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It is no secret or shock to many that the past few years have changed each of our lives to some capacity. Social distancing, school shutdowns, mask mandates, and the list goes on. As we returned to what we may see as “normalcy,” we have started to see a rise in homelessness in not only Charlotte, but also throughout the country, especially amongst adolescents and their families. This raises the question of how homelessness is defined, what are some of the major factors that contribute to adolescent homelessness, what are some of the statistics we are seeing in Charlotte, and available resources. Our Chief Psychologist, Dr. Jennifer Thomas, helps to answer these important questions.

How is homelessness defined?

Definitions of homelessness vary, often depending on various agencies and funding sources used to support programs and resources. The definition of homelessness generally includes emergency shelters, transitional housing, or unsheltered locations. For those youth who are unaccompanied by families or caregivers, the Runaway and Homeless Youth Act defines youth homelessness as “young people who cannot live in a safe environment with a relative and who have no other safe living arrangement.” Other federal definitions of homelessness include “lacking a fixed, regular, and adequate nighttime residence.” Youth homelessness may also include living “doubled up” with other families; couch surfing or staying with friends or relatives; living in hotels or motels; being abandoned in hospitals; awaiting foster care placement; or sleeping in an unsheltered location (e.g., cars, parks, campgrounds, temporary trailers, or abandoned buildings). Notably, many homeless shelters do not accept unaccompanied minors.

Is homelessness on the rise, lowering, or remaining the same for adolescents in Charlotte?

According to the 2022 Charlotte-Mecklenburg State of Housing Instability & Homelessness Report, there were 3,260 people in Mecklenburg County experiencing homelessness (in shelters and unsheltered locations) in October 2022, reflecting an overall 3% increase in homelessness in the past year. This count of individuals experiencing homelessness included 364 families and 127 unaccompanied youth (ages 18-24) but is likely an underestimate given the challenges of identifying all unsheltered locations where individuals may live. Issues with the availability of affordable housing is identified as a significant factor contributing to the increase in homelessness. Notably, minor children ages 0-17 accounted for nearly 25% of the overall number of individuals experiencing homelessness.
During the 2021-2022 school year, 40% more students in Charlotte-Mecklenburg Schools (CMS) were identified as eligible for McKinney-Vento than in 2020-2021, with a total of 4,206 living in doubled up situations in 2021-2022. The McKinney-Vento Homeless Assistance Act (MVA) provides school access and support for academic success for students experiencing homelessness and housing instability.

What are some of the major factors that contribute to adolescent homelessness?

According to a national survey on unaccompanied youth homelessness in America, results show that one in 10 young adults ages 18-25 (an estimated 3.5 million) and at least one in 30 adolescents ages 13-17 (an estimated 700,000) experience homelessness unaccompanied by a parent or guardian over the course of a year (Missed Opportunities: Youth Homelessness in America, National Estimates, 2017). Poverty is a contributing factor to homelessness, and youth with lower household incomes were more likely to experience homelessness. Young parents had three times the risk of experiencing homelessness when compared to non-parenting peers. Young adults without a high school diploma or GED had 4.5 times the risk of experiencing homelessness compared to peers who completed high school. Youth of color and youth who identify as LGBTQ disproportionately experience homelessness and housing instability at higher rates. According to the 2021 National Survey on LGBTQ Youth Mental Health, 28% of LGBTQ youth reported experiencing homelessness or housing instability during their lifetime with many reporting being mistreated or kicked out due to their identity. Family conflict is often indicated as a reason youth give for their homelessness or running away.

What are the common struggles of adolescents who are identified as being homeless?

Youth experiencing unstable housing face higher risks for poor physical and behavioral health outcomes (McKinnon, et al., 2023). Periods of unstable housing might serve as barriers to accessing consistent, comprehensive physical and behavioral health care and may contribute to health challenges resulting from inadequate nutrition and food insecurity. Homelessness also can impact education, sense of safety, and overall development (American Psychological Association, 2022). Students experiencing homelessness are more than twice as likely to be chronically absent, more likely to change schools multiple times, to be suspended, have lower test scores, and have increased risk for dropping out than their peers experiencing housing stability. They also may have limited support systems, be more likely to experience adverse childhood events (ACEs), family rejection, and family instability.
National results from the 2021 Youth Risk Behavior Survey indicated that 2.7% of US high school students experienced unstable housing (McKinnon, et al., 2023). Students experiencing unstable housing were more likely to engage in sexual risks behaviors, substance use, suicidal ideation and attempts, and to experience violence and victimization (McKinnon, et al., 2023; Smith-Grant et al., 2022). Alcohol and other substance use are 2-3 times more prevalent, and the prevalence of depressive symptoms is significantly higher among youth experiencing homelessness.

