Voices from the Field Blog: Peer Support for Veterans Involved in the Justice System

by Darby Penney
May 29, 2014

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Homeless and Housing Resource Network contributing writer Darby Penney highlights the work of MISSION DIRECT VET (Maintaining Independence and Sobriety through Systems Integration, Outreach and Networking-Diversion and Recovery for Traumatized Veterans), which is a treatment program that serves veterans with co-occurring mental health and substance abuse issues.

“Shortly after the opening of the pilot site for our Jail Diversion-Trauma Recovery program, we quickly realized that one of the veterans involved in our program was homeless,” said David Goldstein, a team member of MISSION DIRECT VET in Massachusetts. “So the two of us got in the car and drove over to the local veterans’ shelter. We were introduced to the staff, and after the veteran told his story of how PTSD (post-traumatic stress disorder) contributed to his homelessness and his involvement with the courts, he was welcomed with open arms. The warmth present in the room brought me to tears. This was my first, and certainly not my last, experience with a homeless veteran and a welcoming shelter.”

The MISSION DIRECT VET program began with a single pilot site in Worcester, MA in 2009 that has expanded to two other sites in the state. Its goal is to serve veterans with mental health, substance abuse, and other trauma-related issues who are involved with the criminal justice system in order to divert them from jail into trauma-informed services. Originally funded through a five-year SAMHSA grant, the program continues now with state funding.

MISSION-DIRECT VET is a manualized treatment program for people with co-occurring mental health and substance abuse issues. It is the primary treatment service that is offered, and it is supplemented by 12 months of peer support services and case management. Referrals and linkages to vital community-based services such as veterans’ services, vocational and independent living skills programs, family support, and transitional residence programs are also central to the program.

Veterans are over-represented among people experiencing homelessness (e.g., in 2010, veterans accounted for about 10 percent of the total U.S. adult population and 16 percent of the homeless adult population). The good news is that homelessness among veterans has declined by an estimated 25 percent since 2007, according to the U.S. Department of Housing and Urban Development’s 2013 Annual Homeless Assessment Report. 

The National Alliance to End Homelessness reports that homeless veterans include service members from every era since World War II. While Vietnam-era veterans are at greater risk of homelessness than those from other eras, veterans of recent conflicts are more likely to be more gravely disabled. One recent study found two-thirds of homeless Iraq and Afghanistan veterans were diagnosed with PTSD, a rate far higher than earlier generations of veterans (Tsai et al., 2013).

This is where programs that offer a strong peer support component can be especially helpful. MISSION-DIRECT VET team member David Goldstein is a Vietnam veteran, a trauma survivor, and person in recovery. He provides the veterans who participate in the program with one-on-one peer mentoring, facilitates veterans support groups, and connects veterans to resources in the community. Perhaps most importantly, he listens, sits with people who are in trouble, and offers a non-judgmental perspective of someone who has been through many of the same experiences as the people he serves.

While Goldstein has seen the success stories of many of the veterans who have been through the program, he cautions that there are still areas for improvement. “Veterans who go into homeless shelters are often there, directly or indirectly, because of substance abuse issues with drugs and/or alcohol that are often related to PTSD. Because of the rules of the shelters subsidized by the VA (Veterans Administration), they may be asked to leave due to abusing the very substances that got them there to begin with. To keep these veterans from falling back into homelessness, the protocols for these shelters must change,” he said.

References
Henry, M., Cortes, A., & Morris, S. (2013). The 2013 Annual Homeless Assessment Report (AHAR) to Congress. Washington, DC: The U.S. Department of Housing and Urban Development, Office of Community Planning and Development.

National Alliance to End Homelessness. (n.d.). Veterans. Washington, DC: National Alliance to End Homelessness. [Website article]. Retrieved from http://www.endhomelessness.org/pages/veterans

National Center for Veterans Analysis and Statistics. (2012). Profile of Sheltered Homeless Veterans for Fiscal Years 2009 and 2010.  Washington, DC: The U.S. Department of Veterans Affairs.Retrieved from http://www.va.gov/vetdata/docs/SpecialReports/Homeless_Veterans_2009-2010.pdf

Tsai, J., Pietrzak, R. H., & Rosenheck, R. A. (2013). Homeless veterans who served in Iraq and Afghanistan: Gender differences, combat exposure, and comparisons with previous cohorts of homeless veterans. Administration and Policy in Mental Health and Mental Health Services Research, 40(5), 400-405.

