can be independent – with your help!</p> <p>I want to learn all the skills to be independent. But not in the group home! I can learn these skills in an apartment, with CAS providing me with supports!</p> <p>CAS worker:</p> <p>I am not saying you shouldn't have your own place in the future! You've been in foster homes and group homes since you were 10 years old, do you really think you can handle living on your own?</p> <p>The good thing about returning to the group home is that we can work on your goals. If you want to be independent, you will have time to learn the skills you need, at the group home!</p> <p>I think we want the same thing, but you're not ready!</p> <p>Francois:</p> <p>[struggling to control his emotions]</p> <p>You barely know me! I've only met you twice. How do you know that I'm not ready?</p> <p>Chris knows me better than you do! I've been at this shelter for 6 weeks, and I've been very responsible: attending all the programmes Chris set up for me, hitting all the targets, and doing well in school!</p> <p>You're not the best person to judge how ready I am!</p> <p>Besides, I'm not saying I can live on my own without any supports. I'm saying I want to live on my own with some supports, like I'm getting here.</p> <p>Me and Chris developed plans to help me to be independent and Chris is supporting me; giving me help if I need it and offering extra support for things that are new for me. I think something like that moving forward will work for me.</p> <p>CAS worker:</p> <p>[patronizing tone]</p> <p>Living on your own is more than that, you'll also need to keep track of your medications, manage your finances...</p> <p>Shelter worker:</p> <p>[surprised, worried]</p> <p>I didn't know that Francois takes medication. I knew he sometimes gets anxious, but not that he was on meds. He hasn't been taking any medication while he's been at the shelter.</p> <p>Mental Health worker:</p> <p>This is really important information. It could have a big impact on any plan we make for Francois.</p> <p>DSO worker:</p> <p>[concerned]</p> <p>It certainly does!</p> <p>CAS worker:</p> <p>[smugly]</p> <p>See, that's what I mean! How can we trust that you can take care of yourself when you haven't been taking care of your mental health and taking your prescribed medication!</p> <p>Francois:</p> <p>But I've been doing fine without meds! No‐one here even knew I used to be on them! And no‐one said they felt I needed meds!</p> <p>Teacher:</p> <p>I've been working in the school programme with Francois for 6 weeks. I've never felt he had problems that required medication. In fact, he's done very well. I think...</p> <p>CAS worker:</p> <p>[interrupts teacher]</p> <p>Living on your own isn't that simple, Francois. I've seen many youths moving out, trying to live on their own too soon and ending up on the streets or couch surfing, bouncing from one place to another.</p> <p>But you can learn all the skills you will need—like you've been doing here—at the group home, and then get your own place.</p> <p>We need time to make it happen, to make sure that it will be stable, permanent housing that will be maintained even after CAS is no longer working with you. You should take advantage of the fact that we are still here to help you. Once you age out of care, you won't have the supports you do now!</p> <p>Francois:</p> <p>[angry]</p> <p>I'd rather live on the streets! That place is like a jail, you have no freedom! Why did you think I left?</p> <p>CAS worker:</p> <p>[minimizing his concerns]</p> <p>You mentioned a conflict, a misunderstanding, with a staff. I'll speak with the group home to make sure there are no future misunderstandings.</p> <p>Francois:</p> <p>It is not just a misunderstanding! I told you he assaulted me. You won't believe me!</p> <p>See, that's why I don't say anything. What's the point of telling you if you don't trust me! I am not going back there. PERIOD!</p> <p>CAS worker:</p> <p>[with an air of finality]</p> <p>Well, if you refuse to do what is best for you, I don't know if we can help you.</p> <p>Shelter worker:</p> <p>[alarmed]</p> <p>OK, let's back up a bit. My apologies for jumping too quickly to a discussion of housing.</p> <p>Francois identified a few goals, and housing is only one of them. While it's the most urgent one from my perspective, I think there's much value in listening to all of the goals Francois has in mind first before rushing to solutions.</p> <p>Francois, I think it's very important for you to let us know what you want, and then we can try to think of possible options and ways for you to achieve those things.</p> <p>Francois:</p> <p>[relaxing a bit]</p> <p>Thank you, Chris. Like I said, I want to be able to live on my own in my own apartment.</p> <p>I also want to go back to a regular school to finish my high school diploma. I need that to get a good job, otherwise my future will be very bleak.</p> <p>I really want to go to college someday, even though everybody tells me that I am not good enough for college, or even to learn in a regular classroom. Just because I have a disability, they think I can't learn anything!</p> <p>I've always liked school, it's a safe haven for me. I know if I stick to my plan and with some support, I can do it.</p> <p>But one problem is the meds—meds that I don't even need!