Homelessness Puts the Sin in “Sin City”

by Susan Milstrey Wells
May 21, 2013

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Homeless and Housing Resource Network contributing writer Susan Milstrey Wells shares her observations about the stark contrast between the opulence of Las Vegas, its citizens who are homeless, and her uneasiness about how to respond.

I recently returned from attending a conference in Las Vegas. It was my first trip to the aptly named Sin City, where every manner of decadent behavior is on display 24/7. It didn’t take me long to discover that Las Vegas isn’t my kind of town. I don’t drink, smoke, or gamble. I do love to shop, but the prices in Vegas are eye-popping. You can spend $400 to $800 a day on a pool cabana, complete with television and a private cocktail waitress. Or you can order a $1,000 sundae covered in 23K edible gold leaf served with an 18K gold spoon. You get to keep the spoon.

But you don’t have to look far, amid the opulence and the excess, to find the sadder, seamier side of Vegas. On every overpass, street corner, and grand entrance to an even grander hotel and casino are people whose luck has run out. People who are homeless in Las Vegas are in stark contrast to their surroundings. I’ve been in major cities—New York; Washington, DC; San Francisco. I’ve seen people who are homeless. But this time they really got to me.

After 25 years of writing about homelessness, I know that giving money to people I see on the streets isn’t a good idea. But I wanted to help. I wanted to give twice what he was asking to the man whose sign read, “Girlfriend locked in pay toilet; need 50 cents to free her.” I thought his creativity surely was worth $1. Or the man whose sign said simply, “Trust me, this sucks.” Undoubtedly his honesty was worth some help.

I kept my wallet closed, but I couldn’t get these people out of my mind. And a little bit of research revealed that I was only seeing the tip of the iceberg. According to the U.S. Department of Housing and Urban Development’s (HUD’s) 2012 Point-in-Time Estimates of Homelessness, Las Vegas has the fifth largest number of homeless people in the country, at more than 8,700. Nearly 65 percent of these individuals are unsheltered, but many of them you never see.

In his book Beneath the Neon: Life and Death in the Tunnels of Las Vegas, author Matthew O’Brien tells the story of people who live in the tunnels under the Las Vegas strip. Built to protect the desert from flash floods, they are now home to people like Steve, who moved underground after a drug problem left him homeless. Profiled by ABC’s Nightline program in 2009, Steve said he got clean when he met his fiancée, Katherine. Steve and Katherine slept by day—under Caesars Palace, where my room cost $200 a night. They played the slots in the evening, sometimes earning as much as $50 a day.

But the casinos are always the big winners. According to the Las Vegas Convention and Visitors Authority, in the first two months of this year alone, gaming revenue on the Las Vegas Strip was $1.2 billion. In 2012, the average visitor stayed three nights and wagered $485. This is in a city where the per capita annual income (in 2011 dollars) was $26,755 and 15 percent of residents live below the poverty line.

Perhaps things are getting better. In 2006, Las Vegas enacted its 10-year plan to end homelessness. And the city saw the third largest decrease in homelessness between 2011 and 2012, according to HUD.

Clearly, I don’t have any answers. And I’m not pure of heart. While in Vegas, I luxuriated in a bathroom that was as big as my bedroom back home. I fell in love with a $400 purse that I almost bought. But I wish I’d given a dollar, or maybe two, to the man who needed to free his girlfriend from the restroom. Mostly, I wish I’d had the courage, and the humanity, to look him in the eye and smile.

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Category: Guest Entry

I Am Not My Diagnosis

by Melissa Cogswell
April 22, 2013

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Homeless and Housing Resource Network contributing writer Melissa Cogswell shares her personal experience with mental illness—her struggles, her strength, and her realization that having a diagnosis does not mean that you are the diagnosis.

I have bipolar disorder.
 
It has taken me ten years, numerous doctors and therapists, many medications, countless relationships, and too many cycles through mania and depression to count (or even remember) to realize that I HAVE bipolar, not that I AM bipolar.
 
