(A Blog Series) Youth Mental Health in DC: Housing Instability and the Challenge of Staying Connected to Care

Housing Instability and the Challenge of Staying Connected to Care

As the previous blog in our series made clear, while a behavioral health system exists for young people in the District, with programs across the spectrum doing valuable work, young people often struggle to navigate it and are forced to overcome the many barriers that stand in their way to access the services they need. The difficulty young people face in navigating DC’s behavioral health system becomes even more pronounced when viewed through the lens of housing instability. These conditions do not exist separately from mental health needs. Instead, they directly shape whether young people are able to find care in the first place and whether they are able to stay connected once they do.

In FY25, 1,688 unaccompanied youth experiencing homelessness were served through the District’s youth homelessness system. This system includes drop in centers, street outreach, transitional housing, and permanent supportive housing programs that are specifically designed for young people. While these programs are primarily focused on housing stability, they also function as critical access points into behavioral health services, particularly for youth who are not connected to certified community based organizations or other clinical providers.

The overlap between homelessness and mental health needs is significant. In the 2024 Homeless Youth Count, which surveyed 1,114 young people, 57% of unaccompanied youth and 53% of youth heads of household reported regularly experiencing symptoms associated with a mental health condition. Despite this high level of need, only about half of those respondents reported seeking mental health care for their symptoms. This gap highlights a key issue that extends beyond individual behavior. It reflects system level challenges in connecting youth experiencing instability to consistent care.

Department of Behavioral Health service data further illustrates this disconnect between need and service reach. In FY25, the Department of Behavioral Health served 8,071 children, adolescents, and young adults ages 0–24 through its mental health system. Of those clients, 140 were identified as youth experiencing homelessness, representing less than 2% of the total population DBH served. In FY26 through January, 58 youth experiencing homelessness were identified among 4,302 clients ages 0-24 receiving services. While these figures do not capture the full scope of need, they suggest that only a small portion of youth experiencing homelessness are being reached through formal behavioral health services pathways.

Housing instability intensifies these challenges. In DC Action’s survey of 108 young people—primarily focused on transition-age youth ages 16–24, though including a small number of respondents slightly outside that range–approximately 75% of youth experiencing homelessness and 85% of youth experiencing housing insecurity reported wanting mental health support but not receiving it, compared to roughly 30% of youth who were stably housed.. These differences underscore how strongly housing status shapes both access to care and continuity of care within the behavioral health system.

For young people navigating both housing and behavioral health systems, the challenge is not simply accessing services within one system, but navigating multiple systems simultaneously. Housing providers, outreach teams, crisis responders, and behavioral health clinicians often operate in parallel  rather than through a unified structure. As a result, a young person may be connected to housing support without behavioral health care, or vice versa, depending on how referral pathways align at a given moment. Without consistent warm handoffs and cross-system coordination, young people are often left to navigate transitions on their own. A change in housing placement, program exit, or loss of housing services can unintentionally sever relationships with trusted behavioral health providers, forcing youth to restart the process of accessing care and increasing the likelihood of disengagement. This fragmentation can undermine continuity of care and create barriers to sustained engagement, particularly for young people who are already experiencing instability or crisis.  

This reinforces a broader structural issue even when services exist across multiple systems, meaningful access depends on coordination between those systems. For young people experiencing housing instability, that coordination is often the difference between temporary contact with services and sustained engagement in care over time.

Yet for many youth, particularly those navigating homelessness, system involvement, or behavioral health needs simultaneously, fragmented pathways are increasingly compounded by funding pressures across both the youth homelessness and behavioral health continuums. Two consecutive years of proposed and enacted cuts in FY26 and FY27 across both the youth homelessness and youth behavioral health systems have created an environment of ongoing uncertainty, where providers must repeatedly prepare for service reductions, staffing changes, shifting priorities, and program closures. This instability makes long-term planning difficult, disrupts partnerships across systems, and undermines public trust in efforts to build a coordinated system of care. For young people, these disruptions can translate into fewer available services, longer wait times, inconsistent relationships with trusted providers, and greater challenges maintaining engagement in care. 

We hope this pattern of uncertainty does not continue into the next Council period. Young people cannot build stability when the system designed to support them is forced to operate under constant uncertainty. Consistent investments are necessary to sustain services, retain experienced staff, strengthen cross-system collaboration, and ensure young people can access the housing and behavioral health supports they need without interruption. 

Take Action 

Addressing these disparities will require more than preserving isolated programs. DC Action is calling on District leaders to protect and expand youth-serving systems, strengthen coordination between housing and behavioral health providers, invest in youth-specialized and culturally responsive workforce capacity, and ensure that young people can access integrated supports without being forced to navigate disconnected systems alone. Without intentional policy and funding decisions, the young people with the highest needs will continue to face the greatest barriers to care.

If you believe young people in DC deserve timely, culturally responsive mental health care, add your name to our petition calling on the DC Council, the Department of Behavioral Health, and the Mayor to take action.

Sign the petition HERE.