By Andy Smith

Even over the phone, San Francisco’s Homeless Youth Alliance exudes a very “West Coast” vibe.  This laidback tone, however, belies a highly effective and carefully structured program run almost entirely by young adults who were once on the streets themselves.

A $15,000 grant from BC/EFA is helping the organization fund its HIV Prevention and needle exchange programs, among other services for homeless young people.

Although the alliance in its current incarnation was formed two years ago, HYA’s needle exchange and drop-in center have deep roots in the Haight-Ashbury neighborhood, having evolved from long-standing grassroots programs dating back to 1992.

Today, HYA sees between 50 and 120 clients daily. “Over the last few months we’ve been insanely busy,” says Mary Howe, founder and executive director. “It could be the economic crisis putting stress on families. We’re not sure yet.”

Directly proportional to HYA’s rising numbers are its tiny physical parameters. “The center is about 3,000 square feet, and we have 10 staff members in two really tiny offices,” Howe says. “The bathrooms are bigger than the office.”

Despite space limitations, HYA strives to meet the many needs of its participants. “We try to provide everything possible: food, bathrooms, phones, internet, case management and most of all support. We work with kids to get state IDs and birth certificates for those who don’t have them, both of which are a major step toward finding a job and a place to live.”

HIV and The Homeless
In spite of the challenges faced by youth living without a home, Howe is cautiously optimistic about the center’s HIV prevention efforts.

“The bad news is that about three (3) percent of our youth have told us they’re HIV-positive, but we believe the percentage is higher. There are some we know are positive, but we only count the ones who tell us about their diagnosis,” Howe says. “The good news is that if we catch them early in their behavior, prevention education is highly effective. The older anyone gets, the harder it is to get them to change their behavior.”

Because homeless youth face so many interrelated risk factors, a wide continuum of care is essential to preventing the spread of HIV among this population. HYA offers weekly health groups, along with access to counseling, case management and medical referrals to the Haight-Ashbury Free Clinic and Cole Street Clinic.

Also of prime importance is the alliance’s needle exchange program, which makes sterile syringes available to homeless youth who use speed, heroin and other IV drugs. Open for a total of eight hours each week, the exchange serves between 40 to 90 injection drug users and other community members weekly.

Focus on Physical & Mental Health
Mental health counseling is a major component of HYA’s services and this aspect of the program has been helped by the addition of psychologist Mike Toohey, who works for the Haight-Ashbury Free Clinic and does outreach at HYA. Known affectionately as “Dr. Dude” to his clients, Toohey provides his services four days a week, up to four hours a day, holding one-on-one therapy sessions as well as twice-weekly group sessions.

“A lot of the work I do is trying to instill a sense of personal value,” says Toohey. He facilitates an all-gender health group with a broad range of topics. “One week we did ‘scabies,’ another ‘overdose prevention,’ “foot care,’ and ‘how to ride trains safely.’ We also have an all-men group, where ‘We sit around and talk about sex, drugs and rock and roll.”’

“We get youth from all over the world: Maine to Florida to the Ukraine to Japan and everywhere in between. They come to San Francisco for its famous ‘free love.’ That means they’ve been in family situations with conditional love or no love. They’re looking for a place where they can fit in and won’t be judged.”

While HYA serves the homeless from ages 13 to 29, Toohey says that for many of the youth he counsels, the damage that can lead to a homeless lifestyle came earlier. “Many of them were in mental hospitals at some point, often between the ages of eight and 12.”

Howe and Toohey both stress the importance of building self esteem. “Most of these kids don’t have a sense of self worth. And a lot won’t identify as ‘homeless.’ They’ll call themselves ‘travelers,’ or ‘houseless.’ The majority don’t see having a decent income as attainable,” Toohey says. “They don’t know how to work towards that end.”

A few of HYA’s committed volunteers. Homeless youth and the formerly homeless donate their time to the organization.

First Hand Knowledge
Like most of HYA’s staff, Dr. Dude knows how to survive on the streets. “Every person who works at our drop-in clinic has an experience with homelessness.  When I was 18, I got kicked out of my home. I did the same lifestyle ‘til I was 22. That’s when I got into school and discovered a passion for psychology.”

Higher education and homelessness can coexist, adds Howe. “We have kids who are living in the park and going to community college. We give them extra support in any way we can, like extra time on the internet or just access to space with electric light. It’s hard to study at night in a dark park.”

Right now, the center’s youth help facilitate workshops, participate in monthly center clean-ups, sit in on the hiring committees, and play a major role in designing HYA’s programming.  “My ultimate goal is for the center to be run entirely by formerly homeless kids,” says Howe, who also survived a period of homelessness and drug use. “I have a board member who used to be a participant and now she’s working towards her Masters Degree at UC Berkeley.”