</p> <p>In the group home, they gave me meds for my [sarcastically] 'anger problems', and I couldn't wake up in time! I was always late for school. I was like a doped kid. I wasn't doing well in school, and the teachers and group home got mad at me for missing school.</p> <p>Without my meds, I don't miss school in the shelter, and I get up on time with no problem!</p> <p>Teacher:</p> <p>He does.</p> <p>Mental health worker:</p> <p>But you can't skip your medications, it will worsen your condition even more!</p> <p>Francois:</p> <p>[unhappy with how the conversation is going]</p> <p>When I ran away from the group home, I couldn't take my meds with me could I?</p> <p>They're always locked up. I have no access to them. I'm not in control of them! They treat us like babies in the group home, like we can't do anything by ourselves!</p> <p>But my point is that the medication makes me tired and dopey, and I couldn't get to school on time, and now I'm behind!</p> <p>Mental health worker:</p> <p>[dismissively]</p> <p>Medication only works if you take it as it is prescribed! With any medication it can take some time for your body to get used to it. Sometimes you might need to go back to the psychiatrist to make some adjustments so that it works as it should for you. Did you follow up with that?</p> <p>Francois:</p> <p>You know that youth in a group home can't call the psychiatrist! Staff do everything like that!</p> <p>Mental health worker:</p> <p>[addressing CAS worker]</p> <p>Did anyone at the group home follow up on that?</p> <p>Francois:</p> <p>I've been taking medications like, forever! I don't know if they ever changed it! They just tell me I have to take them!</p> <p>What I know is that I couldn't get up in the morning, and the teachers called me lazy and unmotivated. But I wasn't!</p> <p>Seriously, why would I want to stay in the group home all day? Why would anyone want to! I wanted to go to school, it's an escape for me.</p> <p>Mental health worker:</p> <p>[ignoring Francois]</p> <p>If you took the medication the way you're supposed to, that would have helped you to focus on your schoolwork. That is your responsibility.</p> <p>Francois:</p> <p>[dismisses mental health worker with a wave of his hand]</p> <p>But there was another problem—it didn't feel like staff were concerned about me at all.</p> <p>I wanted to do well in school, but I had to struggle on my own. The staff always said they were 'too busy', so no one was there to help me with my homework.</p> <p>I would have done better in school if I had help at the group home.</p> <p>Teacher:</p> <p>[concerned]</p> <p>Weren't you getting help at your school? From your teacher? Or from teacher assistants?</p> <p>Francois:</p> <p>No!</p> <p>Teacher:</p> <p>I think an alternative education programme—like this one here at the shelter—would be much better for you. You could learn at your own pace, and you would get better support.</p> <p>Don't you think that is a good idea?</p> <p>Francois:</p> <p>Maybe. But I don't always need help. If I need it, I'll ask for it.</p> <p>Teacher:</p> <p>Exactly! Alternative education programmes can offer that flexibility and provide you with extra help when you ask for it.</p> <p>I think you would just get lost in a regular school.</p> <p>[others nodding their heads in agreement]</p> <p>Francois:</p> <p>But if you are in those kinds of programmes everyone treats you like you're 'different'. I don't want to feel any more different than I need to.</p> <p>I prefer to go to a regular school, it's better for me! I don't want to be treated as if I'm 'stupid' or a 'retard'. That's what they call you if you're in those classes. Why would I want that!</p> <p>[no‐one looks at him when he says this]</p> <p>Shelter worker:</p> <p>[changing the topic]</p> <p>OK, we've got side tracked again. How about you finish telling us your goals, Francois?</p> <p>To recap, you said that you wanted to have your own apartment, go back to school to finish your high school diploma, eventually go to college: is there anything else?</p> <p>Francois:</p> <p>I also want to work. Since I am still in school, I'd like a part‐time job to get some work experience.</p> <p>[others shaking their heads]</p> <p>Shelter worker:</p> <p>OK. So, you want to have your own apartment, finish your high school diploma and work part‐time. And then, later, go to college.</p> <p>[Francois nodding in agreement]</p> <p>CAS worker:</p> <p>Then you need to stay at the group home! That way you will have a roof over your head while you <emph>try</emph> to finish high school.</p> <p>Francois:</p> <p>[frustrated]</p> <p>But I can't work if I live in the group home. It doesn't match staff schedules! There aren't enough staff—no‐one will have time to help me with job training.</p> <p>CAS worker:</p> <p>[dismissively]</p> <p>You don't know that! I'll talk to them, make some arrangements so that you can stay there, try to finish your schooling, and get a part‐time job.</p> <p>It is only by going back to the group home will you be able to achieve <emph>any</emph> of your goals! You won't get your own apartment immediately, but you will, once you find a permanent job, and you can only do that if you finish high school. You can't go to school and work if you are homeless.</p> <p>Francois:</p> <p>I don't want to stay homeless! Why are you saying that! But I also don't want to go back to the group home. It's suffocating.</p> <p>You don't know—no‐one can know what it's like unless you've actually lived there!