Street involved youth


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Street involved youth

  1. 1. RISKY BUSINESS ORRISKY ENVIRONMENTS?Street-Involved Youth, Crystal Methamphetamine& Mental Health in Victoria, British ColumbiaPresented By:Alexandra HoltomMA StudentSocial Dimensions of HealthCentre for Addictions Research ofBritish ColumbiaUniversity of VictoriaRisky Business? Principle Investigators & Supervisors:Dr. Cecilia Benoit - Centre for Addictions Research of BritishColumbia & Department of SociologyDr. Mikael Jansson - Centre for Addictions Research ofBritish Columbia & Department of SociologyDr. Bernadette Pauly - Centre for Addictions Research ofBritish Columbia & School of NursingSaturday, 18 May, 13
  2. 2. OUTLINEIntroductionData Sets - Risky Business? & Healthy Youth SurveyResearch QuestionsBackground & Context - Street-Involved Youth, Crystal Methamphetamine Use &Mental HealthRisk Environment FrameworkAmending the Risk Environment Framework through Meso-Level AnalysisTimelineFeedback & DiscussionSaturday, 18 May, 13
  3. 3. INTRODUCTIONTopic: Street-involved youth, crystal methamphetamine use& mental healthPurpose: To shed light on the social and structural changesneeded in order to reduce risk in the environments of street-involved youth who use crystal methamphetamine andexperience simultaneous mental health struggles.Saturday, 18 May, 13
  4. 4. DATA SETS:RISKY BUSINESSProject title:Risky Business? Experiences of Street-InvolvementProject dates: 2003-2013Study population: Non-probability sample of 185 street-involvedyouth aged 14-19 (average age at first interview: 17.3)Criteria for enrolment:~Low level of attachment to parent or guardian~Low level of attachment to education system~Low level of attachment to formal economy~High level of attachment to informal (street) economySaturday, 18 May, 13
  5. 5. DATA SETS:RISKY BUSINESSRecruitment: Work closely with community partners, posters, keyinformants, peer-recruitment using respondent-drive samplingtechniqueMixed methods: Closed ended and open ended questions, bodymappingPanel data: Individuals interviewed in-person repeatedly over time,following them into early adulthoodComparison group: Compared street involved youth to random sampleof youth in the same geographical region (Healthy Youth Survey)Saturday, 18 May, 13
  6. 6. DATA SETS:HEALTHY YOUTH SURVEYWave 1: 2003~Random sampling through phone calls in VictoriaMetropolitan Area~9,500 homes called, 1,036 eligible~Youth at home between the ages of 12-18~852 (82%) parents agreed~664 (78%) of youth agreedWave 2: 2005 (longitudinal follow-up)Wave 3: 2007 (longitudinal follow-up)Saturday, 18 May, 13
  7. 7. DATA SETS:COMPARATIVE STATISTICSGender (F/M): 54% Risky Business Youth53% Healthy Youth SurveyAverage Age: 17.3 Risky Business Youth17.7 Healthy Youth SurveyAboriginal: 33% Risky Business Youth2.4% Healthy Youth SurveyHeterosexual: 64% Risky Business Youth89% Healthy Youth SurveyFoster care (ever): 28% Risky Business Youth<1% Healthy Youth Survey0%25.0%50.0%75.0%100.0%14-15 16-17 18-19 20-21HYSRBUsers of marijuana in last 12 months (HYS)or last 6 months (RB)Saturday, 18 May, 13
  8. 8. RESEARCH QUESTIONSHow can we alter the environments of street-involved youth who use crystal methamphetamineto decrease risk factors and increase protectivefactors?What social and structural changes are needed toimprove the environments of street-involved youthwho use crystal methamphetamine?Saturday, 18 May, 13
  9. 9. STREET-INVOLVED YOUTHLack of agreed upon definition & numbers are very difficult toestimateInclude not only youth who live mainly on the street, but also“couch surfers” who share shelter with intimate partners orfriends, youth who are in and out of government care, and youthwho frequent shelters for people who are homeless/not housedThere are roughly 250-300 street-involved youth, betweenthe ages of 14 and 24 years old, at any given time in Victoria(Benoit et al., 2008, p. 329-330)Saturday, 18 May, 13
  10. 10. SUBSTANCE USEIn 2012, 84% ofstreet-involvedyouth used alcoholand marijuanawithin the past 30days (n=50)In 2012, 42% ofstreet-involvedyouth used ecstasywithin the past 30days (n=50)In 2012, 36% ofstreet-involvedyouth used cocainewithin the past 30days (n=50)(n=99, both Victoria & Vancouver)(Centre for Addictions Research of British Columbia, 2012)Saturday, 18 May, 13
  11. 11. CRYSTAL METHAMPHETAMINEWhat is it?~Psychoactive form of methamphetamine that can bring about feelings ofeuphoria, alertness, feelings of endless energy, restlessness,depression, paranoia, acute psychosis, and sleep deprivation~Negative consequences of use include deteriorating physical andmental health, neurological damage leading to impairments in social-cognitive functioning, social isolation, anxiety, depression, andphysical harm(Homer et al., 2008)Common street names: “jib”, “crystal”, “chalk”, “black beauties”, “batu”,“quick”, “poor man’s cocaine”, “tina”, “tweak”, “yaba”, “yellow bam”,“shabu”Saturday, 18 May, 13