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Voices From the Field Blog: Alcohol Management: Reducing seizures, falls, and brain injury among alcohol dependent people

by Livia Davis
March 25, 2014

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Homeless and Housing Resource contributing writer Livia Davis details the work of Downtown Emergency Service Center (DESC) in Seattle, Washington in implementing Alcohol Management as a harm reduction strategy and the need for research to determine if Alcohol Management results in better health outcomes, improved safety, and less victimization.

To limit potentially life-threatening effects of alcohol withdrawal, including seizures, hallucinations, falls resulting in head trauma or broken bones, and victimization due to acute intoxication, Downtown Emergency Service Center (DESC) in Seattle, Washington decided to implement Alcohol Management as a harm reduction strategy for eligible residents in their 1811 Eastlake supportive housing facility that serves “formally homeless men and women with chronic alcohol addiction.” Alcohol Management is offered to residents who are at risk of harm during periods of alcohol withdrawal or other dangerous behavior associated with their alcohol use. Not without controversy in the local community, DESC is committed to improving the quality of life for program participants, increasing their housing stability, and reducing the harm of alcohol withdrawal. Currently, about 16 out of 75 residents at 1811 participate in Alcohol Management indicating it's not an intervention best suited for everybody. At the Housing First Partners Conference in Chicago held on March 13, 2014, DESC explained how Alcohol Management works.

Using Motivational Interviewing, staff members first approach potential program candidates to facilitate the completion of a client’s alcohol intake goals. Questions are asked to develop an agreement for each participant, including: Do you drink more in the morning to stave off withdrawals? How many drinks do you need to avoid feeling sick? How long between drinks do you begin to go into withdrawal? What is your goal? Do you want to cut back? Based on responses, an individual alcohol management plan is developed and signed by the participant and DESC.

The plan details the dosage of alcohol to be administered by staff at certain intervals. For example, the plan may detail 2 beers at 8 a.m., 12 noon, 4 p.m., and 8 p.m. every day. At the agreed-upon times, the Alcohol Management participant then proceeds to the staff desk and is given the agreed-upon amount of beer.

To implement Alcohol Management, a number of processes and infrastructure and training need to be developed or be in place. Clients need to have a steady income source and a payee. Program funds are not used to purchase alcohol, and both the participant and their payee agree to provide needed funds according to the alcohol-purchasing schedule. Purchasing, storing, and dispensing alcohol dosages also require a number of processes and safeguards that 1811 Eastlake has developed over the last seven years, including locked cabinets, training of staff, and dosage tracking charts.

DESC collects anecdotal data on outcomes from the Alcohol Management program and reports the following:

  1. Increases stability: The chaos of binging and withdrawing occurs less often and provides participants with a sense of stability and control they have not experienced in a long time. This increased stability is often associated with the development of new goals, including changing long standing drinking patterns;
  2. Allows for intervention in case of alcohol withdrawal: With dosage tracking documentation sheets (e.g., if a participant misses his/her dosage for 24 hours) staff will go and check to be sure that the person is not experiencing harmful effects due to withdrawal;
  3. Fosters engagement: Regular conversations can be maintained that increase awareness and stimulate articulation of goals, and allows for engagement around alcohol use to be a centerpiece of ongoing treatment planning;
  4. Slows health decline: Alcohol management is not a magic bullet but getting less intoxicated means more engagement with health providers to address chronic and acute health need;
  5. Likelihood of a decrease in alcohol use over time for some participants. While often not the inital goal, a number of residents participating in alcohol management have cut back or even stopped drinking altogether; and 
  6. Risk of loss of independence: Some participants get dependent on staff through structured alcohol dosage, and DESC recognizes that loss of independence is not necessarily a positive outcome, although has seen the same participants rediscover abilities to better integrate with community members or service providers through the stability afforded by participating in alcohol management.

DESC staff discussed the need for research to determine if Alcohol Management results in better health outcomes such as improved safety (e.g., fewer falls and reduction of instances of brain injury) and less victimization.

For additional information, please click on www.DESC.org or contact
Noah Fay at NFay@DESC.org or Hector Herrera at HHerrera@DESC.org.
 
Sources for this article include: www.DESC.org and the Housing First Partnership Conference workshop on March 13, 2014: Alcohol Management: A Practical Harm Reduction Intervention conducted by Noah Fay and Hector Herrera from DESC.