</p> <p>CAS worker:</p> <p>But even if you live in your own place, there will still be rules from adults, rules from CAS, a landlord, all your workers!</p> <p>Francois:</p> <p>At least it's not abusive!</p> <p>Shelter worker:</p> <p>[trying to calm things down]</p> <p>So, I am hearing Francois say that he doesn't want to go back to the group home. That it is not the best environment for him to learn to become independent or to feel safe. It really does sound like going back to the group home is not the best option.</p> <p>CAS worker:</p> <p>[angry]</p> <p>I disagree! I can't let him end up on the streets. That is the only option he has right now!</p> <p>Mental health worker:</p> <p>We really need to consider what Chris just said—if Francois is not feeling safe, that matters to his mental health. We need more options here. Chris, are there any other spots at another youth shelter that Francois can go? To buy us some time?</p> <p>Shelter worker:</p> <p>No, unfortunately. There are only a few other youth shelters in town, and he's been barred from them because of his past anger issues.</p> <p>Megan, are you sure that there is nothing DSO can offer Francois before he turns 18?</p> <p>DSO worker:</p> <p>No, there is nothing. We cannot begin to access any adult services for him until an updated assessment is completed and we know for sure that he meets our eligibility criteria. And even then, there are other steps to take before a placement might be secured.</p> <p>As mentioned earlier, I received paperwork from CAS 2 years ago, but it is now outdated. The assessment process stalled when Francois ran away from care—if he hadn't run away, we'd be much farther along.</p> <p>We can certainly re‐start the process, but he has to have a stable placement to do that. That's the biggest challenge. If he could stay here longer or move back to the group home, we could get started. But if he disappears again there's nothing we can do until he shows up again!</p> <p>Francois, you are slowing down your own process.</p> <p>CAS worker:</p> <p>CAS has access to psychologists; I can arrange for all the tests. But, in the meantime, he still needs a place to stay.</p> <p>He can't live on his own. Who will manage his medication? He won't be able to learn how to do that.</p> <p>Mental health worker:</p> <p>Yes, it will be difficult for Francois to manage his medication independently as he hasn't had the opportunity to learn to do that at the group home. That's a shame that this didn't happen. And he will need to be re‐assessed to determine if the medication he's receiving was the right one or given at the right dosage. This will take some time.</p> <p>CAS worker:</p> <p>[taking charge]</p> <p>Exactly. He needs to be in a stable, monitored placement while we get everything in place for a successful transition. CAS and the group home staff had already started working on his transitioning, and I must stress that I think it's just better for him to go back to the group home and then wait till a place is available for him through the DSO.</p> <p>There's no point moving him around: it's not good for his mental health having to adjust to many different new environments. And I don't believe he is at all ready to be on his own!</p> <p>Mental health worker:</p> <p>Yes, stability is important.</p> <p>DSO worker:</p> <p>Well, as I have said, the DSO can do nothing until we have confirmation that he's eligible for DSO support. If he is eligible, we can put him on the needs list and wait till a place opens up.</p> <p>[alarmed, everyone turns to look at DSO worker]</p> <p>Shelter worker:</p> <p>How long will that take?</p> <p>DSO worker:</p> <p>[nonchalantly]</p> <p>It's hard to say. This is the frustrating part for families and caregivers. We can't really give them a specific time frame; we never know when something might open up after their disabled adult is put on the list.</p> <p>Furthermore, I'm not sure if all the homes in the developmental sector are equipped to support someone who also has mental health needs. We certainly can't force service providers to take on clients with needs they don't feel comfortable with or have programmes for!</p> <p>This means the number of options for someone like Francois will be reduced. He might be waiting for some time. And chances are, he might not be able to remain in this community—he will have to go wherever a placement is available.</p> <p>Francois:</p> <p>[alarmed]</p> <p>You can't make me do that!</p> <p>DSO worker:</p> <p>Audrey, are there any mental health residential programmes with shorter wait times than the developmental sector?</p> <p>Francois:</p> <p>[very frustrated]</p> <p>But I already told you—those homes are not suitable for me!</p> <p>Mental health worker:</p> <p>There are a few, but they don't have the expertise and resources to work with people with intellectual disabilities.</p> <p>I'm also not sure the wait is much quicker to be honest.</p> <p>CAS worker:</p> <p>Well, it seems the group home really is the ONLY option to get him housed right now.</p> <p>Mental health worker:</p> <p>But his safety is important as well! How can we be certain his needs will be properly addressed in the group home?</p> <p>Shelter worker:</p> <p>Yes. This must be considered. And what about school and work......