I was first diagnosed when I was nineteen. I was informed that I was bipolar and that if I wasn’t heavily medicated, I would kill myself. It felt like a death sentence; at least if I committed suicide, I would have some level of control. After I began the medications, I went from being a driven, curious, academically inclined person to a lump that slept twenty hours a day. I couldn’t read; I couldn’t think; I could barely focus to watch a 30-minute sitcom on TV.
 
I knew that I couldn’t handle a life I wasn’t living, so I stopped seeing the doctor. I stopped taking the medications. I began to self-medicate. I spent years cycling through mania and depression, occasionally seeking help from a doctor whose first inclination was to medicate me. No one wanted to hear what I wanted. I felt that, because I was ill, what I wanted didn’t matter. The doctors “knew” what was best for me. I had to obey or not receive treatment. I opted not to seek treatment.
 
In the summer of 2008, I found myself in the emergency room after being sexually assaulted. I was manic and I was scared. I asked for a doctor and I asked for medication; both were provided to me. I immediately liked Dr. S. She wanted to hear how I felt and not just prescribe me drugs. She listened to me. She didn’t just want to talk about my illness. In her office I talked about my hopes, my dreams, my goals, and my relationships. In her office I realized that I wasn’t my illness. My illness was, and always will be, a part of me, but it does not define me.
 
After several months working with Dr. S and taking medication I realized that it was not what I wanted. The drugs kept me from cycling, dulled my thinking, and had other impacts on my life that I wasn’t comfortable with. With trepidation, I asked her if we could begin to work towards managing my illness without medication. After listening to me explain how I felt I could manage my illness with the coping skills we had identified in our time together, she readily agreed.  She understood that this was my life and my illness, and it was her job to help me implement the choices that I felt were best for me.
 
Dr. S. helped me understand that I am not bipolar, but instead that I have bipolar disorder. She was the first doctor I worked with who understood that I was not my illness; that I had my own hopes, dreams, and goals; and, just like people without mental illness, I am allowed to decide what is best for me.
 
Interested in being a HRC Guest Blogger? Email us at generalinquiry@center4si.com.

 

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Category: General | Guest Entry

I Could Look People in the Eye

by Donna Wilbur
March 29, 2013

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Donna Wilbur collaborates with Homeless and Housing Resource Network writer Wendy Grace Evans-Dittmer to share her personal recovery experience. In this blog, Donna recounts how, with the support she received along the way, she can now “Look People in the Eye.”

I work at the Center for Psychiatric Rehabilitation at Boston University as a teacher. At first, I volunteered to teach a typing class. As I received positive reviews, I slowly began to fill in for other teachers who were out on leave or taking time off. After three years, I was offered the opportunity to teach a number of courses, including a computer course, Social Security Income courses, and a Navigating Recovery course that is comparable to developing a Wellness Recovery Action Plan (WRAP).

The Navigating Recovery course was comprised of developing an understanding of fitness, as well as learning the importance of connectedness and wellness. While I don't like to disclose on a regular basis, I choose to disclose when it will be beneficial because I believe that disability needs to be valued.

I was trained by Marilyn Copeland in Vermont and have worked at the Center for Psychiatric Rehabilitation for 13 years. Currently, I live and work as the House Manager at a women’s lodging house. All of the women in the house have psychiatric symptoms. They all work in professional careers and choose to live in the house where they receive support for their demanding lives. I have a third job working with a young adult man who has severe disabilities, which include hearing voices, obsessive compulsive disorder, and paranoid delusions.

I had my own darkest days before I entered the Center for Psychiatric Rehabilitation's Training for the Future course and began my recovery. I never thought that I could finish the program, but my father and my best friend supported me through this time. Prior to entering the program I had been on disability for ten years, had posttraumatic stress disorder symptoms, suffered from bipolar disorder, and was receiving trauma therapy. It was through my therapy that I learned of Bessel Van der Kolk's work at The Trauma Center in Boston. I went through several hospitalizations prior to enrolling in Training for the Future, but eventually completed my B.S.W. at Bridgewater State College with assistance from Massachusetts Rehabilitation, who helped me with the cost of books and transportation. Additionally, they paid for half of the cost of enrolling in Training for the Future, while Social Security, through the PASS program, covered the other half. I use much of this training at the Center now.