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Voices From the Field: Walking In Daylight

by Steven Samra
February 27, 2014

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Homeless and Housing Resource contributing writer Steven Samra opens up about his mental health recovery journey and from his perspective what peers need to help into support others who are experiencing acute symptoms overcome ostracism, shame, and misinformation.

I “aged out” of the mental health system at 17, after having spent much of my adolescence under the influence and control of the amphetamine Dexedrine, which was used to treat Attention Deficit Disorder for “hyperactive” children in the days before Ritalin and Adderall. For the following 23 years, I wandered from job to job, relationship to relationship, and street drug to street drug, trying to calm the anxiety and the uncontrollable need to move, talk, think, and do something—anything. I suffered classic hypomania symptoms of bipolar disorder throughout my adult life, and eventually gravitated towards those drugs to help me slow down the noise and activity in my mind and body. 

Throughout those decades, the idea of experiencing a mental health condition never really occurred to me. After all, I had been “cured” back in the 70’s, and there was no way I was “crazy”; I was just “high energy,” which frankly served me quite well until I would “overamp” and make inappropriate decisions due to my inability to gauge and tailor/control my own behavior and responses effectively.

Worse, even if I would have been self-aware that I was experiencing a mental health condition, I would have never told anyone because being branded with a “mental illness” brought with it almost certain scorn, ridicule, ostracism, and blatant discrimination from those in my immediate circle and the larger community. It wasn’t until I entered counseling and a Methadone maintenance program in early 2000 that I began to understand there was something underlying my compulsion to use, a need to self-medicate symptoms of my mental health challenges away. 

Fast forward 15 years later and today I am in the final stages of a medically supervised withdrawal from Methadone, but more importantly, I am acutely aware that I suffer from some mental health challenges, exacerbated by trauma experienced as a youth and the repeated retraumatization—accompanied by “collateral” trauma—of decisions and behaviors related to a life spent in addiction. 

Today, I wear the scars of my addiction and underlying mental health conditions on my sleeve. I do so because when I was open to and seeking treatment, I didn’t ask the service deliverer I approached whether they were “addiction” or “mental health.”  I asked, “can you help me figure out what is going on inside?” Unfortunately, what I found was that very few were able to work with me on both fronts and that treatment delineation, to a large extent, continues in provider organizations today. Strides have been made, to be sure, but we as providers, as people in recovery, and as people needing the support of both groups, are still seemingly light years from effective and complimentary dual treatment options. Worse, the discrimination, ignorance, and fear of those experiencing a “mental illness” are still rampant in our communities and show little sign of abating anytime soon.

To help combat this, I and many others now talk openly, freely, and regularly about our “co-occurring” disorder and work daily to raise awareness, reduce discrimination, and promote mental health because with mental health comes not just recovery from the condition, but a liberating freedom, self-esteem, and genuine self-worth as well. We stand as a testament, along with millions of others—colleagues, friends, and peers—that recovery from both addiction and mental health challenges is not only possible, but to be expected. 

From my perspective, what my peers need to do to help support those who are both in recovery and experiencing acute symptoms is simple:

  • Provide easy to understand information that helps us identify and understand what’s happening to us as we endure our mental health challenges;
  • Offer real treatment and “return to life” options that are tailored to—and driven by—our complex needs and conditions; and
  • Suggest opportunities to join our larger community without fear of discrimination, verbal and/or physical abuse, and/or marginalization.

We are making progress every day, and the more we share about our lived experience and our journey into recovery, the more we raise awareness, smash stereotypes, and reduce the ignorance associated with mental health issues. Make no mistake; however, we still have a very long road to travel, and it will be up to us to walk in the daylight along this path so that others are unafraid—and in fact, empowered—to join us.

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Voices From the Field Blog: Will You Still Be Mine?

by Rachael Kenney
January 27, 2014

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Homeless and Housing Resource Network contributing writer Rachael Kenney illuminates the challenges that couples experiencing homelessness face in forming connections with others as well as redefining intimacy in their daily lives.

Mark: “Well, if you had three wishes, what would they be?”
Paul: “House. Job. Baby.”

Watch a few of Mark Horvath’s videos about couples and it immediately becomes clear: Couples that are homeless have a similar desire for intimacy as couples who aren’t homeless. Not just physical intimacy, but emotional intimacy; a sense of closeness and emotional warmth. But so many of the ways that we build intimacy aren’t accessible while homeless. There is no kitchen in which to cook for one another, no TV to cuddle in front of, and no place to come home to together.