</p> <p>[workers continue arguing among themselves, ignoring Francois who slowly moves away from table, muttering, 'it's like I'm not even here...']</p> <p>Scene ends.</p> <hd id="AN0178558297-8">DISCUSSION</hd> <p>The forum theatre scene begins to make plain the multiple social, environmental, economic, and political factors that affect youth with intellectual disabilities in becoming homeless, including systems disjunctures and failures, in experiencing and exiting homelessness. It highlights the impacts on their 'right to enjoy the highest attainable standard of physical and mental health' (Embleton et al., [<reflink idref="bib7" id="ref34">7</reflink>], p.147), their opportunities for a long, stable, and healthy life. Revealed instead is the likelihood of a difficult and precarious life.</p> <p>In this section, we share some of a discussion amongst the authors. Drawing on the scene, Patrnering for Change project data that had informed development of the scene with co‐authors, and the co‐authors with intellectual disabilities experiences of youth homelessness, we consider how these factors combine to produce significant social and health inequalities, with both short and potentially life‐long impacts. We end our paper with three recommendations for change.</p> <p>Many systems are involved in the lives of disabled homeless youth, for example:</p> <p></p> <ulist> <item> Homelessness and social housing</item> <p></p> <item> Education</item> <p></p> <item> Mental health and other medical systems</item> <p></p> <item> Criminal justice system</item> <p></p> <item> Addiction services</item> <p></p> <item> Employment services</item> <p></p> <item> Child welfare/protection</item> <p></p> <item> DSO and other disability services</item> </ulist> <p>As the scene demonstrates, sectors typically operate as siloes; systems disjunctures occur when sectors have too little knowledge of the others (see Baker Collins et al., [<reflink idref="bib2" id="ref35">2</reflink>]). The specificity of service eligibility and provision within each sector makes it difficult for youth to get the services they need. Narrow mandates and understanding of 'what kind of youth', 'what kind of problem' each sector will support misses so many and so much. For example, the mental health worker's singular and unwavering focus on medication, despite contradictory assessments from Francois, the teacher, and shelter worker. Linking such systems failure to disability discrimination, O'Neil Allen, asserted that shelter mandates target able‐bodied youth, not youth with disabilities. Nor can siloed systems or systems failures address the interconnected nature of supports required by homeless youth with intellectual disabilities. As O'Neil noted 'staff can only suggest supports based on what they know—if they don't know about intellectual disability, they don't know the supports and they can't help'. This situation is exacerbated when supports are in limited supply. While connection to adult services through DSO is initially held up as the solution to Francois' homelessness, the reality of the multi‐year waiting list for services, demonstrates the paucity of necessary supports available. Left to deal with the many cracks and gaps within these systems, and the lack of coordination between them, homeless youth with intellectual disabilities often get lost in the shuffle and their lives remain or become even more precarious. All Partnering for Change data sources revealed how this can lead to significant social and health inequalities for youth intellectual disabilities experiencing homelessness.</p> <p>Problematic living conditions and daily precarity include the following factors: limited sources of income, poverty and food insecurity, and lack of access to healthy food (Gaetz et al., [<reflink idref="bib10" id="ref36">10</reflink>]; Kulik et al., [<reflink idref="bib11" id="ref37">11</reflink>]). It may mean sleeping in a crowded, noisy shelter or sleeping rough—'having no choice but to sleep in dangerous spaces, with people you don't know or trust' (O'Neil), having to be constantly vigilant, worrying about where you will stay, where you will find food, and ways and places to attend to daily hygiene. This precarious access to daily needs affects physical and mental health, including malnutrition. Homelessness and siloed service delivery can dangerously impact access to health care, medical assessments, access to and monitoring of medications (Gaetz et al., [<reflink idref="bib10" id="ref38">10</reflink>]; Kulik et al., [<reflink idref="bib11" id="ref39">11</reflink>]). Although these consequences apply to all homeless youth, Nathan Gray spoke to how the risk for youth with intellectual disabilities is greater. Homelessness can lead to death from violence, or from 'self‐medicating' to cope because 'it's dog‐eat‐dog out there; other homeless people may target you because of your disability' (Baker Collins et al., [<reflink idref="bib2" id="ref40">2</reflink>]). He spoke to how intellectual disability may mean you 'don't know how to keep yourself safe', you can be 'exploited, coerced or forced into things, like crime or selling drugs'. Heather Allan, O'Neil Allen and Nathan Gray discussed how intellectual disability may mean that youth might struggle to understand the rules of a shelter or, if housing is found, a rental agreement, and end up evicted (Baker Collins et al., [<reflink idref="bib2" id="ref41">2</reflink>]). If you communicate in different ways, or your speech is not clear, misunderstandings can occur, or you may be made fun of; either way, your needs will not be met, and you may be discouraged from even trying. Youth with intellectual disability may need more support, or certain kinds of support. Without such they are more likely to make decisions that put them in precarious situations, and to being taken advantage of by others (Baker Collins et al., [<reflink idref="bib2" id="ref42">2</reflink>]). For O'Neil, being deliberately taken advantage of because of disability is a form of violence, one that he understands to be rooted in social devaluation and ableism.