What are some resources that adolescents can use if they are experiencing homelessness?

The following programs focus on providing education, awareness, and support for local and national
initiatives that provide resources and work towards ending youth homelessness:
For information on McKinney-Vento Program services for CMS students, visit https://www.cmsk12.org/Page/9726.

The Family and Youth Services Bureau (FYSB) funds the National Runaway Safeline which includes a crisis hotline (1-800-RUNAWAY) and online services 24/7.
Locally, youth can contact The Relatives youth crisis center at 704-377-0602 for help with finding shelter and support.

National Substance Use Prevention Month is an observance to highlight the vital role of substance use prevention for both individual and community health. Millions of Americans suffer from a substance use disorder, including underage drinking, alcohol dependency, non-medical use of prescription drugs, misuse of over-the-counter medications, and illicit drug use. Our Teen Advisory Board Coordinator, Bain Brown, shares some of the statistics of substance use amongst adolescents and ways to combat these issues.

What trends are we seeing in the US?
The CDC’s 2021 Youth Risk Behavior Survey (YRBS) reports that about 30% of high school students reported substance use in the past 30 days. A significant portion, about 35%, of those students used multiple substances. Although there is still progress to be made, youth substance use in the U.S. has seen a decline over the past decade, including during the COVID-19 pandemic. Despite this decrease, substance use remains prevalent among high school students nationally. The reduction in substance use might be attributed to pandemic-related factors such as reduced peer contact and increased parental oversight. Given the evolving markets for alcohol and drugs, it is essential to continuously monitor these trends. Evidence-based prevention programs, such as the Teen Advisory Board at Teen health Connection, that target the factors contributing to youth substance use could help sustain and amplify this decline.

How does NC compare to the rates of the US as a whole?
North Carolina teens report similar rates of substance use as their peers across the nation. The 2021 YRBS reports that there is no significant difference between national and state rates of underage drinking and marijuana use among high school students in NC. However, North Carolina teens are more likely to use electronic vapor products, or e-cigarettes, with current use rates 5.8% higher than the national average. Additionally, the number of high school youth in NC who report taking a prescription medication (such as Vicodin, Oxycontin, or Percocet) without a doctor’s prescription is 3.6% higher than the national average. These higher rates of prescription drug misuse are alarming given the national increase in accidental overdoses due to Fentanyl poisoning.

What substances are most often used by adolescents?
In 2021, about 30% of U.S. high school students reported using substances like alcohol, marijuana, or misusing prescription opioids. Among these, alcohol (22.7%) and marijuana (15.8%) were the most used substances by these students.
What are some types of resources teens can use to help if they are struggling with substance abuse?
If you, or someone you know, needs help with a substance use disorder, call SAMHSA’s National Helpline at 1-800-662-HELP (4357) or text your zip code to 435748 (HELP4U).

When looking at the statistics, we can see the importance of having prevention-based programs for adolescents in place as well as substance use education for both adolescents and parents. Here at Teen Health Connection, we offer different programs to help in these areas.

For adolescents, we have our Teen Advisory Board, who together work to promote the prevention of underage drinking and prescription drug misuse in Charlotte, North Carolina while also serving as the youth sector representatives on the Teen Health Connection Youth Drug-Free Coalition. If you would like to learn more or even join, visit our website using the link here or contact our Teen Advisory Board Coordinator, Bain Brown, at Bain.Brown@TeenHealthConnection.org.

For parents and guardians, we offer parenting classes on different topics surrounding different topics that are affecting teens today. If you are interested in learning more or would like to sign-up for one of our upcoming classes, you can see our schedule here or reach out to our parenting facilitator, Kris Hawkins, at Kris.Hawkins@TeenHealthConnection.org. You can also read Kris Hawkin’s latest topic for Substance Use Prevention month, Parental Monitoring: A Protective Factor Against Adolescent Substance Use to learn about the different ways parents can effectively monitor their teen(s).

Spotlight on Success: Jewel Wood – A Year After the Johnston Ziegler Youth Leadership Scholarship

Spotlight on Success: Jewel Wood

It is with great pleasure that we share an inspiring update on our outstanding scholarship recipient for the graduating class of 2023. Jewel Wood, the recipient of the Johnston Ziegler Youth Leadership Scholarship, has continued to shine brightly in her journey toward personal and academic success.

