During this COVID-19 pandemic, we have been bombarded with messages on Instagram and Facebook, television, and even highway billboards asking us to “stay home.”

But what if you have no home? There are many people – young people – who don’t have a home. Like a teenage boy who has many aliases, changing birthdates, and was stealing food from a small market. Or a 16-year-old girl who dropped out of school, was cleaning homes for money, and living in a shelter. Left to fend for themselves, these children have no place to “stay home.”

In 1943, the renowned American psychologist Abraham Maslow proposed a theory describing the “hierarchy of needs.” First, we have physiological needs (food, water, air). Without those needs being met we cannot move up the hierarchy. Next, we need safety. Without safety, we cannot feel like we belong, feel loved, have a positive self-esteem, or pursue what makes us happy. No one feels safe during this COVID-19 crisis, and children without a home are among the most vulnerable.

How do we identify homeless youth? Some we can’t, as they try to stay under the radar to avoid juvenile detention centers or foster care. Others, we do find and are able to help. Like a pregnant teenager who met a helpful social worker who found her a group home for pregnant teens. Or a caring high school teacher who noticed a decline in a boy’s school performance, discovered that he had been staying in a shelter, and connected him with the Philadelphia School District’s Office of Education for Children and Youth Experiencing Homelessness.

Homeless youth are typically defined as ages 12 to 24 without family support who are living on the streets, in shelters, in cars, or in vacant buildings — or who are in other unstable circumstances like “couch surfing.” Homeless youth are “accompanied” or “unaccompanied” depending on whether they are homeless with or without a parent.

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Every January, outreach workers and volunteers across the country survey people experiencing homelessness. This annual Point in Time Count gives a clear picture of who, on one cold night in January, is living in a shelter or on the streets. In 2019, the survey identified nearly 6,000 homeless people in Philadelphia. One in five individuals was under age 18 and one in 13 was an 18-to 24-year-old. This does not include those who were couch surfing, estimated to make up half of the youth with insecure housing.

Even one homeless youth is one too many. How do we recognize those who are at higher risk for ending up on the street? Teens who have dropped out of high school are over four times as likely to lose housing, and those identifying as LGBTQ are over twice as likely. Two thirds of homeless youth suffer from mental health problems, a third struggle with substance abuse issues, a third have been in foster care, and half have been in the juvenile justice system.

Gwen Bailey, executive director of Youth Services, Inc, a local organization that runs an emergency shelter for teenagers, said youth who are homeless during the pandemic “are experiencing increased anxiety because they don’t know what’s next. Things are paused and they’re hovering over problems.” For the teens she works with, that often means postponed meetings and court hearings to decide their futures.

Bailey emphasized the emotional complexity of those staying at Youth Services. She said “every single teenager in the emergency shelter has experienced trauma of some sort, and when they are labeled as ‘homeless’ it re-traumatizes them.” She added, “I can remember this young man saying to me, ‘I’m sick of people saying we’re homeless.’ These young people have the same needs, the same goals, the same aspirations, and the same wants as every other teenager.”

If you know a teenager who needs help, “The Safe Place” operates a national crisis hotline (888-554-2501) 24 hours a day, seven days a week for those in need of emergency shelter.

Dina Zaret is a fourth-year medical student at Sidney Kimmel Medical College at Thomas Jefferson University. Rima Himelstein is an adolescent medicine specialist at Nemours/Alfred I. duPont Hospital for Children.