Room 307

by Wendy Grace Evans
January 07, 2013

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Homeless and Housing Resource Network writer Wendy Grace Evans-Dittmer recently had the opportunity to testify on a hate crimes bill in the state of New Mexico. If passed, this bill will elevate crimes against people who are homeless to the status of hate crimes. In this blog, she recounts her experience.

Eloise goes to the Plaza Hotel in New York City. Wendy goes to the legislature in Santa Fe, New Mexico. Several weeks ago, Senator Elect Bill O’Neill asked me to testify for a hate crimes bill to protect people experiencing homelessness. I testified on another homelessness matter for the Senator Elect in the past and was immediately happy to participate. Emails back and forth, as well as my experience covering Maryland’s passing of a homeless hate crimes bill, helped develop our plan for the testimony. I spoke with Michael Stoops of the National Coalition for the Homeless for additional information, including how to field questions we might receive from the sub-committee.

While all physical assault is a crime, a “hate crime” is prosecuted more seriously. A hate crime is a crime that is motivated by prejudice towards a minority. Congress’ definition of a hate crime includes: "criminal offense against a person or property motivated in whole or in part by an offender's bias against a race, religion, disability, ethnic origin or sexual orientation." If passed, the bill that Senator O’Neill and I testified for would add New Mexico to the list of states that include homelessness in their hate crime legislation.

I entered the Capitol building in search of Room 307. It was difficult not to meander through the majestic halls, but instead I raced to the third floor. Senator Elect O’Neill had begun his testimony and beckoned me to take a place beside him. My role was to explain that people who misunderstand “the homeless” misunderstand that they are simply human beings without a home. Homelessness is a state of being. Someone you might see on the street is someone else’s brother, sister, mother, father, or child. I stated gruesome statistics about the beatings, burnings, and even decapitations of 880 individuals experiencing homelessness in 46 states over the course of ten years.

Senator Elect O’Neill shared the story of a man experiencing homelessness that he knew personally. This man was the victim of what would be a “hate crime” if this bill is passed. Father Rusty Smith, a giant of a man and the Director of St. Martin’s, a “hospitality center” located in Albuquerque, New Mexico, testified as well. He knew of a young man who lived with his parents, had a job, a car, and lived with mental illness. His parents died suddenly and he lost everything, only to wind up under a bridge. Young boys attacked him, relentlessly stabbing him 20 times. While the man who was living under the bridge survived, his story embodies the kind of hatred-fueled attack that skip the daily lives of the average citizen.

The subcommittee voted to take the bill to a vote for an endorsement the following day. Wendy returned to the Capitol and witnessed the political process: a machine at work. In this case, the machine returned an almost unanimous endorsement, save one abstention. The bill will now go to the legislature. We will testify again, and potentially a third time, if fortune shines through the windows of the legislative hallways.

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Taking a Different PATH

by Amy SooHoo
December 05, 2012

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Amy SooHoo recently began working with SAMHSA’s Homeless and Housing Resource Network (HHRN), coming to this position after two years of providing outreach services in Boston, Massachusetts with the Projects for Assistance in Transition from Homelessness (PATH) program. Here, she reflects on how her past experiences in outreach influence her work today.

What gives a day meaning? This can vary from person to person, day to day, and year to year. For me, I find meaning in simple moments—in the time I share with friends and family, reading a good book, and going for an evening run. But most importantly, I find meaning in my work.

In my prior position as a Projects for Assistance in Transition from Homelessness (PATH) outreach worker, I didn’t have to look far for meaning in my day—the direct service aspect of that position ensured it. My days were spent in conversation with those experiencing homelessness. I worked to plant seeds of hope and change, wanting others to believe that their future could be different. At the end of the day, I could reflect on what had meaning for me that day, how the tiny part of the world with which I had interacted was different because of my actions. I could reflect on taking a young woman to apply for food stamps, and how she’d now be able to buy food because of that. I could think of visiting a client at his new apartment, the smile on his face, and the long road leading to that moment. I could recall a counseling session in which a woman shared a piece of her struggle and painful past, allowing me to bear witness to her story, and think of the ways that her story had changed me.