Paul, and his girlfriend Katie met when they were both already living on the street in London. Like many young folks on the street, they were not in school and could not secure employment, so they built intimacy by spending all of their time together, searching for resources, panhandling, and just waiting for tomorrow. One might suggest that these relationships are dangerous, that the young people glamorize homelessness and getting into relationships will just perpetuate the situation. There is some truth to this claim, as couples have more difficulty getting off the street because they often disregard housing options that won’t allow them to stay together. But dating while living on the street can also have a positive impact. For Katie, homelessness and her relationship with Paul contributed to her sobriety.

Others, like Edward and Anita, were married for twenty-two years before they became homeless. It appears that their strong foundation is what carries them through episodes of homelessness. And then there are Maria and Neville:

Maria: “[I’d wish for] a cheap little car so I can get around, and a wheelchair. Actually, a wheelchair is my priority.”
Neville: “And each other.”
Maria: “And each other. We’ve been married for four months, been together for five years. And I’ve never been happier in the sense of a relationship.”

Even with the stressors of being homeless together, these people value their relationships and work hard to maintain them. Their relationships remind them that they are valuable and worthy. They are important in at least one other person’s life.

When night falls, these three couples can be found “sleeping rough,” or on the street. Some of the reasons they do this are the same reasons that single people avoid shelters: theft, violence, and strict rules. But couples also sleep outside because most shelters can’t accommodate couples, even same-sex couples, in the same sleeping quarters. Sleeping rough may be a way to hang on to a sense of normalcy. Regardless of whether or not they are physically intimate during this time together, it gives them the opportunity to build emotional intimacy. And as they close their eyes and drift off into sleep, they can almost believe that they are holding one another in bed in their own home. And that the light from the stars and the streetlights is filtering in through the windows, rather than directly down on them from above.

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Limitless Potential

by Valerie Gold
December 20, 2013

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Homeless and Housing Resource Network contributing writer Valerie Gold recounts the experience joining a team of runners from Back On My Feet, an organization that uses running to help people experiencing homelessness change the way they see themselves and to achieve real change. 

So much of the work to address homelessness involves waiting: waiting for people’s names to rise to the top of various lists, waiting for apartments to pass inspection, waiting for replacement documents, approvals, or funds. Waiting, and its accompanying frustrations, contribute to the sense of powerlessness and hopelessness endured by many people experiencing homelessness.

As 2014 begins, Back On My Feet (BOMF) is not waiting, but instead is racing forward with its mission to use running to help people experiencing homelessness to realize their own power and to achieve real change. With the addition of two new chapters in the last twelve months, BOMF now operates running teams based in homeless shelters in eleven cities across the country. Nearly 400 individuals experiencing homelessness are running with these teams each month. Eighty-two percent report that their health is good or excellent, and 94 percent describe themselves as hopeful about their futures. And so far, 46 percent of BOMF runners have obtained employment, housing, or both.

The Monday before Thanksgiving, I joined the team of BOMF runners who live at the New England Shelter for Homeless Veterans for a pre-dawn run. The team assembled at 5:20 a.m. in the lobby of the shelter. The runners were easy to spot, bundled up in BOMF tracksuits and shod in bright new running shoes. As we waited for a few volunteers (referred to as "nonresident team members") to arrive, Eric,* a tall and friendly vet with an easy laugh, described the 5K race in South Boston that he had run the day before through a fierce wind and temperatures well below freezing. This was his first race, he said, and he almost stopped several times, but was urged on by Kathleen, BOMF’s Program Coordinator, who ran with him the entire way to set his pace and make sure that he achieved his goal of completing the event.

Once everyone arrived, we moved outside, formed a circle, did some jumping jacks to warm up, and then put our arms around one another and recited the Serenity Prayer. And then we were off. I settled in to run next to Joe, an elegantly-coiffed runner with a white goatee whose pace accelerated as the stars faded and the moon slowly set, until I nearly collapsed from trying to keep up with him. The physical suffering was worth it, as Joe was a great conversationalist, expounding upon the concepts of self-efficacy and mental toughness as I gasped and groaned and otherwise generally displayed my lack of any toughness – mental or otherwise. When I finally gave up and waved Joe on, I was immediately joined by a group of women from the Common Ground Team. One of them had her arm in a sling, and all of them shivered cheerfully as they introduced themselves and told me how long they had been on the team. I had no idea which of them were people experiencing homelessness and which of them were nonresident team members. This is part of what works about BOMF– by building teams of runners instead of groups of givers and recipients of support, of assistance, of anything but fellowship and mutual encouragement and accountability, BOMF makes it possible for people who have experienced terrible things, including great isolation, to resocialize and reconnect with others, while building or rebuilding key aspects of their identities: as athletes, teammates, morning people, or just plain survivors. At the same time, nonresident runners have the opportunity to connect in a meaningful and immediately rewarding way with people with whom they might otherwise never be engaged.