  12. 12. CRYSTAL METHAMPHETAMINEIn 2008, 17% of street-involved youth used crystalmethamphetamine within the past 30 days (n=487)In 2012, 40% of street-involved youth used crystalmethamphetamine within the past 30 days (n=50)(CARBC, 2008 & 2012)Most street-involved youth said they used CM to stay awaketo protect their belongings, to enhance socialinteractions, to cope with negative feelings, and as analternative to pharmaceutical medications(Bungay et al., 2006)Saturday, 18 May, 13
  13. 13. MENTAL HEALTHCommon for street-involved youth to experience concurrent substance useand mental health struggles; also likely to experience physical abuse as achild, greater transience, street victimization, and/or previous arrest(Kirst et al., 2011)63% of females & 50% of males reported one or more of the followingconditions:~learning disabilities~Fetal Alcohol Syndrome (FAS)~Attention Deficit Hyperactivity Disorder (ADHD/ADD)~depression~addiction~problems with anger & violence~Post-Traumatic Stress Disorder (PTSD)(Saewyc et al., 2006; Smith et al., 2007)Saturday, 18 May, 13
  14. 14. MENTAL HEALTH32% of females vs. 13% ofmales reported beingdiagnosed withdepression13% of females vs. 7% ofmales reported chronicanxiety33% of females vs. 25%of males reported feelingvery sad, hopeless, ordiscouraged in the past30 days55% of females and 35%of males reported beingunder high levels of stressDifferences betweenmales & females:(n=762, including Vancouver, Victoria, Abbotsford & Mission, Surrey,Prince Rupert, Nanaimo, Prince George, Kamloops, and Kelowna)(Smith et al., 2007)Saturday, 18 May, 13
  15. 15. RISK ENVIRONMENTFRAMEWORKEnvisages drug harms as a product of the social situations andenvironments in which individuals participateShifts the responsibility for drug harm, and the focus of harm reducingactions, from individuals alone to include the social and politicalinstitutions which have a role in harm productionFour types of environments (physical, economic, social, policy) thatinteract with two “levels of environmental influence” (micro, macro)Emphasizes the interactions, adaptations, and exchanges between thevarious types of environments and levels of environmental influence(Rhodes, 2002 & 2009)Saturday, 18 May, 13
  16. 16. RISK ENVIRONMENTFRAMEWORKEnables harm reduction approaches in four ways:(1) critiques the tendency of public health and behavioural sciences toemphasize harm as the primary determinant of individual behaviour andresponsibility(2) encourages resistance to “blame for harm” being laid upon the affectedindividuals(3) focuses on risk as socially situated and how risk environments areembodied and experienced as part of everyday life(4) incorporates harm reduction inside broader frameworks that promotehuman rights approaches to public healthRhodes’ argues that his conception of the risk environment framework is acall to “mobilize resources in social science towards reducing drug-related social suffering” (p. 198)Saturday, 18 May, 13
  17. 17. RISK ENVIRONMENTFRAMEWORKlevel of environmental influencetype of environmentmicro macroeconomicsocialpolicyphysicalcost of living & healthcare,employment & incomehealth servicerevenue & expenditures,uncertain economic transitionsocial & peer group norms,local policing normsgender inequality,stigmatization & marginalizationof substance usersavailability & coverage of harmreduction supplies,availability of social housingpublic health policy governingharm reduction, laws governingpossession of drugsusing substances,using in public & private spacesdrug trafficking & distributionroutes, geographical populationshiftsThe interactions between the various types of environment and levels of environmentalinfluence are essential to Rhodes’ conceptualization of the “risk environment framework”Saturday, 18 May, 13
  18. 18. BRONFENBRENNER’SMESOSYSTEM“A mesosystem comprises the interrelations amongmajor settings containing the developing person at aparticular point in his or her life - a mesosystem is asystem of microsystems”Can include the interactions and relations among family,school, peer groups, church, workplace, etc.(Bronfenbrenner, 1977, p. 515)Saturday, 18 May, 13
  19. 19. BRONFENBRENNER’SMESOSYSTEMFour types of interconnections are possible:(1) Multisetting participation(2) Indirect linkage(3) Intersetting communications(4) Intersetting knowledge(Bronfenbrenner, 1979, p. 209-210)Saturday, 18 May, 13
  20. 20. TURNER’SMESODYNAMICSThe macro realm of reality consists of:(1) institutional domains(2) stratification systems(3) societies(4) the systems of societiesThe meso realm of reality includes:(1) corporate units(2) categoric unitsThe micro realm of reality is composed of:(1) focused encounters(2) unfocused encounters(Turner, 2012)Saturday, 18 May, 13