I’ve recently done a bit of a 180-degree turn. I left my position as a PATH outreach worker and began a new position working primarily with the PATH program at the national level with SAMHSA’s Homeless and Housing Resource Network (HHRN). It’s an entirely new perspective on the PATH program, and my time spent as an outreach worker informs my work in important ways. HHRN works to provide support and training and technical assistance to SAMHSA’s homeless program grantees, and accomplishes this by offering various resources, trainings, webinars, and consultations.

As a PATH outreach worker, I didn’t give much thought to the work that went into the PATH program—I was simply grateful that my position existed, and that I had the tools and resources I needed to do my job. I entered data about my clients, but didn’t really consider what that meant or how it would be used. I went to trainings and read articles, but didn’t think about the work involved with planning an effective training, or in writing an informative and relevant article.

In my new position, I witness the incredible amount of work that goes into ensuring that the PATH program provides effective services. I am grateful to have opportunities to apply what I learned as an outreach worker to the work that occurs on the national level. I find that I am constantly coming back to my time as an outreach worker, trying to determine how a potential change or new policy might affect the services being offered on the ground. I think about what was most challenging to me when I was working in the field, and if there’s anything that can be done to address these challenges.

At the end of the day, the meaning of my work has not changed. I still strive to improve the lives of those experiencing homelessness, and I know that while my current work does not generally have a direct effect on this population, it indirectly affects these individuals in powerful ways. This is what matters most to me, and what gives my days meaning.

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Remembering the Motivators

by Steven Samra
October 03, 2012

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As a deputy project director for SAMHSA’s Bringing Recovery Supports to Scale Technical Assistance Center Strategy, I sometimes find myself feeling removed from the day-to-day work performed by my colleagues providing direct service to those individuals who must cope with, and exist through, the challenges that arise from mental health and/or addiction issues.

This is challenging for me. I am a person with lived experience whose life dramatically changed for the better because of interaction with direct service providers. I’ve also done my share of service delivery and know firsthand that the real experts are those sitting across from me, hoping that I will be able to provide the answers that will assist in guiding them out of homelessness and into a better life. Truth be told, the best answers for that assistance often come from the individuals themselves. As a direct service provider, my job was simply to reflect what people already knew back to them in a way that reinforced and validated their own knowledge. The people I worked with taught me far more than I could teach them.

So, it is with great enthusiasm and excitement that I greet any occasion to reconnect with direct service providers so that I may learn, refresh my understanding, and share in the joys and the challenges of the work they do and I am passionate about.

Recently, I had this opportunity as organizer of a SAMHSA Homeless and Housing Resource Network (HHRN) webinar, “Increasing Consumer Involvement in Planning, Implementing, and Assessing Homeless Programs.” Three direct service providers shared perspectives on operationalizing their work as Peer Specialist, Recovery Coach, and Tenant Advisory Board Consumer Specialist.

Each presenter articulated not just the standard information concerning the roles of these specialties but, more importantly, their motivation for—and their understanding of—the raison d'etre of each position. As peers who entered their professional roles with a desire to serve and “give back” to their communities, the insight and perspective they shared offered a deeper, more personalized sense of the responsibilities the titles carry, as well as the intense level of commitment each of them bring to the role.

Their passion and commitment came through in dramatic fashion as the presenters completed the discussion portion of the webinar and began answering questions posed by the audience. I felt pride—and a twinge of envy—as I listened to their personal stories of engagement; of working side by side with those individuals who continue their struggle for housing, for recovery, for hope; and of application of their own lived experience as catalysts for providing, as William White calls it, “experientially credentialed” guidance.

Their responses were potent reminders of the importance of peer contributions in behavioral health, and how essential they are to the field and to the constituency we serve. Peers’ additions to the overall treatment protocols established by treatment teams complement clinicians and professionals in a manner that provides insight, balance, and dignity.

The issues of homelessness and the journey of recovery are as complex and unique as the individuals who experience them. The contributions of peers in assisting them and those who endeavor to serve them are important for many reasons. They provide an important perspective for the rest of the team. Furthermore, peers providing direct service stand as a testament to the ability for recovery. They provide hope and inspiration that simply cannot be conveyed by a non-peer. This in no way diminishes the incredible importance of the professionals in the treatment team. Rather, in my opinion, it provides the impetus for the mandatory inclusion of peers in a treatment team construct.