After my run, I followed the Boston BOMF staff back to the offices that they occupy, courtesy of Comcast. Victor, Kathleen, and Allison, all fearsomely fit, energetic, and passionate about their work, described their goals for doubling the number of BOMF runners in Boston, and for maximizing the positive impact of their program through strategic partnerships with homeless service providers and individualized supports for runners. They shared challenges, ranging from the easily addressed (advising a new team member that he should relieve himself before leaving the shelter as opposed to doing so mid-run in front of his teammates) to the more complex, like the heightened risk of substance abuse relapse, arrest, or other crisis occurring during the weeks between Thanksgiving and New Year’s Day. Running alone won’t eliminate this risk, of course, but it can help, and the accountability and sense of belonging that comes from being on a team provides further protection. As Victor, the Boston Executive Director, shared his plans for "over programming" with movie nights, dinners, and races during this period, his investment in the safety and success of each team member was clear.

BOMF is more than a novel idea or a promising practice. It is a reminder that the people we work with in outreach programs and homeless shelters have limitless potential for healing and growth. Running is a great way to tap into this potential. It changes a person from the inside out, and provides a daily demonstration of the lesson so eloquently articulated within BOMF’s vision statement: If we keep moving forward, we arrive someplace different, we arrive stronger and often as better versions of ourselves.

Of course, running is not the only way to move forward or fulfill potential. As 2014 begins, I challenge myself and my colleagues to stop waiting and take inspiration from BOMF to search for new and better ways to be reminded of the tremendous power that each of us holds within.

*Permission was granted by all of the individuals identified in this piece to share first names.

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Voices from the Field Blog: Reflections on Homeless Persons’ Memorial

by Lisa Sepahi
November 18, 2013

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Homeless and Housing Resource Network contributing writer Lisa Sephai details the significance of Homeless Persons Memorial Day that have been held annually since 1990 on the longest night of the year. These national events are aimed at raising awareness of the tragedy of homelessness and to remember individuals who have died on the streets.

Nancy* was 54 years old when she died of cancer. I first met Nancy at an overnight homeless shelter. She was bubbly and happy-go-lucky, her bright personality stood out despite her dire circumstances. Nancy spent the previous four years living on the streets after losing her job as an accountant. Shortly after I met Nancy, she was offered permanent housing through a Housing First program. 

This housing opportunity could not have come soon enough; shortly after becoming housed, Nancy learned that she had terminal cancer. Fortunately, Nancy was housed when she died, but the years on the streets had a significant impact on her health and her ability to seek the treatment that she needed to diagnose and treat her illness. Nancy's story is not unique; however, Nancy was fortunate to die in the comfort of her own home with her friends around her. Many people experiencing homelessness are not as fortunate and die on the streets.

It is for this reason that each year The National Coalition for the Homeless, the National Consumer Advisory Board, and the National Health Care for the Homeless Council encourage communities to host public events on December 21 to remember those individuals in our communities who have died homeless in the past year.  Homeless Persons Memorial Day events have been held every year around the first day of winter and the longest night of year since 1990. 

Homeless Persons Memorial Day raises awareness of the tragedy of homelessness and serves to stand as a public memorial in recognition of friends and neighbors who have died on the streets. The National Health Care for the Homeless Council provides toolkits that include an organizing manual, posters, and fact sheet to help groups organize events every year.

According to The National Health Care for the Homeless Council:

  • Homelessness dramatically elevates one's risk of illness, injury, and death.
  • The average age of death of a person experiencing homelessness is about fifty years, the age at which Americans commonly died in 1900.
  • People experiencing homelessness suffer the same illnesses experienced by people with homes, but at rates three to six times higher.
  • Persons experiencing homelessness die on the streets from exposure to the cold.
  • Poor access to quality health care reduces the possibility of recovery from illnesses and injuries.
  • Persons experiencing homelessness die on the streets from unprovoked violence, also known as hate crimes.

Homeless Persons Memorial Day is an opportunity to bring attention to an every day tragedy. It stands as a testament to the vital importance that housing plays to the health, well-being, and safety of all people.

