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Show Medications Given Approximately 409 medications were dispensed during the two-year interval. Respiratory medications accounted for 27% and antibiotics (oral or topical) 20% of all medications dispensed. Analgesics (including aspirin and acetaminophen) accounted for 12% of all medications given. See Chart A. Chart A. Medications Dispensed to Homeless Youth Vitamins 2% Rsychotherapeutic 6% Other 10% Analgesic 11% Antibiotic 19% Antigermicidal 3% ^Antihistanine 5% Referrals Approximately 130 referrals were given to the youth attending the Open Door Clinic. Roughly 71% of these referrals were to specialty clinics, including orthopedics and mental health clinics. Nineteen prenatal referrals were given, including those to Baby Your Baby, Women, Infants, & Children, University of Utah, and others. Discussion Adolescents choose to live on the streets for various reasons. For some adolescents, living on the streets seems to be a better option than remaining at home. Unfortunately, being homeless also creates situations that can lead to exploitation and abuse, affecting an adolescent's health and well-being. As a consequence of poor living conditions, improper nutrition, increased substance abuse, and unprotected sexual activity, homeless youth are at high risk for sexually transmitted diseases, pregnancy, HIV, suicide, assault, and malnutrition. (Kipke, 1991; Greene, 1998; MacKellar, 1996). Homeless youth in need of medical attention often fail to access traditional health services. Mainstream healthcare is often fragmented, expensive, and unavailable to the homeless population at large (Breuner, 1998; Deisher, 1991). If medical care is available and accessible, street youth often fail to seek it for fear of conflict with the homeless adult population or because of a general distrust in agencies designed to treat adults. This clinic's primary goal is to provide long-term continuous care by reducing these barriers to access. In order to reduce these barriers, the clinic focuses on 1) providing health care in a supportive and nonjudgmental environment; 2) locating health care services in safe and familiar territory; 3) operating in the evening on a walk-in basis with a free meal incentive; and 4) providing services free of charge. Because street youth are often plagued with physical, emotional, and mental stress, providing health care in a nurturing and nonjudgmental fashion is essential. The clinic is successful, in part, due to the nurturing and caring relationships that providers exhibit towards their patients. The ability of the provider to offer compassionate and non-judgmental care helps create strong and trusting relationships with the youth. Many youth that come to the clinic often present seeking care for minor ailments, and only after the provider begins to talk with the patient, are more serious issues disclosed. Providers must be prepared to quickly treat health issues that are a result of poor living conditions (lice, scabies, etc.) and look for opportunities to address more complicated physical and psychological problems. 32 |