With the aid of a service dog—a miniature, wire-haired dachshund—I am able to get out of bed in the morning; she helps me not to disassociate. Lee Walmack, a mentor, once said when I thought I could not finish my program, "I hope you dance." When I think of where I am today, and where I have been, I know that I am able to dance. At that time I had no confidence, but by the end I could look people in the eye. I had hope.

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Category: General | Guest Entry

Where did you sleep last night?

by Rachael Kenney
March 04, 2013

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Homeless and Housing Resource Network writer Rachael R. Kenney recently volunteered for Denver’s annual point-in-time homeless count. In this blog, she recounts her experience and the important lessons she learned when she asked, “Where did you sleep last night?”

Did I really want to do this again? Two years ago I volunteered for Denver’s homeless count. I was stationed in an administrative building and the staff were all in a training that day so my volunteer partner and I only handed out one survey for the entire four-hour shift. I longed for my experience at the Boston count a few years prior, where volunteers take to the street on foot and in vehicles. We didn’t see anyone then, either, but at least it was a change of scenery. But I’ve been meaning to get more involved locally and they say that the best time is the present, so I signed up. I was pleasantly surprised.

We set up at a folding table in the hallway of an administrative building. Instead of us playing the role of eager young salespeople, nearly everyone who passed approached us to ask what we were up to. My partners and I would explain the homeless count and, much to my surprise, the person would usually sit down to talk with us, including: the nervous man who I was certain would say that he had housing—he didn’t; the young woman whose daughter was bouncing in her stroller—I wondered if offering her fruit snacks was a good idea; and the smiling young man whose son wore sweatpants and sweet little sneakers.

There were two people who stood out and tugged at my heart. The first was an elderly woman who was hearing impaired and didn’t have hearing aids. I’m hearing impaired and the thought of going without aids is scary, even just “thank you, please come again” can spiral into a stressful experience. Rather than read her the survey like we were trained to do, we handed it to her to fill out on her own. She told us about her day as she carefully checked off the boxes. When she reached the end she couldn’t remember what city she was in the night before and began to cry. I wanted so badly to walk around the table and hug her, but I didn’t think that was appropriate and I just sat there.

The second person was a man in his mid-30s. His sly smile and lanky gait reminded me of a goofy friend on a sitcom. He told us that he was supposed to check into detox that morning but he wasn’t clean so he needed to wait. It amazes me that, even though I’ve worked so hard to break down my stereotypes, it still knocks me off guard when someone is high and communicates so well; these beliefs are such a deep part of our psyches. He made an inappropriate joke; we all laughed. He was trying to get clean to be with his family; we all cried inside. He seemed genuine about wanting to change. We rooted for him as he strolled out into the cold and hoped that we were right.

Almost everyone I spoke to that day fit somewhere on the spectrum of homelessness. I reflected on the fact that I was only two miles from home in an affluent town that doesn’t seem to know poverty, yet here I was, surrounded by it. These were people who I wouldn’t give a second thought to if they were in line behind me in the grocery store or strolling past as I walked the dog. The afternoon was a stark reminder of the importance of open mindedness, of providing a spectrum of services, and of how important it is to ask the question, “Where did you sleep last night?”

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Katy Hanlon In Recovery: Certified Peer Specialist

by Katy Hanlon
February 04, 2013

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Homeless and Housing Resource Network writer Katy Hanlon recently trained to become a Certified Peer Specialist. In this blog, she and fellow writer Wendy Grace Evans-Dittmer collaborate to share her experience.

I have not always had a voice.