  21. 21. TURNER’SMESODYNAMICSTurner theorizes that at some point in almost all societies, discriminationon the basis of categoric-unit memberships and the formation ofstratification systems will encourage “victims” to mobilize and createtheir own corporate units that have “ever-more clear agendas”For Turner, escalating grievances, continuous discrimination, andunrelenting marginalization are the basis for social movementorganizations; however, he is careful to note that social movements donot always successfully achieve what they originally intendedSaturday, 18 May, 13
  22. 22. INTEGRATING AMESO-LEVEL ANALYSISMeso-level analysis allows for the investigation of Victoria as acommunity and organizations within the city, specifically theVictoria Youth Clinic (VYC), where I currently volunteerThe VYC is a wonderful example of a “corporate unit” that experiencespressure from both the micro and macro levels on a daily basisCurrently, I am considering including a small reflexive chapter withinmy dissertation that will examine meso-level communityorganizations.I hope to use and integrate a number of my personal experienceswithin the busy, clinical setting of VYC to explore the elements ofmeso-level organizationsSaturday, 18 May, 13
  23. 23. AMENDING THE RISKENVIRONMENT FRAMEWORKlevel of environmental influencetype of environmentmicro meso macroeconomicsocialpolicyphysicalcost of living & healthcare,employment & incomefunding for community-based organizationshealth service revenue &expenditures, uncertaineconomic transitionsocial & peer group norms,local policing norms,psychosocial integrationstrong, cohesive communitygroups & organizations,stigmatization of illicit drug usewithin neighbourhoods &communitiesgender inequality,stigmatization &marginalization ofsubstance usersavailability & coverage ofharm reduction supplies,availability of social housingorganizational policyregarding harm reductiondistributionpublic health policygoverning harm reduction,laws governing possessionof drugsusing substances,using in public & privatespacesaccessible & publiccommunity spaces,especially for youthdrug trafficking &distribution routes,geographical populationshiftsSaturday, 18 May, 13
  24. 24. TIMELINEMay - August 2013:~draft thesis proposalSeptember - December 2013:~defend thesis proposal~finish two final course-based creditsJanuary - April 2014:~research & analysis of Risky Business & Healthy Youth Survey dataMay - August 2014:~finish analysis & write, write, write!~submit final thesisSeptember 2014:~defend final thesisSaturday, 18 May, 13
  25. 25. WORKS CITEDBenoit, C., Jansson, M., Hallgrimsdotter, H., & Roth, E. (2008). Street Youth’s Life-Course Transitions.Comparative Social Research, 25(1), 325-353. doi:10.1016/S0199.Bronfenbrenner, U. (1977). Toward an Experimental Ecology of Human Development. American Psychologist, July2007, 515-531.Bronfenbrenner, U. (1979). Ecology of Human Development: Experiments by Nature & Design. Cambridge,Massachusetts: Harvard University Press.Bungay, V., Malchy, L., Buxton, J. A., Johnson, J., MacPherson, D., & Rosenfeld, T. (2006). Life with jib: Asnapshot of street youth’s use of crystal methamphetamine. Addiction Research & Theory, 14(3), 235–251. doi:10.1080/16066350500270901.Centre for Addictions Research of British Columbia. (2008 & 2012). Alcohol and Other Drug Monitoring Project:High Risk Populations. Retrieved from, B. D., Solomon, T. M., Moeller, R. W., Mascia, A., DeRaleau, L., & Halkitis, P. N. (2008).Methamphetamine abuse and impairment of social functioning: a review of the underlying neurophysiological causes andbehavioral implications. Psychological Bulletin, 134(2), 301–10. doi:10.1037/0033-2909.134.2.301.Kirst, M., Frederick, T., & Erickson, P. G. (2011). Concurrent Mental Health and Substance Use Problems amongStreet-Involved Youth. International Journal of Mental Health and Addiction, 9(5), 543–553. doi:10.1007/s11469-011-9328-3.Rhodes, T. (2002). The “risk environment”: a framework for understanding and reducing drug-related harm.International Journal of Drug Policy, 13(2), 85–94. doi:10.1016/S0955-3959(02)00007-5.Rhodes, T. (2009). Risk environments and drug harms: a social science for harm reduction approach. InternationalJournal of Drug Policy, 20(3), 193–201. doi:10.1016/j.drugpo.2008.10.003.Saewyc, E., Wang, N., Chittenden, M., Murphy, A., and the McCreary Centre Society. (2006). BuildingResilience in Vulnerable Youth. Vancouver, B.C.: The McCreary Centre Society.Smith, A., Saewyc, E., Albert, M., MacKay, L., Northcott, M., and the McCreary Centre Society. (2007).Against the Odds: A profile of marginalized and street-involved youth in B.C. Vancouver, B.C.: The McCreary CentreSociety.Turner, J. H. (2012). Theoretical Principles of Sociology, Volume 3: Mesodynamics. United States: Springer Science.Saturday, 18 May, 13
  26. 26. FEEDBACK & DISCUSSIONTHANK YOU!Saturday, 18 May, 13