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Children's Voice Article

Covenant House: From the Streets to Success

By Carrie McVicker and Sue Steib

Young adults should see opportunities and choices before them as they leave their childhood behind and begin to take on adult responsibilities. Unfortunately, not every youth starts out on an even playing field. Many begin adulthood without the benefit of a solid support network of family and friends. Often, they even lack such basic needs as shelter, food, and clothing. Some are transitioning out of foster care and must make independent, "grown up" decisions without help from adult role models or mentors.

For young adults who find themselves homeless and alone, there is Covenant House. Founded in 1969, it is the largest privately funded homeless shelter in the United States. Covenant House facilities operate 24 hours a day with a consistent open door policy--no one is turned away.

Not only does Covenant House provide the basic needs of shelter, food, and clothing, it offers an array of other services designed to help young adults find pathways to success. At the Covenant House Crisis Shelter, youth can take advantage of services like health care, mental health and substance abuse treatment, counseling, educational and vocational services, parenting classes, and nursery services. Since its inception, Covenant House has expanded to 22 cities in the United States, Canada, Mexico, and Central America, serving more than 600,000 homeless and at-risk young people.

In 1998, in partnership with the Menninger Foundation, Covenant House evaluated its crisis services in New York City and Los Angeles. The evaluation ad two parts:
  • The Assessment Project was designed to gather information on all young adults who entered Covenant House between November 1998 and January 2000 to better identify the population the agency serves.

  • Project Connect was designed to follow up with these same young adults at two weeks, three months, and six months after discharge.

On the Streets of New York

Covenant House in New York City has two main sites--its 41st Street Crisis Center, where youth like Kevin in the story below can find safety and a multitude of services, and the 52nd Street Mother/Child Building, which provides shelter and services for young mothers and their children. Most young people seeking help from Covenant House are 18--21, although some are as young as 12.

Kevin's Story

Kevin knew he had to swallow his pride and find the closest shelter when he couldn't feel his hands anymore.* He had no gloves, and only a thin, worn jacket that wasn't protecting him this winter. After he had seen his best friend get his face smashed on the train to Brooklyn, Kevin realized the subway was dangerous to ride at night.

Kevin had been living on the streets for two months after being expelled from his group home for fighting. He was fed up with the system and at age 19 thought he was old enough to take care of himself. This night was different. He needed warmth, a meal, and some extra clothes. At Covenant House's Crisis Center, Kevin got what he needed.

The next day, he began taking advantage of the appointments Covenant House staff had made for him. He got a physical at the health clinic and applied for Medicaid. Because he had lost all forms of identification, he applied for a new birth certificate. He attended the Regional Training Center, a vocational training center that would prepare him for the world of work.

In the days ahead, Kevin attended job readiness workshops, prepared a resume and cover letter, and was accepted into a desktop publishing and graphics design class. When his new birth certificate arrived, he was able to get a state nondriver's ID. When he completes his training program, he'll have the necessary documents to get a job in the graphics field. His hopes soared as he pictured himself working in a graphics department.

Sophie's Story

Sophie stared down her crack pipe in a chemically induced panic and wondered where her rocks were. She had to find more. With the 10 bucks she was going to use for food the next day, she ran down to the street corner and purchased a few treasured crystals. The next morning, Sophie didn't wake up in a warm bed or have a cold shower to sober her up. She's pregnant and homeless with a habit. That habit is more important to her than finding shelter, finding a job, or living the next day, as long as she's high.

By the time she could speak in complete sentences, Sophie's parents were feeding her alcohol. By age 10, Sophie was smoking marijuana daily and washing down the effects with a pint of liquor. A social worker described her as having "a severe cannabis consumption" problem-a perfect way to describe her ingestion of drugs, similar to the body's need for food, becoming as essential for survival. This need has been with her all her life; it's all she knows.

Sophie was kicked out of her home at 16 when her drug use began interfering with her mother's own drug habit. Since then, she's been in and out of shelters and short-term treatment centers, all of them failing to curb her overwhelming desire to transport herself from the streets to some emotional high void of crises.

Her addiction thwarts any attempt to hold a job or stay in school. Sophie knows she has a problem and has sought help. But she knows better than others that the help she needs is intense, long-term treatment and the support that has been lacking all her life. That help is scarce, especially with no health insurance and no money.

Sophie went to Covenant House's crisis shelter and was placed in the Mother/Child unit. She got a free health check up and a referral for prenatal care and met with a health educator who discussed the effects of her drug use on her unborn child. She met with a substance abuse counselor who referred her to a local inpatient treatment program and helped her secure her ID and then Medicaid to pay for the treatment.