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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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Shifting the Paradigm by Judge Paul Herbert

by Wendy Grace Evans
May 24, 2012

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Judge Paul Herbert of Columbus, Ohio leads the Changing Actions to Change Habits (CATCH) program, which is a two-year program for women who have been involved in sex work or human trafficking. Instead of sending them to prison, the program allows the women to spend two years on probation and to enter an intensive rehabilitation program for substance use and Posttraumatic Stress Disorder (PTSD). Judge Herbert shares some reflections on the CATCH program.

The Changing Actions to Change Habits (CATCH) program is two years in length, and while many women do not make it the whole way through, I can track them through the criminal databases. Data shows that of the 80 women who have been accepted into the program, 78 percent have not committed a new crime. The remaining 22 percent are women who relapsed and have committed crimes and are back in the system.

The other venture we are pursuing is an attempt to differentiate between prostitution and human trafficking. The more I see women come through my courtroom, the more I am convinced that many are human trafficking victims.

I have spoken to different people in search of a human trafficking assessment tool. I found one in Washington, D.C. with the Polaris Project, which is the leading national human trafficking research organization. It defines human trafficking as follows: whether by force, fraud, or coercion, a person submits to a commercial sex act if they are over the age of 18. If they are under the age of 18, the selling party must have sold them for sex in order for sex to fall under the guidelines of human trafficking.

Based on this definition, we assessed 20 women who are currently in the program, and 93 percent fell within the guidelines of being human trafficking victims.

This tool helps enormously because it gives me hard data, which can help me shift the culture and mindset of how people in Ohio and the country view prostitution. In Columbus alone, 1,500 women a year are arrested for prostitution. Based on the results of the initial Polaris assessment, this would mean that approximately 1,396 are actually trafficking cases. I cannot sit back and watch this happen. The recovery centers are full, and women are now waiting in jail cells.

I also had another epiphany, which is a belief that Ohio State University should become the first university to open a center on human trafficking. The center would provide research, education, publishing, treatment, and outreach. Some of the most prominent issues that these women face include Posttraumatic Stress Disorder (PTSD) from trauma, Traumatic Brain Injuries (TBI), substance use, mental illness, homelessness, and physical health problems (including vision and dental problems).

I am looking for an approach that keeps the women at the center of our attention as a community so they can heal, and so society understands they have been sold into this lifestyle of degradation—and it should be said that it is hardly a lifestyle. It is more of a death sentence.

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“We Are All In This Together”: Highlights from the HRC Regional Training in Los Angeles

by Wendy Grace Evans
August 30, 2011

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Continuing the cross country training tour, SAMHSA’s Homelessness Resource Center training team just returned from a well-attended Regional Training in Los Angeles, California. This year’s regional training series will conclude with the last training in Roanoke, West Virginia, on August 23-24, 2011.

The training was held at The Center for Healthy Living, a beautiful architecturally green space, with both indoor and outdoor space, and rock and water gardens, all funded by The California Endowment. Over 200 participants came from as far away as Alaska and as close as LA’s Skid Row.

I was able to catch up with Rene Buchanan, a Volunteer Coordinator from OPCC’s Daybreak, who shared her reflections on presenting as part of the HRC workshop, “Moving Forward Together: People in Recovery as Colleagues.” Rene shares:

I was incredibly honored when SAMHSA’s HRC made me an integral part of the training. The full presentation was empowering for me. My experience working with the HRC training team has shown me that they are such an amazing group of people and so special to interact with.

I have often shared my story to benefit the agency where I work and where I had received services, but to share my story in a training capacity, where I am teaching, was something else for me. It was validating. My inclusion was a moment of validation. I walked away feeling more conviction for what I truly believe in.

I can continue to do these kinds of trainings. People seem to understand consumer integration in theory, but in practice, people have concerns and doubts. People have to see it happen and how people who come in for services can really help others. Those preconceived notions of who consumers really are creates a power differential that is hard to overcome. It will take a dramatically different way of thinking.

