Objective: Provide a free, one-stop, easily accessible drop-in center for youth that can serve their health, social support and STI/HIV prevention needs, with as few administrative barriers as possible.
The SPOT: Health care for teens includes hassle-free STI/HIV testing and free computer access.
Photo: Supporting Positive Opportunities with Teens
In a Nutshell: The SPOT tries to remove barriers that impede youth from seeking or obtaining health and illness prevention services by creating a center that is youth-specific and separate from a child or adult clinic environment. The center combines health and social services in a single setting, while engaging youth in all aspects of program development and giving them leadership opportunities.
“The only requirements to access services include the person’s name, age and what service they would like to access for the day,” said Regina Whittington, The SPOT’s program director. “Everyone has an option for accessing as many services as they need per session. They can request general services such as food, computers or television. They can request more clinical services such as STI/HIV testing, counseling or case management.”
Where It Happens: The SPOT is located in the central west end region of St. Louis. Its roughly 2,500 square-foot office and clinic space is located on the lower level of the building occupied by its leading partner, Project ARK.
When It Began: September 2008.
Who Started It and Who Runs It: Washington University-Project ARK (AIDS/HIV Resources and Knowledge), in collaboration with the Adolescent Center in the university’s pediatrics department, led a community partnership to develop the drop-in center for youth. The motivation came partly from the need to reduce the staggering rates of sexually transmitted infections and HIV among the region’s youth.
The SPOT has 15 full-time staff members, including contract workers, plus three graduate students. The administrative team includes Executive Director Kim Donica, Medical Director Katie Plax, Whittington, and Program Coordinator Lawrence Lewis. The staff includes teams for case management, nursing, mental health and youth development, as well as a prevention specialist and workforce development specialist. Most of the lead staffers hold graduate degrees in social work, counseling or public health.
Obstacles: “One of the largest challenges relates to the overwhelming need expressed by the community,” Whittington said. “The initial projections for this project included reaching 1,500 unduplicated youth in three years. The program has served over 2,300 unduplicated youth in less than two years.” As a result, there frequently is not enough space to provide one-on-one services.
Whittington cited the need for psychiatric services as another obstacle. “The program has a psychiatrist available for internal referrals four hours a week, but there is a tremendous request for psychiatric evaluation and ongoing intense psychiatric care,” she said.
How They Overcame Them: “The team is very creative in making use of space, as well as being incredibly flexible,” Whittington said. “Various clinical services are offered, both by appointment and on a walk-in basis.”
“For psychiatry services, the program prioritizes the use of the psychiatrist for youth who do not have insurance or have very limited options for outside psychiatry services. The mental health team has also worked very hard to establish a referral process to link youth to available community resources.”
Cost: The annual operating budget is $1.1 million.
Who Pays: Most of the funding comes from grants and private donations, the largest of which are from the Missouri Foundation for Health and a U.S. Substance Abuse and Mental Health Services Administration grant. Additional sources of funding include Barnes Jewish Hospital Foundation, St. Louis Children’s Hospital, Washington University and BJC HealthCare. Individuals contribute clothing, food, hygiene products and general services.
Youth Served: The SPOT serves 13- to 24-year-olds, focusing on racial and sexual minorities and on runaway and homeless youths. Since the program began, 2,389 youth have accessed its services; about 56 percent are female. The racial breakdown is 78 percent African-American, 14 percent Caucasian, 2 percent multiracial and 1 percent Asian Pacific Islander.
Youth Turn-On: The low threshold for accessing services, including no need for photo ID or Social Security cards, encourages many youth to come to The SPOT. “Additionally, youth like the fact they can receive a wide range of services at one place,” Whittington said. “They are able to work on multiple goals with various staff members.”
Youth Turn-Off: “Sometimes the youth comment they wish the services were available later in the evening and on the weekends,” Whittington said. The program is open for walk-in services Mondays through Fridays from 1 p.m. to 5 p.m.
Research Shows: The program is in the process of evaluation.
What Still Gets in the Way: The capacity of the program is limited due to the staff and space available.