At the first of nine eight-hour classes to become a Certified Peer Specialist I met a Marine veteran. He introduced himself to me and expressed his thoughts on mental health recovery. He had applied to the program three times before being accepted, but never gave up. That impressed me—his conviction. We developed a friendship that was part of a larger community. I drove him home from class every week. I was connecting with someone I would not normally have the opportunity to meet. This tied back to our classes, where one of the things I learned was the value of difference. Peer Specialists, united in recovery, are all coming from unique places; this is an asset to the profession.

The Certified Peer Specialist (CPS) course I am taking is provided by The Transformation Center of Boston and funded by the Massachusetts Department of Mental Health. It is the only certifying program in the state. I initially took this peer-run course because I wanted to gain knowledge and experience to contribute to my work on SAMHSA’s Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS) initiative. I soon realized my strong desire to also give back to the peer community that has given me so much.

Recovery is difficult to define because its path is determined by the individual. With input from the community, SAMHSA offers a working definition that encompasses the four basic tenets: health, home, purpose, and community. Supporting the importance of community is the term peer itself. It is not possible to be a peer or a peer specialist in isolation. There must always be mutuality.

Not all states have certification programs for peer specialists and there is no national listing of programs. Georgia started their program in 2001 with the Georgia Certified Peer Specialist Project and they are key program contributors as other states look at certification. While there continues to be discussion about whether the certification process removes the “peerness” in peers, there are efforts underway to develop a set of national standards. The International Association of Peer Supporters, formerly The National Association of Peer Specialists, is bringing its voice to the table and BRSS TACS will offer a recovery framework. These efforts will be key as states continue to broaden Medicaid funding for CPS services.

Prior to learning about the Peer Recovery Movement, its historical context, and the opportunity to become a CPS, I experienced all of the traditional paths of treatment. My acceptance to the Boston University Center for Psychiatric Rehabilitation’s Training for the Future program changed my perspective as it introduced me to the concept of recovery, peers, and hope for the future. Yes, hope. I gained so much from my peers that I wanted to give back by sharing my own recovery story, which will always be a work in progress.

As part of the nine classes, we had a three-day retreat. Each day focused on specific modules of the curriculum developed by The Transformation Center. All of the modules supported the foundation of a CPS: Peer Support, “In” but not “Of” the system, and Change Agent. This retreat not only brought our class of 26 together, but by example gave me a sense of empowerment and purpose.

I have a voice now.

To find out if there is a Certified Peer Specialist training near you, reach out to local community-based Recovery Learning Communities, State Department of Mental Health, organizations such as The Transformation Center and New York Association of Psychiatric Rehabilitation Services (NYAPRS), or projects such as the Georgia Certified Peer Specialist Project.

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Giving Back in the City of Brotherly Love

by Marcella Maguire
November 07, 2012

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Marcella Maguire, Ph.D., of the Department of Behavioral Health (DBH) and partner in the Journey of Hope project in Philadelphia, has worked in recovery outreach programs for many years. Her work with Journey of Hope demonstrates a commitment to a recovery-focused system that provides support for long-term recovery and enhanced quality of personal and family life. This is a significant change from acute serial episodes of brief stabilization, and requires cooperation across many levels of service, family, and community. In her own words, she explains how the city of Philadelphia is ending homelessness, one person at a time.

Some questions are so simple and yet so complex at exactly the same time. “How do we end homelessness in this county?” is exactly that type of question. The simple answer is that housing ends homelessness. It’s that simple. It’s exactly that simple answer that Philadelphia’s Mayor Michael Nutter decided upon when he took office in January 2008 and decided to make ending street homelessness a priority for the City of Brotherly Love.

When we began the program we had no idea how it would work. The initial thought was that 200 people a year could come off the street, receive vouchers, and leave homelessness. But we knew people need supportive services and it is challenging to determine which supportive services are necessary for someone who is still living on the street. Limited resources make service matching important; you never want to give someone more services than they need because someone else needs them, too. On the flipside, you never want to give people too little services because that may set them up for failure. People experiencing chronic homelessness often have many failures in their lives. One more is not necessary.