For more information on events in your area or if you are interesting in hosting your own event, visit: http://www.nhchc.org/resources/consumer/homeless-persons-memorial-day/ and http://www.nhchc.org/wp-content/uploads/2011/09/2013-national-homeless-persons-memorial-day-
organizing-manual.pdf


*Name has been changed

Source: National Health Care for the Homeless Council (2006) "The Hard, Cold Facts About the Deaths of Homeless People" http://www.nhchc.org/wp-content/uploads/2011/09/HardColdFacts.pdf


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Voices From the Field: Bearing Witness to Self-Sufficiency

by Kevin Lilly
September 24, 2013

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Youth homelessness is a major problem. There are many young people on the street on a given night with nowhere to go and no access to adequate shelter. That being said, with every social injustice in the world today, you have people who work tirelessly to fight for change. These activists don’t do this for any attention or reward, but because they want to see a difference and see an eventual end to a perpetual problem.  Bridge over Troubled Water (BOTW) is an organization that since its inception in the 1970’s has helped over 80,000 homeless and runaway youth out of the grips of poverty and into self-sufficiency. This shelter may look like an ordinary cozy house like its neighbors on the street, but the power within is something that you just need to visit for yourself to experience.

One of the case managers, Theresa Heisler known by everyone as “Terri”, a 23-year veteran, was gracious enough to give me a tour of the shelter. At this particular location, they deal with four primary groups of young adults: males, females, runaways, and young mothers with children. Each group has their own housing area, but they come together for community dinners and social events. When I arrived, I spent most of my time in the young mothers building. During the tour, I noticed the housing itself is well kept. Fridges are filled with healthy choices, and the mothers have a monthly trip to BJ’s, a wholesale warehouse grocery and retail store. The bedrooms are tidy and the young people are encouraged to keep the house clean and organized. I could go on about the housing itself, but the power of this shelter isn’t so much in the housing as much as it is the people in it.

These mothers are nothing short of amazing young women. As a young man I can’t imagine all the work that goes into raising a child. These young women also work (some working multiple jobs) and complete assigned house tasks and attend classes. It’s inspiring to hear their stories of survival to make it to where they are today. A few stories Terri told me were tough to hear. One mother shared that she had become homeless after an unfortunate incident forced her out of her family’s house. Then she lost custody of her son. She ended up coming to the BOTW shelter where she worked hard to get her son back. She continues to work 40+ hours a week at popular restaurant chain while enrolled in a BOTW GED program as well. This is one of many powerful stories that I came across in that shelter. These young people have been through a lot. As Terri put it, “It’s like they are carrying the weight of the world on their shoulder”. What I admire about all these young people is that although life has them on the ropes and is hitting them with everything it got, they continue to fight and endure.

What BOTW hopes to do is not only to offer these young people in need safe and adequate shelter, but to teach skills so that they could one day successfully make the transition from shelter to permanent housing. Young people staying in the shelter are encouraged to make preparations for independent living. They are assigned house tasks specifically to ensure they have a good foundation once they move out and will need to perform household duties in their own apartment. The shelter also provides the young people with resources to not only get on their feet, but have fun as well. Throughout the buildings, there are bulletin boards filled with information about free events, job postings, employment opportunities, as well as healthcare resources.

The staff members are incredible men and women. I didn’t get a chance to meet all of them but Terri, Cynthia, and Steve are three people who genuinely care and work tirelessly, to help young people. While some people might see these young people’s present circumstances alone, staff members at BOTW see their untapped potential. Shelter staff members are present 24 hours a day, and are really invested in these young people’s lives. As Terri put it, “We try to find out who they are, what they like, help them with their self esteem, and meet their goals so that one day these kids could have the life they dream about.”

While on the tour I came across an image that I feel does a great job in summing the program, the people, and the shelter. This image was a photo taken during a recent graduation. In the picture it shows one young mother smiling proudly in her cap and gown with her handsome son dressed up right by her side. The picture is just one of many successful stories that come out of this house. It shows that although the odds appear to be stacked, one can always overcome. This whole experience has made me even more grateful for the support system and opportunities I have in my life. It also energizes me to do more as far as being an advocate for unaccompanied homeless youth. As a young person I know I would not be where I am today had it not been for the great support system around me.

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Voices From the Field: Housing First Fixed in my Memory

by Lisa Sepahi
August 28, 2013

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I have been inspired by the many stories of the people who I have encountered in the nearly twenty years of working in the field. However, there is one story in particular that has motivated me over the last several years. Prior to joining my current employer I was the lead for homelessness strategic planning for a Continuum of Care. 