</p> <p>Heather spoke to the importance of connection: 'Not having love can make you feel sad, it can make you feel lonely', which she understands to include 'being accepted for what kind of person I am'. We spoke at length about how homeless youth with intellectual disabilities typically lack a dependable adult in their lives. Francois has experienced significant turnover in CAS workers and, while he has developed a relationship with the shelter worker, he is unable to remain in the shelter which will likely end that relationship. That his current CAS worker appears to minimize his assault by a staff at the group home, and insists on his returning there, means he is not likely to turn to her for support. Family issues, bouncing in and out of care or from one placement to another, not having people who listen and try to understand, that you can call on for support means never feeling safe. Combined with the other factors at play, what becomes clear is the vulnerability of homeless youth with intellectual disabilities leading to homelessness, while homeless, and after being housed. O'Neil summed it up this way: 'If you're lucky, a staff will take an interest in you to get supports for your disability' but this alone is inadequate and not to be counted on. The absence of social connection and networks further compromises one's well‐being, in the present and going forward.</p> <p>The benefits, and precarity, of having even a single support person was also seen in the context of education. In the scene, and in the face of the CAS worker's contrary opinion, the teacher demonstrates her support for Francois and encouragement of Francois's desire to complete secondary school but to little avail. Homelessness compounds one's ability to attend and actively engage in an education programme (Decter, [<reflink idref="bib4" id="ref43">4</reflink>]), despite disabled youths' recognition of the importance of education to exiting homelessness. As the scene demonstrates, it also complicates securing and maintaining employment. In addition to the immediate effects, the importance of an education to employment opportunities points to potential negative impacts on their future lives and opportunities (Decter, [<reflink idref="bib4" id="ref44">4</reflink>]). Absent a stable, accessible, and supportive education programme and employment, youth are denied additional opportunities for valuable social connections and networks.</p> <p>Partnering for Change data and research literature (Embleton et al., [<reflink idref="bib7" id="ref45">7</reflink>]; Gaetz et al., [<reflink idref="bib10" id="ref46">10</reflink>]) suggest that ongoing homelessness will exacerbate social and health inequities, however we do not yet clearly understand how long‐term homelessness consequent to the lack of access to adult disability services may also exacerbate disability.</p> <hd id="AN0178558297-9">CONCLUSION AND RECOMMENDATIONS FOR CHANGE</hd> <p>Recognizing health inequities as being 'socially produced, systematic in their distribution across the population and unfair' (WHO, as cited in Embleton et al., [<reflink idref="bib7" id="ref47">7</reflink>], p.147), project participants and co‐authors with intellectual disabilities emphasized that homeless youth with intellectual disabilities were not the problem, not the cause of their situation. Drawing on key findings from Partnering for Change and recognizing the limits on our ability to effect change, the co‐authors identified three interconnected recommendations by which involved sectors could better address the social and health inequities experienced by homeless youth with intellectual disabilities.</p> <hd id="AN0178558297-10">Take responsibility for learning about intellectual disability</hd> <p>A key finding from the data, and one made visible in the forum theatre scene, identified the need for all staff, professionals, and managers in all involved sectors to learn about intellectual disability—the different ways it is understood, indicators that a youth might have an intellectual disability, the supports required and how to access them. O'Neil stressed how knowledge of disability discrimination, rooted in ableism, was also essential. Heather was adamant that responsibility for this learning lay with professionals and organizational staff—it is not the job of youth to teach them. Many involved sectors have limited knowledge or understanding of 'disability' and even less of 'intellectual disability'. Consequently, their perspectives and understanding of both may be informed by and reflect deficit‐based ideas of 'disability' as a problem located in the individual that needs to be fixed, cured or eradicated. This view ignores the reality and impacts of neoliberal and capitalist priorities and ableist systems (Shildrick, [<reflink idref="bib16" id="ref48">16</reflink>]) on the lives of homeless youth with intellectual disabilities. It also sustains social devaluation and hold youths responsible for their situation and for changing it.