“Winning the JZ Scholarship has impacted my personal and academic journey significantly,” Jewel stated about winning the JZ Scholarship. “Without this scholarship, the financial burden on my family and I would’ve been overwhelmingly difficult. In fact, there was a period of time where I had to deeply consider attending other universities due to financial costs. However, once I heard that I won the JZ Scholarship, it stirred a sense of hope that attending my dream school, Howard University, could be a real possibility.”

We could not be prouder of the positive impact Jewel is making in the lives of those around her. She is a testament to the power of youth leadership and the potential for change when young individuals are given the support and resources they need. Thank you for your continued support, which allows us to nurture the potential of remarkable young leaders like Jewel Wood. We look forward to sharing more success stories and updates with you in the future!

If you would like to make a contribution to the Johnston Ziegler Youth Leadership Scholarship, click here.

Parental Monitoring describes the extent to which a parent supervises the activities of their adolescent and the level of concern and awareness they demonstrate to their adolescent regarding those activities.
And yes, research shows that adolescents whose parents practice effective monitoring strategies are, not only, less likely to use substances, they are less likely to choose risky behaviors in general.

The CDC (Centers for Disease Control and Prevention) has compiled a list of suggestions for parents to use to monitor their adolescent and help protect them from risky behaviors and experiences:

• Talk with your teen about your rules and expectations and explain the consequences for breaking the rules.
• Talk and listen to your teen often about how they feel and what they are thinking.
• Know who your teen’s friends are.
• Talk with your teen about the plans they have with friends, what they are doing after school, and where they will be going.
• Set expectations for when your teen will come home and expect a call if they are going to be late.
• Ask whether an adult will be present when your teen is visiting a friend’s home.
• Get to know your teen’s boyfriend or girlfriend.
• Get to know the parents of your teen’s friends.
• Talk with your relatives, your neighbors, your teen’s teachers, and other adults who know your teen. Ask them to share what they observe about your teen’s behaviors, moods, or friends.
• Watch how your teen spends money.
• Keep track of how your teen spends time online and talk about using the Internet safely.
• Pay attention to your teen’s mood and behavior at home and discuss any concerns you might have.
• If your teen does break a rule, enforce the consequences fairly and consistently.
• Make sure your teen knows how to contact you at all times

Passionate. Dedicated. Selfless. These are just a few words to describe our late founding Medical Director, Dr. John G. Johnston, lovingly known as “Dr. J.” The light he brought to the practice and to those in his presence is one that many will never forget. During his life, he inspired teens, their parents, and medical students to be the best version of themselves.

After leaving Charlotte Pediatric Clinic, where he served the community for 18 years, Dr. J came to serve as Teen Health Connection’s first Medical Director in 1992.  While serving as the Medical Director, he always wanted to make sure each patient left feeling positive and that he would always be a listening ear. He was loved by all and would never shy away from spending as much time as needed with each patient. He loved to hear about their experiences and wanted them to know that Teen Health Connection would always be there.

Even after his retirement in 2005, his love and passion for Teen Health Connection continued and is still felt today.  To have this legacy of Dr. J felt by all and to invest in the future of teens, Teen Health Connection’s Board of Directors created the Johnston Ziegler Youth Leadership Scholarship.  The Johnston Ziegler Youth Leadership Award is a merit-based scholarship that recognizes a local high-school senior who, like Dr. Johnston and Barbara Ziegler, has demonstrated outstanding leadership, advocacy, or service for adolescents. The selected youth will receive a $2,500 educational scholarship to the college or university of his or her choice.

Though Dr. J may no longer be with us, his vision, passion, and dedication live on with each of us here at Teen Health Connection and within those who knew Dr. J. As we mourn his loss, let us remember the smiles he brought to everyone when he entered a room and the passion he brought to helping the Charlotte community.

We would like to welcome our new furry colleague, Pixie, to our Teen Health Connection team. Pixie is a four-year-old Great Dane and is a Therapy Dog certified through Therapy Dog International.

With teens coming from many areas of life, it can sometimes be challenging to open up, especially to those they do not know very well. Because of this, animals can be used as a fantastic way to ease the tension in the room and provide a way for a patient to feel more comfortable.

Animal Assisted Therapy (AAT) is a form of creative therapy that utilizes licensed and credentialed therapy animals in a therapeutic setting. Animal Assisted Therapy can be used with several types of psychological, emotional, developmental, cognitive behavioral, and physical health situations. Numerous studies show that interaction with animals helps people lower their blood pressure, increases engagement, and reduces anxiety and depression.

