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Adolescents need tailored social services packages to succeed

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October 09, 2012

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Ado­les­cents from high-​​poverty neigh­bor­hoods tend to face many mental-​​health chal­lenges, but the solu­tion lies not in finding another place to live, according to pub­lished research by a North­eastern Uni­ver­sity pro­fessor and her colleagues.

Theresa Osypuk, an assis­tant pro­fessor in the Depart­ment of Health Sci­ences in the Bouvé Col­lege of Health Sci­ences, and an inter­dis­ci­pli­nary team of researchers and clin­i­cians recently pub­lished their find­ings in Pedi­atrics and Archives of Gen­eral Psy­chi­atry, two pro­fes­sional peer-​​reviewed journals.

They found that ado­les­cents who have pre-​​existing health con­di­tions or had been exposed to a vio­lent crime while living in public housing did not ben­efit from moving into private-​​market rental prop­er­ties. In some cases, their mental health grew worse.

The researchers ana­lyzed data from a pro­gram spon­sored by the United States Depart­ment of Housing and Urban Devel­op­ment called Moving to Oppor­tu­nity. Under the pro­gram, Osypuk explained, fam­i­lies from the nation's most impov­er­ished neigh­bor­hoods were offered vouchers to move out of public housing and into private-​​market rental prop­er­ties. Ado­les­cent par­tic­i­pants of the pro­gram, as well as a con­trol group that did not receive vouchers, reported on their mental health four to seven years after moving.

While other researchers have pre­vi­ously ana­lyzed the same data, Osypuk's team used more robust ana­lyt­ical methods to tease out new infor­ma­tion that may end up being used to help shape policy reform.

In par­tic­ular, the researchers found that girls with health prob­lems and those in fam­i­lies that expe­ri­enced a vio­lent crime in the six months prior to moving did not expe­ri­ence a change in mental health after relo­cating; girls without a recent his­tory of vio­lence or health con­cerns ben­e­fited from the move. Boys, on the other hand, never ben­e­fited from the move and those with health prob­lems or whose fam­i­lies had recently been exposed to vio­lence expe­ri­enced a decline in mental health.

Osypuk's team and other researchers have attrib­uted the gender dis­crep­ancy to the unique chal­lenges facing boys and girls. "Girls may be escaping sexual harass­ment and threats of sexual vio­lence when they move away from public housing into lower poverty neigh­bor­hoods," said Osypuk.

On the other hand, the social rela­tion­ships that boys form in their neigh­bor­hoods may play a cru­cial role in their mental health, and moving may cause those rela­tion­ships to suffer. Addi­tion­ally, the strate­gies boys use to nav­i­gate the social struc­ture of a high-​​poverty neigh­bor­hood may be unhelpful or even detri­mental in more affluent areas.

The find­ings sug­gest that there is no single solu­tion for helping impov­er­ished youth. "Our results point to the impor­tance of tai­loring social ser­vices for the spe­cific needs of fam­i­lies, and pro­viding social ser­vices across more than one sector," said Osypuk.

She sug­gested that at-​​risk ado­les­cents with a recent his­tory of vio­lence would ben­efit from receiving mental-​​health coun­seling, or infor­ma­tion on spe­cial­ized school pro­grams. As Osypuk put it, "We can't just pro­vide housing vouchers to these kids who are very vul­ner­able on var­ious dif­ferent dimensions."

It may seem obvious that indi­vid­uals with dif­ferent expe­ri­ences will respond to inter­ven­tions in dif­ferent ways, but Osypuk hopes that her study will estab­lish the sig­nif­i­cance of finding an inter­dis­ci­pli­nary solu­tion to reducing the effects of neigh­bor­hood poverty on our nation's youth.

"The public tends to think that health­care is the main pre­dictor of health," she said. But other fac­tors, she added, such as income, edu­ca­tion and housing, are also social deter­mi­nants of health.

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