</p> <hd id="AN0178558297-11">Recognize that this is a complicated issue</hd> <p>Nathan stressed that all involved sectors must also recognize and acknowledge that 'disability' is not the only thing at play here; the lives of homeless youth with intellectual disabilities are extremely complicated. We also challenge a singular focus on homelessness—that securing housing will solve everything—the complexity of youths' lives contradicts that. O'Neil emphasized that intellectual disability, the effects of homelessness and all that led to it and stemmed from it, are 'a lifelong issue—we need lifelong support'. A service focus only on the here‐and‐now, on making sure youth with intellectual disabilities get housed and become 'completely independent', ignores, or disregards, the ongoing need for support. It is critical that sectors learn about each other; what each sector does and the ways homeless youth with intellectual disabilities are or should be supported by the services within those sectors.</p> <hd id="AN0178558297-12">Actively and meaningfully work together and with youth with intellectual disabilities to deve...</hd> <p>Not only must all involved sectors take responsibility for learning about intellectual disability, and about each other, they must then take the more important step of coming together to develop well integrated and coordinated approaches to supporting youth with intellectual disabilities experiencing homelessness. This will require significant time and commitment. It necessitates rethinking siloed ways of working and prioritization of single‐issue service delivery. It also calls for a critical re‐evaluation of both professional expertise and the role of youth with intellectual disabilities in this planning.</p> <p>A common complaint from youth participants was that staff and professionals treated them like children. They strongly objected to being infantilized, arguing instead for their right to be recognized and treated as young adults. Homeless youth with intellectual disabilities may be infantilized due to their age—as youths, they are in the process of becoming adults. A second, more troublesome and lifelong layer of infantilization stems from the label of intellectual disability and the belief that they will never be capable of attaining adulthood. This is a means by which their knowledge is dismissed and 'expert' control over their lives is justified (Mills & Lefrançois, [<reflink idref="bib12" id="ref49">12</reflink>]). In these ways they are made more vulnerable, their lives more precarious. Greater collaboration with youth with intellectual disabilities means professionals abandon the belief that they know best. For O'Neil, by ignoring or discounting the youth's opinions and desires, professionals disrespect youth. When this happens, youth find ways not to comply, and nothing ever changes. Instead, professionals and staff must take the time to really listen to homeless youth with intellectual disabilities. As Heather stressed, 'youths' opinions do count, they need to be heard'.</p> <hd id="AN0178558297-13">ACKNOWLEDGEMENTS</hd> <p>This work was supported by Social Sciences and Humanities Research Council of Canada: [Grant No. 890‐2013‐0086].</p> <ref id="AN0178558297-14"> <title> Footnotes </title> <blist> <bibl id="bib1" idref="ref32" type="bt">1</bibl> <bibtext> Although the larger project focused on intellectual, developmental and learning disabilities, we focus on intellectual and developmental disability in this study. As the terms intellectual disability and developmental disability were used interchangeably by participants in Partnering for Change, and as some youth participants also used the language of 'learning disability' to indicate intellectual disability. For ease, we use 'intellectual disability' here (see Collins & Schormans, [3])</bibtext> </blist> <blist> <bibl id="bib2" idref="ref13" type="bt">2</bibl> <bibtext> Please note that the process for determining prevalence was complex and beyond the scope of this study to report. Greater details can be found in Collins & Schormans, [3].</bibtext> </blist> <blist> <bibl id="bib3" idref="ref19" type="bt">3</bibl> <bibtext> Although we are aware this word is hurtful and do not use it ourselves, for the purposes of adherence to the data, the co‐researchers with intellectual disability wanted this word left in.</bibtext> </blist> </ref> <ref id="AN0178558297-15"> <title> REFERENCES </title> <blist> <bibtext> Boal, A. (1995). Trans. In A. Jackson, Rainbow of desire. Routledge.</bibtext> </blist> <blist> <bibtext> Baker Collins, S., Schormans, A. F., Watt, L., Idems, B., & Wilson, T. (2018). The invisibility of disability for homeless youth. Journal of Social Distress and the Homeless, 27 (2), 99 – 109.</bibtext> </blist> <blist> <bibtext> Collins, S. B., & Schormans, A. F. (2023). Making visible the prevalence of self‐identified disability among youth experiencing homelessness. Journal of Social Distress and Homelessness, 32 (1), 16 – 24.