Best of all, she was not abandoned. After eight months of treatment, she and her baby can return to the Mother/Child Program, where she can learn parenting skills and how to nurture her child. They'll help her transition to Rights of Passage, a transitional living program that will teach her life skills and allow her to continue with her substance abuse counselor while building her employment skills to secure a good job. She can also apply for housing assistance so she and her child will have a permanent roof over their heads.

The Assessment Project

Covenant House's Assessment Project was designed to reach beyond the basic needs of youth who seek out Covenant House and determine their other needs. Between November 1998 and January 2000, Covenant House served 1,189 young adults in 1,297 cases that were included in the data for the Assessment Project. Covenant House decided to count multiple visits by individuals separately because the youth come to Covenant House with different needs each visit.

The Assessment Project's primary goal was to standardize data collection. The measurement looked at 15 different areas:
  • demographic information;
  • personal histories;
  • education and employment;
  • arrests and participation in illegal or survival activities;
  • physical and mental health histories and substance abuse in the past year;
  • current substance use and mental health status;
  • legal, educational, and employment status at intake;
  • social relationships;
  • mother-child issues where applicable;
  • priority needs at intake;
  • case management needs;
  • progress during the youth's stay, and status at discharge;
  • housing and employment status at discharge;
  • mental health functioning at discharge; and
  • priority service requirements at discharge.
The New York City Assessment Project showed that youth need employment services (65%) and educational services (62%) primarily. The data also showed that, by discharge, 61% of youth had made some progress toward their housing goals, and 75% were discharged to a defined location. Sixty percent made progress toward employment goals, and 29% were employed at discharge, compared with 21% employed at intake. When examined together, 64% of the youth were either employed or in an educational program at discharge--significantly more than the 57% in this category at intake.

Following Up

The second phase of the study, Project Connect, was developed to collect more detailed information from selected youth who came to Covenant House and to follow up with them two weeks, three months, and six months after leaving. Initially, Covenant House approached every third youth about participating in Project Connect, but because participation was not robust, staff eventually asked all youth seeking shelter if they would like to participate. The final sample included 202 young people. Two-week follow-up data included 163 youth (81%) from the original sample; three-month data, 141 youth (70%); and six-month data, 183 (91%).

Project Connect showed promising gains for many youth who participated in the study. When they left Covenant House, 49% had favorable housing; that number rose to 68% at three months and 70% at six months. When they came to Covenant House, only 14% were enrolled in an educational program; by they time they left, 38% were. At six months, 24% of youth were in an educational program, the drop explained in part by the fact that 18 youth had completed an educational program by six months. Employment data improved as well. At intake, 15% had jobs; at discharge, 23% were working. Two weeks after leaving, 35% were working, and that number had increased to 38% at six months.

At intake, 28% of youth who came to Covenant House showed signs of depression, and 33%-38% reported signs of behavioral problems. At the six-month follow-up, the number with depression had fallen to 12%, and evaluators observed behavioral improvements in 61%.

Researchers also conducted a comparison study of participants who used specific services offered by Covenant House and those who did not. At the six-month follow-up, 44% of youth who used Covenant House services were working, compared with less than 10% of those who did not use employment services. At three months, only 8% of youth who used legal services at Covenant House had been arrested again, compared with 29% of those who did not; these findings held at six months.

Overall, length-of-stay was a deciding factor for many youth who came to Covenant House. Those who stayed at the shelter and took advantage of the programs did better over time. Demographically, those youth who were U.S. citizens and African American, who stayed longer than the average stay, and who had fewer educational, vocational, and medical needs, faired best. As Bruce Henry, Executive Director of Covenant House New York, points out, however, "There can be critical value for the youth who seek crisis shelter even for one day."

On the Streets of L.A.

Margaret and Robert are busy young adults living in Los Angeles. Margaret has been working full time at a film production studio for two years while attending community college. Her goal is to become a nurse practitioner. She visits often with her younger brothers and sister who live in the area and looks forward to marrying and having her own family some day.

Robert completed job training following high school and has been manager of a department store for three years. He and his girlfriend are busy making wedding plans. Does this sound like the stories of two needy street kids? Surprisingly, Margaret and Robert might have been described as destitute a few years ago if it hadn't been for Covenant House California (CHC). Robert believes he would not be alive if CHC hadn't offered him an alternative to life on the streets and helped him overcome his drug addiction.

Margaret's Story

Margaret's father died when she was 9. Due to her mother's substance abuse, Margaret cared for her younger brothers and sister. When Margaret was 14, her mother was diagnosed with Huntington's disease and placed in a health care facility. The children went to live with an aunt and uncle, but Margaret ran away, living with friends and on the streets.