BL had been living in the downtown train station for over five years. She lived on and off in the shelter system for three years before that. She had some mild mental health issues that life on the street made much worse. Over the winter, she used one of the winter overnight cafes, which are Philadelphia’s version of an overnight drop-in center. The cafe system gives people a warm dry place to sleep and engage with needed services in the morning. She made a good connection with staff at the cafe and they believed she would be successful in her own place with a voucher and a little support. She engaged with a case manager and began the housing process. Her unit was inspected twice before it passed and both delays made her ask the question, would she really receive housing? Eventually, before winter ended, she was able to move in and leave the train station. She still visits friends who remain and advocates for them, but she returns home every night.

We utilized Medicaid-funded supportive services of targeted case management, drug and alcohol case management, and peer supports. Openings that were created in homeless programming were held solely for people with a documented history of street homelessness.

Over three and a half years, my team of committed professionals helped move 587 people out of homeless programming and into their own apartments. Participants were required to participate in supportive services for at least one year prior to their lease being up and had to sign a document agreeing to that fact. Perhaps most importantly, everyone received an individualized recovery plan that matched their needs and desires, rather than a one size fits all approach. As such, the project had fewer participants who disengaged from services and we believe this increased our success rate tremendously. We implemented a monthly feedback form to check in and track housing outcomes such as paying rent, adhering to the terms of their lease, etc. If participants were experiencing challenges there was a process of reevaluating supports to assist them in maintaining their housing and recovery.

As of May 2012, 534 of the 587 remain leased, for a 91 percent housing retention rate. Of those leased, 82 percent have been leased up for at least 12 months. Many have been able to re-enter the work force and a number of them are now employed by the administrative system or provider agencies. Nothing makes this work more worthwhile than being able to organize and plan services with colleagues who have moved beyond their life on the street, engaged with their recovery, and are now giving back to the City of Brotherly Love.

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Category: Guest Entry

Becoming Trauma-informed, Agency-wide

by Jay Crowe
August 30, 2012

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Jay Crowe is the Behavioral Health Program Manager and Clinical Supervisor at Albuquerque’s Health Care for the Homeless, which is the recipient of a Grant for the Benefit of Homeless Individuals (GBHI) from the Center for Substance Abuse Treatment (CSAT). Recently, Jay and three other members of his team were selected to participate in an eight-week virtual learning classroom on Trauma-Informed Care. The course is offered by SAMHSA’s Homeless and Housing Resource Network technical assistance contract, which supports SAMHSA's homeless programs grantees.

Our Executive Director really believes that having a trauma-informed culture is primary, which means that we must have buy-in from senior management. This is why we selected several managers to take the eight-week virtual learning classroom (VLC) on Trauma-informed Care. Most of my web-based educational experiences have consisted of dialing in, or connecting and watching a slideshow, without ever actually coming face to face with another person taking the course. With the SAMHSA VLC, everyone was on webcams and we were able to see not only the instructors, but the other participants as well. I was able to put faces to names. It is so important to see people’s facial expressions when connecting with another person, as it allows you to discern nuances in what they are saying and how they are learning.

One of the most important things I learned is that it is not enough to be only person-centered and client-focused, but that we must also be staff-centered. That really resonated for me. If we have staff who, over time, have been exposed to people who have experienced trauma, then we are likely to have staff who are experiencing vicarious trauma. If we don’t take care of ourselves, and if the staff doesn’t feel safe, then we cannot ultimately help our clients with their complex trauma in a thoughtful manner.

Currently, we are in the midst of an initiative to become a trauma-informed agency, beginning with making our agency a safe and welcoming environment. This is the first of five dimensions of becoming trauma-informed. One of my main goals is to make sure that we are trauma-informed all the way through the system, meaning that we are staff-centered as well as client-centered because we don’t want people to burn out.

And this is not the end; we hope to take this to an even deeper level. Trauma encodes itself within a person’s brain—codes that, when triggered, result in flight, fight, or freeze. It is complicated to transform that type of encoding, which is why we are committed to becoming a trauma-informed agency for everyone that walks through our doors, whether they are staff or clients.