</bibtext> </blist> <blist> <bibl id="bib4" idref="ref22" type="bt">4</bibl> <bibtext> Decter, A. (2007). Lost in the shuffle: The impact of homelessness on children's education in Toronto (Vol. 131). Community Social Planning Council of Toronto. https://d3n8a8pro7vhmx.cloudfront.net/socialplanningtoronto/pages/426/attachments/original/1472012304/lost-in-the-shuffle_final-report.pdf?1472012304</bibtext> </blist> <blist> <bibl id="bib5" idref="ref23" type="bt">5</bibl> <bibtext> Dinning, L. B., & Smit, P. (2005). Adults with developmental disabilities experiencing or at risk of homelessness: Report to Ottawa's community capacity building team. National Homelessness Initiative, Government of Canada.</bibtext> </blist> <blist> <bibl id="bib6" idref="ref14" type="bt">6</bibl> <bibtext> Durbin, A., Isaacs, B., Mauer‐Vakil, D., Connelly, J., Steer, L., Roy, S., & Stergiopoulos, V. (2018). Intellectual disability and homelessness: A synthesis of the literature and discussion of how supportive housing can support wellness for people with intellectual disability. Current Developmental Disorders Reports, 5, 125 – 131.</bibtext> </blist> <blist> <bibl id="bib7" idref="ref5" type="bt">7</bibl> <bibtext> Embleton, L., Shah, P., Gayapersad, A., Kiptui, R., Ayuku, D., & Braitstein, P. (2020). Characterizing street‐connected children and youths' social and health inequities in Kenya: A qualitative study. International Journal for Equity in Health, 19, 1 – 18.</bibtext> </blist> <blist> <bibl id="bib8" idref="ref20" type="bt">8</bibl> <bibtext> Fry, C. E., Langley, K., & Shelton, K. H. (2017). A systematic review of cognitive functioning among young people who have experienced homelessness, foster care, or poverty. Child Neuropsychology, 23 (8), 907 – 934. https://doi.org/10.1080/09297049.2016.1207758</bibtext> </blist> <blist> <bibl id="bib9" idref="ref4" type="bt">9</bibl> <bibtext> Gaetz, S., O'Grady, B., Buccieri, K., Karabanow, J., & Marsolais, A. (Eds.). (2013). Introduction, Youth homelessness in Canada: Implications for policy and practice. Canadian Homelessness Research Network. <ulink href="http://medcontent.metapress.com/index/A65RM03P4874243N.pdf">http://medcontent.metapress.com/index/A65RM03P4874243N.pdf</ulink></bibtext> </blist> <blist> <bibtext> Gaetz, S., O'Grady, B., Kidd, S., & Schwan, K. (2016). Without a home: The national youth homelessness survey. Canadian Observatory on Homelessness Press.</bibtext> </blist> <blist> <bibtext> Kulik, D. M., Gaetz, S., Crowe, C., & Ford‐Jones, E. L. (2011). Homeless youth's overwhelming health burden: A review of the literature. Paediatrics & Child Health, 16 (6), 43 – 47.</bibtext> </blist> <blist> <bibtext> Mills, C., & Lefrançois, B. A. (2018). Child as metaphor: Colonialism, psy‐governance, and epistemicide. World Futures, 74 (7–8), 503 – 524.</bibtext> </blist> <blist> <bibtext> Nichols, N. (2016). Preventing youth homelessness: The need for a coordinated cross‐sectoral approach. In N. Nichols & C. Doberstein (Eds.), Exploring effective systems responses to homelessness (pp. 241 – 254). The Canadian Observatory on Homelessness Press.</bibtext> </blist> <blist> <bibtext> Parks, R. W., Stevens, R. J., & Spence, S. A. (2007). A systematic review of cognition in homeless children and adolescents. Journal of the Royal Society of Medicine, 100 (1), 46 – 50. https://doi.org/10.1177/014107680710000116</bibtext> </blist> <blist> <bibtext> Scully, J. L. (2014). Disability and vulnerability: On bodies, dependence, and power. In C. Mackenzie, W. Rogers, & S. Dodds (Eds.), Vulnerability: New essays in ethics and feminist philosophy (pp. 204 – 221). Oxford Academic.</bibtext> </blist> <blist> <bibtext> Shildrick, M. (2019). Neoliberalism and embodied precarity. South Atlantic Quarterly, 118 (3), 595 – 613.</bibtext> </blist> <blist> <bibtext> Shoemaker, E. S., Kendall, C. E., Mathew, C., Crispo, S., Welch, V., Andermann, A., Mott, S., Lalonde, C., Bloch, G., Mayhew, A., Aubry, T., Tugwell, P., Stergiopoulos, V., & Pottie, K. (2020). Establishing need and population priorities to improve the health of homeless and vulnerably housed women, youth, and men: A Delphi consensus study. PloS one, 15 (4), e0231758.</bibtext> </blist> <blist> <bibtext> Spence, S., Stevens, R., & Parks, R. (2004). Cognitive dysfunction in homeless adults: A systematic review. Journal of the Royal Society of Medicine, 97 (8), 375 – 379.</bibtext> </blist> <blist> <bibtext> Woolley, E. (2015). How many homeless people live with disabilities? [Internet]. The Homeless Hub. Retrieved July 15, 2023, from: <ulink href="http://www.homelesshub.ca/blog/how-many-homeless-people-live-disabilities">http://www.homelesshub.ca/blog/how-many-homeless-people-live-disabilities</ulink></bibtext> </blist> </ref> <aug> <p>By Ann Fudge Schormans; Stephanie Baker Collins; Heather Allan; D. O'Neil Allen and Nathan Gray</p> <p>Reported by Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib10" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib11" firstref="ref2"></nolink> <nolink nlid="nl3" bibid="bib18" firstref="ref15"></nolink> <nolink nlid="nl4" bibid="bib19" firstref="ref17"></nolink> <nolink nlid="nl5" bibid="bib14" firstref="ref21"></nolink> <nolink nlid="nl6" bibid="bib17" firstref="ref24"></nolink> <nolink nlid="nl7" bibid="bib13" firstref="ref28"></nolink> <nolink nlid="nl8" bibid="bib15" firstref="ref30"></nolink> <nolink nlid="nl9" bibid="bib16" firstref="ref31"></nolink> <nolink nlid="nl10" bibid="bib12" firstref="ref49"></nolink>