Margaret was eventually placed in foster care and lived with six different families in three years. At 18, too old for foster care, and with no contact with her family, she tried living on her own. She quickly lost her job, however, and was evicted from her apartment. She lived first with friends, then on the streets again for another year. With no job skills, she turned to prostitution to survive.

When she entered CHC's Crisis Shelter, Margaret was extremely depressed and struggled with the adjustment to structure. She had difficulty getting up on time, making meetings, keeping appointments, and concentrating on her educational and job-related needs. With staff support, however, and her own determination, she learned to follow through on daily responsibilities and focus on positive short- and long-term goals.

While in the shelter, she met regularly with therapists to address issues of depression, low self-esteem, and poor family relationships. She was committed to developing computer and other basic skills necessary for employment. She completed an internship program as a kitchen aide in the CHC cafeteria, then found short-term work at Universal Studios.

Because she demonstrated a desire to be responsible and become independent, she was admitted into the CHC Rights of Passage transitional living program, where she lived for nine months. She entered training at a local film production studio and was hired full-time. She also graduated to the CHC Supportive Apartment Program, sharing a two-bedroom apartment with another CHC resident before moving into a place of her own.

Robert's Story

Abused by both his father and stepfather, Robert went to live with his grandparents when he was 14. But he soon ran away and lived on the streets on and off for three years. CHC first learned about Robert through its outreach program when he was 15 and living in an abandoned building. He was referred to a Hollywood shelter for minors, but after two months he returned to the streets, became involved in survival sex, and started using drugs to kill the pain of feeling alone, abandoned, and afraid.

Incarcerated twice for drug possession, Robert came to the Crisis Shelter asking for help when he was 18 because he "didn't want to die on the streets." Robert would leave and return to the shelter four times, however, before beginning the changes that would turn his life around.

Tackling his substance abuse was the first challenge. In addition to marijuana, Robert had also been using alcohol from age 12, as well as other harder drugs. He was admitted into the CHAAMP Day Treatment program (Covenant House Abuse Addiction Management Program), where he received individual therapy. He worked hard, obtained a sponsor from Narcotics Anonymous, and graduated from CHAAMP within 60 days.

Robert enrolled in school and participated in CHC's Employment Skills Program. Once stable, he moved to the CHC Rights of Passage Program, which provided an opportunity to work, develop independent living skills, and strive toward becoming self-sufficient. He earned his GED and gained the skills he needed to find a job.

Outreach and Project Connect

Neither Margaret nor Robert had to find CHC on their own; the program actually came to them through CHC's Outreach Van. CHC staff take to the streets nightly in the Outreach Van, cruising the Hollywood area, which attracts large numbers of runaways lured by the town's glamorous reputation.

Outreach staff offer food, clothing, counseling, and referrals for shelter and medical services. The van serves many youth for months or even years before they finally make their way to the CHC shelter. Most youth whom CHC serves are single, ages 18-21, and have been on the streets for a long time. Many, like Margaret and Robert, have turned to prostitution to survive. Half were at one time in the foster care system.

CHC's 48-bed crisis shelter sometimes houses up to 52 youth a night, using reserve emergency beds when necessary. Youth remain in the shelter an average 30 days, although a significant number are found at initial assessment to have mental health and substance abuse needs, which require longer courses of treatment.

All shelter residents were asked to participate in the Project Connect follow-up evaluation; 162 agreed, consenting to periodic contact during the six-months after discharge. Demo-graphically, the youth who agreed to participate were comparable to all those served by CHC, although Latino youth and non-U.S. citizens were slightly underrepresented. They also had somewhat fewer needs for health care and identity documents.

The evaluation showed that youth had made significant improvement in several areas six months after leaving CHC. Sixty-four percent were in favorable housing after six months, compared with 34.8% at discharge. Employment increased significantly, too, from 33.3% at discharge to 51.4% six months later.

Measures of adaptive functioning, or the ability to function independently at a level comparable to others of the same age, showed marked improvement, with average scores dropping to well below the clinical range. In no areas were youth doing significantly worse than when they left CHC.

Because of the transient nature of these young people, only about one-third of the original 162 who agreed to participate were available for interviews six months later. Evaluators were concerned that the remaining participants might not represent the larger group, but a comparison of key characteristics and needs with those who dropped out of the study showed little difference between the two groups.

Having information about how youth fare after leaving the shelter program has been helpful and rewarding for CHC staff, allowing them to see the continued effect of their work and to make program changes to better address areas of greater need highlighted by the evaluation. George Lozano, Executive Director of Covenant House California, remarks, "Tracking of kids was the greatest morale booster for staff--they call it 'the healing effect.'"

Carrie McVicker is Research Analyst and Sue Steib is Senior Staff Consultant for the R2P Initiative. For more information on Covenant House, visit their website at www.covenanthouse.org.

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