For most people, the presence of an animal prompts the body to release serotonin, prolactin, and oxytocin. These hormones generate a relaxation and stress-reducing response. Over time, these “happy hormones” lower anxiety and, can “break the ice” between therapist and patient. Interacting with a therapy dog has also been shown to lower cortisol (stress hormone) and reduce blood pressure.

Pixie works alongside her pet parent and Teen Health Connection therapist, Clark Bridge, LCSW. Though still early in her AAT career, we can see that Pixie is really enjoying all the pets she receives when coming to work, even though she has been caught sneaking in a few snoozes during her breaks. Patients are really enjoying their sessions with Pixie, and even other patients who see other providers cannot help but want a few minutes to pet Pixie. We look forward to expanding Pixie’s potential at Teen Health Connection.

Parents: DID YOU KNOW?

A 2014 study found that sleep-deprived teens are more likely to report anxiety, depression, and suicidal thoughts and behaviors.

Quality sleep promotes mental, physical, social, and emotional development in teens, but many teens aren’t getting the recommended 8 to 10 hours of sleep a night. In fact, biologically speaking, a teen’s internal body clock is at odds with this 8-to-10-hour goal. There is a sleep cycle shift during puberty that impacts the two main biological processes that cause us to sleep: (1) teens’ sleep hormone production shifts to later and (2) the pressure to sleep accumulates more slowly, so teens don’t feel sleepy until later. Of course, there are other factors that contribute to a teen’s lack of sleep: (3) overscheduled lives, (4) use of electronics, and (5) mental health conditions like anxiety and depression can all make getting sufficient sleep challenging.

Here are some healthy sleep tips for teens, that can make getting more sleep and better sleep a reality:

1. Create a consistent bedtime routine that helps you relax and fall asleep more easily.
2. Avoid caffeine and energy drinks a minimum of 8 hours before bedtime.
3. Avoid using screens at least 30 minutes before bed. If possible, leave screens in a common room to charge.
4. Respect the bed. Don’t do homework, play games, or eat. Only sleep in your bed.
5. Keep your bedroom cool, dark, and quiet.

August is the time to start preparing for a new school year. But before you dive headfirst into schedules and routines, here are some fun things to do with your teenager to help end the summer on a high note:

1. Spend time in or on the water. Go canoeing or kayaking, bodyboarding, or rafting and if you are less adventurous, spend one on one time with your teen at the neighborhood pool or waterpark.
2. Have a movie marathon. You can even choose a theme. Harry Potter or Harrison Ford. Have a lazy, chore-free, homework-free day.
3. Visit a driving range.
4. Tour a local college or a college or university of their choice. This is a terrific way to make your teen feel special.
5. Take a cooking class with your teen. This can be fun but productive as well. The more confident your teen feels in the kitchen, the more likely they are to help with dinner.
6. Go to a concert together. Try to find a performer you both enjoy.
7. Volunteer together. Choose a cause that is meaningful to you both.
8. Try a new restaurant together. Be adventurous and try something neither of you have tried before but you’ve both wanted to.
9. Tie-dye a t-shirt. This can be messy but fun.
10. Challenge your teen to a thrift store war. Both of you take the same amount of money and at the end of your shopping spree, decide who found the best buys. Allow outside votes for this one if you feel so inclined.

Whatever you do, remember to enjoy the last lazy days of summer. There will be plenty of time for structure and routine in September, but in the meantime, ENJOY each other’s company. Your teenager will not be a teenager forever.

What is a Sports Physical?

• It is an exam completed by a physician to determine if it is safe for an individual to participate in a sport and is comprised of two parts:
  • Medical History
  • Physical Exam

Medical History

• Medical history is typically done by completing a form to answer questions regarding:
  • Any hereditary medical problems
  • Allergies
  • If there have been any recent hospitalizations
  • If the person receiving the sports physical has any medical problems such as:
    • Asthma
    • Diabetes
    • Dizziness, chest pain, or trouble breathing while exerting energy while exercising.
  • It is important to be sure the information on the form is as accurate as possible and to help your teen complete the form if they are having trouble.

Physical Exam

• For the physical exam, the doctor will typically do the following:
  • Check heart, lungs, pulse, and blood pressure
  • Record height and weight
  • Complete a vision test
  • Check muscles, bones, and joints

Why is a Sports Physical Important?

• A sports physical can help find any health problems that may inhibit one’s ability to safely play a sport in terms of performance and risk of injury. If any problems are found, a doctor can work together with you and your teen on skills or tips for how to play safely and effectively.