Header DbId: eric
DbLabel: ERIC
An: EJ1431976
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Homeless Youth with Intellectual Disabilities: Precarious Lives and Health Inequalities
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Ann+Fudge+Schormans%22">Ann Fudge Schormans</searchLink><br /><searchLink fieldCode="AR" term="%22Stephanie+Baker+Collins%22">Stephanie Baker Collins</searchLink><br /><searchLink fieldCode="AR" term="%22Heather+Allan%22">Heather Allan</searchLink><br /><searchLink fieldCode="AR" term="%22D%2E+O'Neil+Allen%22">D. O'Neil Allen</searchLink><br /><searchLink fieldCode="AR" term="%22Nathan+Gray%22">Nathan Gray</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22British+Journal+of+Learning+Disabilities%22"><i>British Journal of Learning Disabilities</i></searchLink>. 2024 52(3):477-488.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 12
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2024
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Intellectual+Disability%22">Intellectual Disability</searchLink><br /><searchLink fieldCode="DE" term="%22Youth%22">Youth</searchLink><br /><searchLink fieldCode="DE" term="%22Homeless+People%22">Homeless People</searchLink><br /><searchLink fieldCode="DE" term="%22Incidence%22">Incidence</searchLink><br /><searchLink fieldCode="DE" term="%22At+Risk+Persons%22">At Risk Persons</searchLink><br /><searchLink fieldCode="DE" term="%22Health%22">Health</searchLink><br /><searchLink fieldCode="DE" term="%22Well+Being%22">Well Being</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Needs%22">Health Needs</searchLink><br /><searchLink fieldCode="DE" term="%22Access+to+Health+Care%22">Access to Health Care</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1111/bld.12588
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1354-4187<br />1468-3156
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Youth with intellectual disabilities experiencing homelessness are invisible within multiple service sectors. We know little about their experiences of homelessness, or the impacts of such on the social and physical health and well-being. Methods: We used quantitative and qualitative methods to measure prevalence and learn from key informants and homeless youth with intellectual disabilities about factors leading to and sustaining homelessness, and the implications of such on their social, physical, and mental health and well-being. The project involved seven co-researchers with intellectual disabilities and experience of youth homelessness in research design, data collection, analysis, and dissemination. We created Forum Theatre scenes that creatively represent the findings of the project. In this paper we share one of those scenes, as well as the recommendations three co-researchers with intellectual disabilities have for improving support to homeless youth with intellectual disabilities. Findings: Lack of awareness of and about homeless youth with intellectual disabilities, combined with siloed ways of working by involved sectors, results in significant disadvantage and health inequities for youth. Also revealed was the likelihood this would continue given existing obstacles to accessing appropriate housing and supports to exit homelessness. Conclusion: Services providers, policy makers and representatives of the involved sectors need to recognize and acknowledge homeless youth with intellectual disabilities and take responsibility for learning and working together to develop integrated and responsive approaches to effectively supporting them.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2024
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1431976
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1431976
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/bld.12588
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 477
    Subjects:
      – SubjectFull: Intellectual Disability
        Type: general
      – SubjectFull: Youth
        Type: general
      – SubjectFull: Homeless People
        Type: general
      – SubjectFull: Incidence
        Type: general
      – SubjectFull: At Risk Persons
        Type: general
      – SubjectFull: Health
        Type: general
      – SubjectFull: Well Being
        Type: general
      – SubjectFull: Health Needs
        Type: general
      – SubjectFull: Access to Health Care
        Type: general
    Titles:
      – TitleFull: Homeless Youth with Intellectual Disabilities: Precarious Lives and Health Inequalities
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Ann Fudge Schormans
      – PersonEntity:
          Name:
            NameFull: Stephanie Baker Collins
      – PersonEntity:
          Name:
            NameFull: Heather Allan
      – PersonEntity:
          Name:
            NameFull: D. O'Neil Allen
      – PersonEntity:
          Name:
            NameFull: Nathan Gray
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 09
              Type: published
              Y: 2024
          Identifiers:
            – Type: issn-print
              Value: 1354-4187
            – Type: issn-electronic
              Value: 1468-3156
          Numbering:
            – Type: volume
              Value: 52
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: British Journal of Learning Disabilities
              Type: main
ResultId 1