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Building Relationships Among Beets

by Jolie Olivetti
August 01, 2012

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Jolie Olivetti is Farm Manager of ReVision Urban Farm, an innovative community located near Boston, MA. It is dedicated to opening doors to recovery and hope for individuals and families facing homelessness and living with addiction and other chronic illnesses. Since HRC last spoke with them, their farmland has doubled in size. They have a new greenhouse, a new terrace, and a new farm stand on Blue Hill Avenue, an impoverished area of Boston. The organization provides not only recovery services and shelter, but also the opportunity for people to rediscover healthy ways of eating food, growing vegetables, and rebuilding confidence. Jolie reflects on her role and shares insights about vegetables to the meaning of her work.

My favorite vegetable? Well, I usually say that I love beets. They are easy to plant. They are grown directly seeded and are fun to grow, fun to harvest, and fun to eat. You pull them right out of the ground. It’s a longer crop. It takes 50 to 55 days to grow, and the growing season runs from April to October. They are versatile. You can eat them raw or cooked, and I think they are delicious.

Part of the beauty of farming is being able to show people where food comes from. Many of the individuals and families who come to our farm have long histories of gardening, while others are gardening for the first time. This is a community of revision, so we share cuisines from all over the world. The work of our shelter is to develop meaningful relationships with individuals and families. At the farm, we are just as much a part of that goal. Working side-by-side while farming is a great conversation starter.

My background is in environmental education and, through working here, my views on homelessness have really changed. All I knew before came from the media, my observations, and volunteering. I have learned that homelessness is not a permanent condition, but rather, that people experience homelessness. It is about stable and safe housing, and it is about poverty. Most people who experience homelessness are not in that situation because of just one thing, and it is not the first thing you should know about someone. It is not an identity.

The young people I work with in the garden have had a significant impact on me. Many of the children between ages 5 and 11 take a real shine to the farm. It is like a dream for them—an exciting place, especially if they like to get dirty. They have so many questions about what we are doing. When a young person calls out to us and shouts out, “What are you doing?”, I may feel I don’t have time to answer because my task list is so long. But I have realized that the most important thing I can do is to make time to answer, because the most important thing that I am doing is supporting and interacting with the young people who are with us.

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Helping Clients Develop Health Literacy

by Claire Berman
June 26, 2012

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Claire Berman, M.S., is a Health Communication Specialist and part of SAMHSA’s Homeless and Housing Resource Network team. She specializes in issues of health literacy, behavior change communication, narrative approaches, and cultural competency. She shares her reflections on the connection between health literacy and homelessness and lessons learned from the Institute for Healthcare Advancement’s Health Literacy Conference of May 2012.

I like to think of health literacy in this way:

Imagine sitting in an advanced calculus class (and for the purposes of this blog, imagine that the last time you studied math was over ten years ago). The professor is saying words and describing concepts you’ve never heard of before—integral, optimize, derivative, function, and infinite series. You are a smart person, but you can’t follow any of it. Before you leave, the professor turns to you and asks, “Do you have any questions?”

You are so lost in the discussion that you don’t even know where to begin. It feels too late to start asking questions now, and you’re afraid you’ll look stupid if you do—so you say no and quietly leave the room.

Now imagine that instead of a calculus class, it’s a doctor’s appointment, and you are a person experiencing homelessness. The last time you saw a doctor was ten years ago. You’ve never had much education around health, and the health issues you struggle with are fairly complex. Your level of health literacy is probably fairly low, which means that you are less likely to understand what your doctor tells you and less likely to ask questions. As a result, your health is likely to suffer.

This May, I attended the Institute for Healthcare Advancement’s Health Literacy Conference in Irvine, CA. The conference explored operational solutions to low health literacy, and it came as no surprise to me that much of the work being done in health literacy intersects strongly with the work being done in homelessness services.

The vast majority of us in the U.S. (nearly 90 percent) have “less than proficient” health literacy skills. We also know that people with certain experiences are especially likely to have low health literacy. Less education, less access to mainstream services, and higher levels of poverty often lead to the lowest health literacy.

