Street-Based Mental Health Services for Homeless Youth

Street-Based Mental Health Services for Homeless Youth

United States
Organization type: 
nonprofit/ngo/citizen sector
$1 million - $5 million
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Larkin Street Youth Services’ innovation is an expansion of our street outreach to homeless youth through street-based mental health assessments and counseling. The project would intervene before individuals are in crisis in order to secure immediate engagement in necessary mental health services.

About Project

Problem: What problem is this project trying to address?

Homeless youth suffer disproportionately from physical health problems, substance abuse, and mental illness and are vulnerable to HIV/AIDS. They are more likely to suffer from a serious mental health disorder or to attempt suicide than housed youth. Homeless youth suffer from thought and mood disorders such as schizophrenia, bipolar disorder, and depression; from anxiety disorders such as post-traumatic stress disorder; and from behavioral or conduct disorders. Many have histories of abuse and neglect, and because of their traumatic experiences are reluctant to access traditional basic emergency care, substance abuse, mental health and other health care services. The project would be particularly beneficial to homeless youth because it provides them with immediate access to needed services such as mental health assessments and referrals and linkages without waiting until they are in acute crisis or until they seek care on their own. The same intervention benefits the providers and systems that help youth by intervening before the clients have reached a crisis stage that is both more challenging and more expensive to address.
About You
Larkin Street Youth Services
Section 1: About You
First Name


Last Name

Tedford Hayes

Website URL
Section 2: About Your Organization
Organization Name

Larkin Street Youth Services

Organization Phone

415 673 0911

Organization Address

701 Sutter Street, San Francisco, CA 94109

Organization Country
Your idea
Country your work focuses on
What makes your idea unique?

This project introduces a new application to the mental health system of practice that has been successful in a non-mental health context. Although street based outreach and crisis intervention services have been available in other social service settings for some time, street based mental health assessments and referrals and linkages to mental health services have not previously been applied to homeless transitional aged youth who are not yet in crisis and/or who may not identify themselves as in need of mental health services. Street based mental health assessment and linkage services will use evidence-based street outreach approaches:
• Non-judgmental Approach. Emphasis on meeting youth “where they are at” in order to overcome distrust of adults.
• Youth-Centered Problem Solving. Individualized, strengths-based approach which supports health-promoting behaviors through self-awareness and problem-solving skills
• Consistent, Caring Guidance. Accountability for youth’s actions and reality checks for youth through alternate explanations and realistic assessments of a given situation to give youth a sense of connectedness to others, control over the future, and identity.

Do you have a patent for this idea?

What impact have you had?

Larkin Street Youth Services already serves the majority of the 5,700 homeless youth of San Francisco each year; last year we provided 3,621 young people ages 12 through 24 with outreach, shelter, employment and educational services, housing, health care, and case management. Our existing Street Outreach program, where the proposed innovation would be implemented, makes over 5,500 outreach contacts each year. Last year 3,354 of those contacts were new youth who had never been seen by Larkin Street services before. Our services are very successful, with 80% of young people who complete our comprehensive programming exiting street life.


Larkin Street Youth Services already provides street outreach to homeless youth, and has been very successful in helping them to access further services. We will apply the same successful approach to a street-based mental health project by meeting youth where they are with harm reduction philosphies and a youth-centered age-appropriate approach that builds trust.

We are also successful because of the involvement of youth themselves. Youth are extensively involved in the design, development and implementation of Larkin Street program initiatives and help to conduct assessment of community need, to review trends, and to design and plan for new Larkin Street programs and facilities. Youth are equal partners in the process of program evaluation and in assuring that Larkin Street’s high standard of relevant and effective services is maintained. They participate in formal external evaluations and provide continuous input to the agency through weekly community meetings, bi-annual consumer satisfaction surveys, and ongoing focus groups


This application of street outreach principles to mental health service provision will have two major beneficial outcomes if successful:

1. Homeless youth who do not self-identify as having mental health issues will be provided with access to care that they would not otherwise seek out on their own

2. Homeless youth who have previously been engaged in the mental health system will be identified and given services before reaching a point of acute crisis and therefore will be prevented from needing a higher level of care

What will it take for your project to be successful over the next three years? Please address each year separately, if possible.