For instance, meeting musician Nathaniel Ayers and seeing the relationship between him and Steve Lopez, author of The Soloist, is part of this dramatically different thinking. When Nathaniel started playing the cello and he started to speak about Mr. Lopez, it made me cry. They are proof positive of one person helping another for fun and for free. I know it started as an article, but it became so much more than that, and today they have something that is based on mutual respect and admiration.

It is always a highlight for me to meet other people from other parts of the US who are doing the same things as I do at the agency where I work. The only way that we are going to make a dent in this problem is if we realize that we are all in this together. We need to share the things that do work and come together as a team. I am leaving this training with a fire beneath me and I feel that I have more conviction around the things I believe in. The people at the training themselves inspired me. I was fortunate to be in a room of such amazing strength and wonderful energy.

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“The Kids Are Listening:” LGBTQ Youth in Foster Care

by Zachary Kohn
August 22, 2011

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“Homosexuality is a bigger threat to this country than terrorism.” This is the attention grabbing and heartbreaking first line to The Kids Are Listening video campaign. It is exactly this type of alarmist and discriminatory rhetoric that the campaign is attempting to counter. Launched in April by the American Bar Association on Children and the Law, the campaign is attempting to raise awareness for lesbian, gay, bisexual, transgendered and questioning (LGBTQ) youth in America’s foster system.

The focus of the campaign is to ensure that LGBTQ youth in the foster care system receive equal protection and rights as youth who identify as straight. This can be achieved by training social services providers to defend LGBTQ youth and be sensitive to the messages youth hear everyday. It is important to protect these children, and The Kids are Listening campaign is stepping up to help.

LGBTQ youth in America face entrenched discrimination, and those who are in foster care encounter even greater obstacles. One in ten youth in the foster care system identify as LGBTQ, and close to 78 percent of these youth experience harassment and abuse in their placement home (1) (2). LGBT youth are also are more likely than their heterosexual peers to run away from foster care (3). The Kids are Listening campaign is attempting to raise awareness about the victimization these young people face every day.

The video introducing the campaign shows four different young people wearing headphones as anti-gay audio clips are played over music. As the music builds and the clips begin to pile on top of each other, adults approach these youth and pull the headphones out. At this point, the video explains, “Our kids are listening. It’s up to us to make sure they hear the right message.” It is a powerful video that asks adults to step up and let the youth of our nation know that there is nothing wrong or immoral about identifying as LGBTQ.

The Kids are Listening Task Force has already written a Bill of Rights for LGBTQ youth living in group homes and several other resource guides for professionals working with foster children. They work to spread their message that everyone deserves respect, regardless of sexual preference.

To join The Kids are Listening task force or to see the video, visit the website or check them out on Twitter and Facebook.

SAMHSA’s Homelessness Resource Center (HRC) is committed to improving the lives of all people experiencing homeless, including youth who identify as LGBT. As a result, the HRC conducted an Expert Panel and Listening Tour of model programs serving LGBT youth. From these activities, key findings on implementing best practices for serving LGBT youth who are homeless were distilled.

In August 2011, SAMHSA’s HRC, in partnership with the Runaway and Homeless Youth Training and Technical Assistance Center and others, will be disseminating these best practices and strategies at four targeting trainings, in New York, NY, Chicago, IL, Santa Fe, NM, and Miami, FL.

To access more resources, visit Serving LGBTQI2-S Youth on the HRC website, or email Laura Winn.


(1) Freundlich, M. & Avery, R.J. (2004). Gay and lesbian youth in foster care: Meeting their placement and service needs. Journal of Gay & Lesbian Social Services, 17(4), 39-57.

(2) Feinstein, R., Greenblatt, A., Hass, L., Kohn, S., & Rana, J. (2001). Justice for All? A Report on Lesbian, Gay, Bisexual and Transgendered Youth in the New York Juvenile Justice System. New York, New York: Urban Justice System.

(3) Sullivan, C., Sommer, S., & Moff, J. (2001). Youth in the Margins: A Report on the Unmet Needs of Lesbian, Gay, Bisexual, and Transgender Adolescents in Foster Care. New York, New York: Lambda Legal Defense & Education Fund.

