Project Profile: Strengthening and At-Risk Homeless Young Mothers and Children

Funded by the Conrad N. Hilton Foundation and other local funders, under the guidance of a Coordinating Center comprised of  The National Center on Family Homelessness, The National Alliance to End Homelessness, and Zero to Three: National Center for Infants Toddlers and Families, this multi-site demonstration program seeks to improve the housing, health and development of young families

Operationalized through local collaborations in four communities, this project seeks to for the following:

  • Ensure better family and individual outcomes for young homeless and at-risk families in the areas of child development, maternal well-being, family functioning, family preservation, and housing stability.
  • Create lasting systems change between the housing/homelessness and child development service sectors by supporting replicable locally-based innovative collaborations.
  • Influence policy and practice nationwide by evaluating and disseminating lessons learned from these local collaborations.

Ellen L. Bassuk, M.D. Founder and President and Debra Medeiros Director of Programs for The National Center on Family Homelessness took time out to talk to USICH about the Strengthening At Risk and Homeless Young Mothers and Children Initiative.

USICH: What are the important components of this initiative?  What makes it unique and what has made it successful?

Dr. Bassuk: This 5-year initiative is set up to end next spring.  One thing that makes this project somewhat unique is that we are actually looking at outcomes in kids, not just moms or parents.  This is really important as it lets us learn about the welfare and development of the children.

Ms. Medeiros: A fundamental of the initiative was the requirement for a  collaboration between two sectors that often are not coordinated but that ought to be in order to achieve  the best outcomes for kids: the housing /homelessness sector and the child welfare / child development sector.  Breaking down the silos that divide the various sectors was a requirement of participation, but beyond that we recognized early on that the solutions are local so we encouraged program sites to develop partnerships and services that made sense in their communities.

USICH: What can you tell me about the population of moms and kids you work with?  What are their special needs?

Dr. Bassuk: The Initiative serves families made up of an 18-25 year old mom with at least one child five years or younger.  Many of our mothers come out of the foster care system.  They age out of foster care and are pregnant or already have a child.  They are losing the only network they have and are all of a sudden caring for a child at the same time.  When you are in your teens or early twenties you are still learning about yourself and how you fit in the world.  It is a very heavy burden to raise a child at that age when you have little in the way of a support network.  These women very much want to be good mothers to their kids.  It is something that drives them, but there are many difficulties in their way.

One commonly overlooked area when trying to help families experiencing homelessness is  clinical depression.  Homeless mothers have higher rates of depression.  Yong mothers have higher rates of depression.  And when you combine both risk factors (young homeless mothers) the rates go through the roof.  It is a shame that this doesn’t get more focus because depression is very treatable.  When depression is properly treated, mother-child bonding improves.  This is an important outcome for the whole family.

Ms. Medeiros:  One thing that surprised me as we learned more about these young families is the degree to which the moms were isolated. They had lost their networks and raising a child meant that they couldn’t do what they had been doing; they couldn’t in many cases rely on the same friends.  We learned that helping build up new networks for these moms is absolutely critical.  A number of our moms have said that being a part of this program, is the first time they have had friends.  In one community, the group sessions that were a part of the project became important network times for both the mothers and the children.  It became a play group for the kids and a support group for the moms.

USICH: What  individual program elements really help families (both moms and kids)?

Ms. Medeiros: Each site had somewhat different services, but all sites found the network building we have discussed to be critical. Also, all four sites used a home visiting model where staff went out and met with the moms where they were.  This helped cut into the sense of isolation but it also made it easier for the moms to participate and for us to get an accurate sense of their family life.  This is something that was borrowed from the child development and welfare sector but it is essentially an outreach model and it worked very well across all sites.  It is just one example of how cross-sector collaboration strengthened the success of the Initiative.

Two of the sites also were able to reliably provide housing vouchers to many of their families.  At those two sites, the housing played a major role in stabilizing the family.

Dr. Bassuk: I think we need more projects like this one that look at outcomes specifically in kids as well as in parents.  This does require some child development knowledge on the part of project staff.  We can’t establish effective interventions for kids without measuring their outcomes .  Also, we and others have found that it is important to assess kids independently from their mothers. 

In terms of what works to help kids developmentally, it is clear that early intervention is what works.  But again- in order to intervene early, you have to identify developmental delay early.  And you won’t identify it if you aren’t even looking for it.

Health care needs are also really important.   A child who has chronic asthma, and can’t go to school, and must make a couple of trips to the ER can be enough to push a family that is barely getting by into homelessness.  Homelessness exacerbates many health conditions in kids including asthma.  If we can make sure these families are getting the care they need before an emergency arises, it can help keep the first domino from falling.  Just the fact of homelessness has a devastating impact on the kids.  This is especially true for school aged kids.  For kids under 5, moms are able to buffer the reality of homelessness a little, but as kids get older this becomes harder to do.  

Five tips for service providers on how to meet the needs of young families:

  • Learn some basic child development skills.  You don’t need a clinical level of skills, you just need to be able to recognize the basics and refer kids  if a child seems to be experiencing a delay.
  • Develop relationships with the pediatricians that treat the kids in your programs.  Our moms tended to be very good about taking their kids in for their well baby visits and regular check-ups.  Pediatricians are in the best position to offer advice on the child’s health and development but they are not always aware of the family’s needs.  By working together you can help connect the dots and make sure the children get what they need without any added burden on the family.
  • Have a case-management plan in place.  Having a reliable plan that you use for everyone can help make sure no one falls through the cracks.
  • Tune-in.  Make it personal.  Get to know the moms and kids.  This isn’t just a problem to be solved. These are real people.  And just making that connection can help.
  • Identify evidence-based practices for working with young families and put them in place.  This will improve your outcomes and also improve your funding streams.

Three tips for policy makers on how to make systems work efficiently:

  1. Intentionally bring different sectors to the table even if they aren’t used to working together.  We need child development working with homeless services.  We need foster care and education at the table.  Also funders should be involved so that they are more inclined to fund what works and providers need to link into the other systems and government departments.  Money is tight and we are all struggling to get as much done with as little money as possible and improved collaboration is one way to get more for the same amount.
  2. Invest in workforce training.  Staff should be trained in the basics of trauma informed care, mental health and depression, and child development.  A properly trained staff can do a much better job of using resources well and effectively implementing best practices. Training needs to provide ongoing support over time, but much can be done virtually so the cost is manageable.  
  3. Develop communities of practice: this can bolster the training  and can also foster collaboration.

Learn more about the Strengthening AtRisk and Homeless Young Mothers and Children Initiative by visiting the The National Center on Family Homelessness website where you can find more information on best practices, case management, training, and other topics.