 

I met Martin* at a Project Homeless Connect event. Among all the hustle and bustle of people streaming in, seeking services, lining up for dental care, or signing up for legal aid, I saw Martin. He walked into the church community room with a gruff look on his face, paying no mind to anyone. Martin had wiry long blonde hair, which seemed to be growing out of control; he immediately sat right down to get his haircut. Within minutes he looked like a new man, as his demeanor changed and a smile began to grow on his face. It was at this moment that Martin became fixed in my memory.

 

Martin’s story became clearer when I saw him drinking on a picnic table near my office parking lot. At this point, I realized that Martin was living on a hill above my office. I would see him every day from my office window; the irony of this was not lost on me, as our offices housed not only myself-- charged with organizing a community-wide response to homelessness-- but the administrative offices for Health and Human Services. I eventually learned more about Martin through connections with the local day center providing case management. Martin was a Vietnam veteran; he had been homeless for over ten years and was suffering from substance use disorder. I also learned Martin’s routine by observing him out my window, where I noticed that he would spend much of his time during the day drinking at the picnic table. On days that I would not see him I would worry and call his case manager to learn that he was in jail or his tent had burned down. 

 

Although Martin was one of many individuals and families that I came to know over the years, Martin was a constant reminder of the need to do more to find permanent options for persons who are chronically homeless with substance abuse problems. Martin became the inspiration for the introduction of a new Housing First program. I was able to use Martin’s story and examples of the success of the Housing First model in other communities to secure funding for a program which would permanently house the most vulnerable chronically homeless individuals in the community with no conditions placed on sobriety or participation in services. 

 

Once the program was up and running it took some time for Martin to consider housing, but he is today successfully and happily housed. Martin has engaged more in services and has cut back on his drinking.  He still has a drink at the same picnic table, but at the end of the day he has a safe, stable foundation from which to continue to make positive changes in his life. 

 

*Martin’s name has been change to protect his identity.

 

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Nashville Changes Strategy to End Homelessness

by Steven Samra
August 06, 2013

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In 2005 Nashville joined many other cities in the development and implementation of a 10-year plan to end homelessness. Unfortunately, despite the best intentions, Nashville has, like many American cities, struggled to accomplish the goal. A cadre of obstacles and barriers, including, but certainly not limited to scarce resources, reliance on “readiness” as a precursor to obtaining housing, a closed Homeless Management Information System, lack of affordable units and housing vouchers, all contributed to the challenge of procuring housing.  A lack of coordination among area behavioral health providers exacerbated these challenges, and frustration and hopelessness were increasing within the homeless community with each passing year.  

Thanks to the efforts of a new Executive Director at the Nashville Metropolitan Homelessness Commission and a committed team of Commissioners, partners, and volunteers, a partnership with the 100,000 Homes Campaign, and a collaboration of several local providers and faith-based organizations, the situation appears to be changing for the better.  

On May 29-31, 2013, twenty teams comprised of over 100 community volunteers canvassed the streets and campsites of Nashville, Tennessee, using the Vulnerability Index to survey and create a priority list of individuals experiencing street homelessness who are most at risk of premature death if they remain homeless. The Vulnerability Index, created by Dr. Jim O’Connell, President of the Boston Healthcare for the Homeless program, identifies those who have been homeless the longest and are the most vulnerable. In addition to gathering the names, pictures, and dates of birth of individuals sleeping on the streets, the teams also captured data on their health status, institutional history (jail, prison, hospital, and military), length of homelessness, patterns of shelter use, and their previous housing histories.

A heavily attended community meeting was held on June 4, 2013, to discuss the results of the survey and kick off the start of a new campaign, “How’s Nashville”. The immediate goal of the campaign is to house 200 of the most vulnerable and chronically homeless into housing within 100 days. Once this is completed, How’s Nashville will continue the effort to house the city’s most vulnerable members with the ultimate goal of ending homelessness within the city by 2015.  Although using a Housing First approach is often more cost effective than alternate methods, and certainly more so than managing homelessness on the street, there are still costs associated with providing housing to those experiencing homelessness.  

Community members rose to the financial challenge associated with the campaign, donating $36,000 during the June meeting to help defray move-in costs associated with the transition from street to home.  Outreach workers began immediately moving individuals identified as high priority into housing at the end of the meeting, and invited attendees to walk with them to a welcome home celebration. Through the city’s efforts, one individual was identified as “most vulnerable” and was moved into housing after more than 7 years of life on the street.

