The number of young people living in out-of-home placements is a crisis, but solutions exist. To implement those solutions and bring youth and young adults safely home from congregate care facilities requires a shift in how we help youth and young adults with complex needs.

Each solution depends on taking a collaborative approach that mobilizes everyone who cares about getting young people home – administrators, parents, teachers, legislators, advocacy groups and young people themselves to implement or expand culturally competent, neighborhood based programs that bring and keep high-risk youth safely home, influence policies that promote bringing youth safely home and empower youth and families.

The Safely Home Campaign proposes shifting the current approach away from fitting youth and young adults into existing services and towards individualizing services based on the needs of each high-risk youth and young adult in the system or at risk of system involvement.

What We Do Now: Place Young People into Existing Services

In most communities, youth and young adults whose challenges put them at-risk of institutionalization receive assistance in one of two ways: they receive help in one of many community-based programs designed to meet a certain need, like substance abuse or anger management or they are removed from their homes and placed in a congregate care or secure confinement facility.

This means that youth or families in need are placed in program slots with pre-designed and pre-set treatments or curriculum. When their unique and complex needs are not met by these programs youth are often sent to residential treatment centers or secure facilities as a last resort. Their needs may not be met here either, and if they do improve, they return to a home and community that has not improved with them. As a result, youth often regress because they lack the appropriate family and neighborhood supports and services.

Youth with the most complex needs often don’t receive any help at all because most existing services, programs and even residential centers reject them, citing lack of capacity to serve them. When governments determine that a youth has needs that go beyond its capacity to serve them in state facilities, youth are often sent to private or public congregate care facilities in another state --sometimes very far away from their families --based on a mistaken belief that they have no other option.

How We Can Do Better: Focus on Needs not Services

To keep young people safely home youth serving systems and communities can be far more creative and implement a variety of solutions. We can build solutions based on the individual needs of each youth. Building these solutions requires a multi-faceted strategy that includes families, public policy, redirecting resources, individualizing services and support to communities and agencies with a desire to improve youth outcomes.

The Safely Home Campaign proposes shifting the current approach away from fitting youth and young adults into existing services and towards individualizing services based on the needs of each high-risk youth and young adult in the system or at risk of system involvement. Many youth may respond best to untraditional services rather than to regimented out-of-home placements or specific community-based programs that mandate certain treatments.

This shift also enables communities to identify and close gaps within their current resources that, left unfilled, will leave the most vulnerable and marginalized young people to fend for themselves or face removal from their families and homes. With this approach, communities can design individual services for each unique youth in need, creating targeted, responsive solutions.

One way to shift the focus from services to need is to include families in the response to youth and young adults in crisis. Families have the experiences, understanding of their own needs and expertise in their children to inform systems about which services and programs are effective for them. Rather than being recipients of prescriptive services that may not respond to their needs, families can contribute to choosing and designing the help they receive. Families are experts in their own children, and their voices should influence how communities and systems help youth succeed.

When solutions are based on the individual need, and not primarily on available services, and families are given voice and choice into what happens to them and their children, systems will be more effective in improving outcomes for youth.

Public policy plays a determinative role in what happens to the most vulnerable youth and families, including allocating funds for programs that either keep families together or provide resources that result in separation. In general, public policy has favored incentivizing placement over community-based programs for youth with the highest risk needs.

For example, the default federal funding stream for child welfare gives states dollars to use for residential treatment; in order to use those same dollars for care in the community, states need to seek a waiver. Likewise, Medicaid dollars often fund institutional care before community-based care for youth in the juvenile justice system, incentivizing governments to utilize out-of-home placements.

By supporting and developing public policies that incentivize keeping families together, more youth will have better outcomes, families and communities will be stronger and governments will save dollars.

Communities and systems can ensure that programs capable of providing individualizing services are available to all youth, especially the highest risk youth. They can also build or augment their capacity to serve high-risk youth so they can play a bigger role in keeping and bringing youth safely home than in rejecting them for services or sending them away.

Youth service systems can decide to spend a portion of the funds targeted for out of home placements and redirect them to fund individualized, family and neighborhood based services. In many jurisdictions this change can be done administratively. Although the cost of out-of-home placements vary, in general, redirecting the cost of keeping one youth in congregate care could benefit 3-6 young people in the community. Redirection can, on its own, provide the resources to realize better outcomes for youth.

Redirecting dollars from out-of-home placements to community-based services is a critical part of reducing the number of youth separated from their families. For redirection to be effective, the community-based service must be capable of providing intensive, individualized services for young people and their families.

Other characteristics are also important for to maximize the benefits of redirection. Programs should possess the elements that research indicates are most successful in helping youth succeed, for example, programs that: individualize services; prioritize hiring neighborhood staff familiar with the community assets and challenges; utilize a strength-based approach; accept all youth, regardless of the complexity of their needs, and; value family engagement.

Implementing a shift in focus from services to needs will go a long way in improving outcomes for youth. How particular governments or communities implement changes to their systems should reflect the unique challenges and assets of their environments. Like the youth they serve, their organizational needs will vary. The Safely Home Campaign can provide these agencies and organizations with support to guide changes and implementation through technical assistance, training and consultation.