People experiencing homelessness often have all of these risk factors, with enormous costs to their personal health and to our health care system.

The thing about health literacy that makes it so hard to “fix” is that it goes far beyond one single skill. Instead, it is a complex process that relies on reading, writing, verbal, and numeracy skills, among others. It’s about how we are able to find and understand health information, and what we are able to do with that information once we have it.

Can we understand the language? Do we have the basic math skills to understand and follow instructions on medication? Do we have the ability to formulate questions for our doctors, and the confidence to ask them? Do we have people we trust to help us when we don’t have these skills?

What I heard at the conference was a commitment from the health literacy field to find new and innovative ways to reach our society’s most vulnerable populations with appropriate health information. Homelessness service providers work hard to cultivate relationships with marginalized individuals—people who may not have any connections to health care at all.

Providers have the chance to be an important part of the solution. As a starting point, I’d recommend some great resources and methods for addressing low health literacy among clients, such as:

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Category: Guest Entry | HRC Insight

My Reflections: 10 Years of Working to End Elder Homelessness

by Kathy MacDonald
March 07, 2012

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Kathy MacDonald, LICSW, is a Clinical Social Worker for Hearth in Boston, Massachusetts. Hearth’s model of service-enriched supportive housing provides elders experiencing homelessness not only with a place to live, but the services and supports to keep them housed. In this blog post, Kathy shares her reflections upon approaching 10 years of service at Hearth, considering what is at the core of the organization’s work in ending elder homelessness.

In just a few weeks, I will celebrate 10 years of working at Hearth. This has made me think a lot about the work that we do, why we do it the way that we do, and what keeps me here. Although homeless services organizations around the country serve elderly people, Hearth is the only one with a sole focus on and comprehensive approach to ending elder homelessness.

Our clients are not always easy to help. We often house people who no one else wants to house. Sometimes our clients make me laugh, and sometimes they tell me stories about their lives that break my heart. Many struggle with mental illness, intellectual disabilities, medical issues, substance abuse, or all of the above. Because of all of this, some have what one might call “behavior management issues.”

But I am constantly impressed by their strength and resilience.

At Hearth, we believe that it is not enough just to find a place for an elder experiencing homelessness to live. Many elders need additional supports in order to stay housed and to thrive. This is why our model is one of service-enriched supportive housing. Each of our six residential programs has a site director, a licensed social worker, and a registered nurse, as well as personal care homemakers and numerous paraprofessional staff.

There are so many elders we have helped over the years.

Bill* was 70 years old when he came to Hearth after living 25 years under the Massachusetts Avenue Bridge with untreated Schizophrenia. He lived there year round because he did not feel safe in the shelters. To say that it’s cold under a bridge in Boston in the winter is an understatement. At Hearth, we gave him housing and helped him turn his “junk food junkie” diet into a healthier one. We also gave him a new community of peers and friends (with whom he could often be found joking in the lobby). We made him feel safe.

Another elder, John*, struggled for years with substance abuse and mental health issues, then had several small strokes. He was often victimized on the street and suffered from terrible anxiety as a result. But the structure Hearth’s program and staff gave him has helped him to recover, and to feel secure. He now goes to Adult Day Health twice a week, and - not one to sit around in his room all day - participates in every activity we offer, including Bingo, Art Therapy, and Wii Bowling.

In April, Hearth will open a seventh site that will house 59 elders experiencing homelessness. It will expand our capacity by 40 percent and offer the same service-enriched housing environment as our other sites.

And as both Hearth and I turn a new corner, I think about what has kept me here. It’s knowing that the work my colleagues and I do every day matters. It’s knowing that from the Board of Directors down, people here truly care about the elders, and we care about each other, too. And it’s knowing that our programs translate into fewer elderly folks who are cold, hungry, alone, without the care they need, or sleeping under bridges every night.

*Not their real names. Their names have been changed to protect their privacy.

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