The campaign is off to a strong start with 43 people successfully housed and supported during the month of June.  Conversely, from January to May 2013, just 19 people experiencing homelessness were placed into housing.  uly is also off to a solid start and should meet or exceed the minimum number of placements needed to meet the final housing goal of 200 people housed within 100 days.  

Nashville’s homeless population may finally have reason for optimism instead of pessimism.  There will continue to be challenges associated with scarce resources and the city’s approach is far from perfect.  Clearly however, Nashville has turned a corner and embraced a new approach that is proven to dramatically reduce homelessness.  With the momentum of the How’s Nashville campaign firmly pushing the effort forward, for the first time in many years, Nashville is housing those experiencing homelessness in a systematic, logical, and coordinated manner. The future appears brighter for the city’s most vulnerable residents than it has been for a very long time.

Interested in being a HRC Guest Blogger? Email us at generalinquiry@center4si.com.

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Category: General | Guest Entry

From Different and Discredited to Valued and Hopeful

by Gloria Dickerson
July 03, 2013

Image of Gloria Dickerson

Sitting in my living room, sipping on a cup of “just right” coffee and glued to the television, I begin my morning’s laughing until it hurts. On this day, Steve Harvey ends his segment with an even more hilarious joke. And, I think to myself, “what a great start to the day!”

Excited for more hilarity, I was surprised when the program sudden shifts in tone from happiness to somberness. Noah, a 12 year-old, round-faced, handsome boy poised beyond his years is introduced. He quietly talks about what it is like to be deemed different and discredited—a target of bullying: “I was thinking of committing suicide after the kids kept bullying me. They called me ugly… I didn’t think anybody cared. I was going to kill myself on my 13th birthday. I thought to myself who ever said, ‘Words don’t hurt?’”

Steve asked Noah’s mother, “How is it to hear this from your son?” The sadness in her voice was as striking as her words, “I had no idea what he was going through. I found out when I received a call from one of his friend’s mother. This past weekend he had posted on his Instagram account that he was planning to commit suicide on his birthday. He also posted images of his arm where he has been cutting himself for the past two months. My heart sank. I knew I had to do something. We immediately took him to the hospital.”

His mother continued, “While waiting in the ER, I took to Facebook. Noah has been dealing with bullying for the past year. He has been feeling alone and left out, ostracized from old friends and a misfit among new kids. Noah is getting treatment, but he needs people to rally. Which is why I've created the website Letters for Noah and a Facebook Page.”

Noah continued, “Thousands of people I didn’t even know sent me cards and e-mails telling me to hang in there. I didn’t know people cared.” When he was asked why he wanted to tell his story, he said, “I wanted other people to know that they are not alone. Other people will help you!” 

Noah has turned his experience of victimization into one of empowerment. Strangers reached out to him with loving words. Their support helped Noah feel reconnected. Noah’s story reminds us of the power of receiving kind words. The support Noah received could be defined as a “holding environment”—a community of individuals who spoke with compassion and hope for his recovery that became nurturers who soothed his pain. Noah actively accepted this show of love and is now demonstrating how to use his story to help others. Stories can be a gift that keeps on giving by connecting us out of our isolation. Words of support by strangers created a loving community, a container of love that held and lessened this young boy’s pain. Noah’s story has the power to warm our hearts. I believe that suffering is diminished when we witness love in action. This kind of love is how stigma, hate, and fear are transformed.

Noah’s story is an example of the transformative and restorative power that hope and access to an inclusive community can provide. People who experience homelessness, mental illness, trauma, and/or substance use conditions are often met with stigma, discrimination, and prejudice—all of which are forms of bullying. Noah has shown us what helps. As strangers, professionals, and lay individuals, each of us can reach out, include others, show care, and share stories to form a community that provides a lifeline and roadmap to recovery. I believe that people are our greatest resource and source of healing and hope.

Additional Readings:
Chaudoir, S. R., Earnshaw, V. A., & Andel, S. (2013). “Discredited” Versus “Discreditable”: Understanding How Shared and Unique Stigma Mechanisms Affect Psychological and Physical Health Disparities. Basic and Applied Social Psychology, 35(1), 75-87.

Interested in being a HRC Guest Blogger? Email us at generalinquiry@center4si.com

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Category: General | Guest Entry