With adequate support from funders, the project could successfully ramp up its operations within 2 years, and continue to expand its operations to serve additional youth in the 3rd and following years. A 2 to 3 month start up period would include clarification of roles and relationships, community outreach, and staff training. This would be followed by a 1 year pilot project, to be evaluated by tracking the overall number of youth accessing care, the number of youth never before having accessed mental health services being taken into care, and a drop in the number of clients who are previous consumers of mental health services needing to access higher levels of care.

What would prevent your project from being a success?

We our confident that our project methodology would be successful; the challenge would lie in our need to raise adequate funds to implement, continue, and evaluate it.

How many people will your project serve annually?


What is the average monthly household income in your target community, in US Dollars?

$100 ‐ 1000

Does your project seek to have an impact on public policy?


What stage is your project in?

Idea phase

In what country?
Is your initiative connected to an established organization?


If yes, provide organization name.

Larkin Street Youth Services

How long has this organization been operating?

More than 5 years

Does your organization have a Board of Directors or an Advisory Board?


Does your organization have any non-monetary partnerships with NGOs?


Does your organization have any non-monetary partnerships with businesses?


Does your organization have any non-monetary partnerships with government?


Please tell us more about how these partnerships are critical to the success of your innovation.

Partnerships are absolutely crucial to the work we do. Our CBO and government partners help us to reach more youth in the community through referrals, they increase our capacity by sharing information and providing training, and they participate in our street outreach teams through their own efforts to reach homeless youth.

What are the three most important actions needed to grow your initiative or organization?

1. Fundraising to sustain the project
2. Hiring to staff the project
3. Planning and Evaluation to ensure that the methods used are successful

The Story
What was the defining moment that led you to this innovation?

With the recent economic downturn, we have seen an upswing in youth homelessness. Staff in every Larkin Street program report that the youth that we are now seeing are more likely to have severe untreated mental health issues or behavioral problems than in the past. The past year has been a difficult one for social services in San Francisco, with numerous funding cuts to many of the organizations who might otherwise help intervene with these high-needs youth. This combination of factors make up the "defining moment" that led Larkin Street staff to develop the concept of taking mental health assessments and treatment to youth on the streets.

Tell us about the social innovator behind this idea.

Larkin Street is a leader in the field of youth development in large part because of our high caliber staff who share a rich base of knowledge, experience, disciplines, and skills that fortify our programs to achieve dramatic results among the homeless and at-risk youth we serve. Larkin Street’s Executive Director, Sherilyn Adams, leads Larkin Street with over 20 years of experience in program development and nonprofit management, addressing issues such as substance abuse, mental health, HIV/AIDS, child abuse, and family violence. Previously the Division Director for Supportive Housing and Case Management Services at Baker Places, Sherilyn developed and administered six housing and case management programs targeting dually- and triply-diagnosed adults. This included supervision of the agency’s Intake and Placement Team, and clinical oversight for all programs in a variety of housing and treatment settings. She has also managed residential treatment and outpatient drug and alcohol treatment programs.

Sherilyn has served as Larkin Street’s Executive Director since August 2005. She demonstrates her deep commitment to building a diverse staff that is reflective of the clientele we serve, and to ensuring that staff development trainings are focused on leveraging and respecting diversity and cultural competencies.

Sherilyn sits on local, statewide and national planning, advisory and policy committees, including the San Francisco Transition Age Youth Task Force, the San Francisco Human Services Network, the California Coalition for Youth, the National Alliance to End Homelessness, and the AIDS Alliance for Children, Youth and Families. Her efforts to increase Larkin Street’s impact and reputation on the national level have garnered recognition from such prestigious sources as the Lewis Hine Award for Outstanding Services to Youth (2008) and the National Foster Care Parents’ Change a Lifetime Award (2007). Most recently, she was personally recognized as one of the San Francisco Business Times 2009 Most Influential Women in Business.

How did you first hear about Changemakers?

Through another organization or company

If through another, please provide the name of the organization or company

Robert Wood Johnson Foundation