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One Size Does Not Fit All: Lessons Learned in Baltimore, MD

by Laura Winn
July 06, 2011

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A couple weeks ago I attended a SAMHSA workgroup meeting for programs offering sober housing and treatment options for women experiencing homelessness. The workgroup began as a technical assistance (TA) request from Lori Criss of Amethyst Programs, a program in Columbus, Ohio. Amethyst offers integrated sober housing and treatment to women experiencing homelessness and substance use issues. Amethyst staff have sometimes felt isolated because this integrated approach is a unique model in their community. Lori knew that there was interest among other programs across the country, and was seeking an opportunity to begin this dialogue on a national level.

In response, SAMHSA’s Homelessness Resource Center helped to convene a workgroup of similar programs, along with SAMHSA’s Women, Children, and Families TA Center. With such a strong national focus on Housing First, sober living models often struggle to find their place. Programs find themselves straddling a divide between housing and addictions treatment. Some identify primarily as housing providers, some as treatment providers, and others as both, adding to the difficulty of seeking funding in various continuums of care. However, sober housing can be a tremendously beneficial model for women with children, trauma histories, and safety concerns.

Based on the clear desire of workgroup members to connect in person and further define key elements of this integrated model, SAMHSA convened a meeting in Baltimore, MD. Sixteen representatives of sober housing and treatment programs for women attended. The group shared their program designs, discussed what works (and what doesn’t), and explored commonalities, challenges, and promising strategies.

Having worked in this field for a year and half, it has become clear that there are no one-size-fits-all models for individuals experiencing homelessness, substance use disorders, or mental health issues. However, I’ve never seen this so clearly illustrated as I did at the workgroup meeting. Not only were providers recognizing a need for alternatives to Housing First for some individuals and families, but they were also highlighting differences among their own gender-specific sober housing models. For some women, being allowed to live with their children and within a community is an important step toward recovery. This demanded more restrictive relapse policies, in recognition of the safety and recovery of children and other families. For others, living independently, becoming economically stable, and thriving in healthy relationships is central to success.

Programs differed on drug testing policies, services for fathers and children, relapse policies, and approaches to treatment. However, it was clear that these programs were each finding success with their participants. I spend a lot of my time trying to understand what works in homeless services. Through the process, I sometimes forget that there are many paths to success. Flexibility to respond to the needs of consumers is essential.

I was inspired by the providers I met in Baltimore. They were committed to finding the best individualized options for women. These providers, many of whom were in recovery themselves, exemplified that fact that one-size-fits-all is not always possible – or necessary – when working with individuals and families.

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Rachel's Story

by Wayne Centrone
June 22, 2011

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Sometimes the most important lessons—the kinds of lessons that have lasting effect on one’s attitude or outlook—occur in the most unlikely of situations. I recently recalled a patient I had the good fortune of working with a number of years ago, while I was still in clinical practice.

I had a busy morning in clinic that day. The schedule did not leave a spare moment for reflection. After a working lunch, I planned to catch up on phone calls and e-mail correspondence. Around 2 p.m., a young woman came to the clinic. She really made me think twice about all the “business” in my life.

Rachel (not her real name) was a 16-year old suffering from a heroin addiction. She wanted help with her third attempt at drug detoxification. What made Rachel so unique to me (keep in mind that I worked for a number of years in very close proximity to a needle exchange program and thus saw many intravenous drug use patients) was the fact that she came to the clinic with her parents. Mr. and Mrs. Smith (again, not their real names) were anything but “typical” patrons at my clinic. They were both in professional careers, lived an upper-middle class lifestyle, and never thought they would find themselves sitting in a community healthcare center. However, they expressed their commitment to Rachel and wanted to help in any way possible.

It is important to mention that injection drug users do not fit a particular profile. Sure, we can stereotype them to the “skid row” image of Hollywood, but there really is no “one size fits all” addict. I saw injection drug users come into the clinic fresh off the streets, and I saw some come straight from their offices. The single caveat that holds them all together is their powerlessness over a drug that has the potential to destroy their lives.

Rachel started using drugs when she was a 13-year old. She never saw herself becoming an addict. It just seemed to happen. Previous attempts at detox and sobriety had all come to naught. Strung out as a 16-year old, her face held the sort of sorrow that one would expect to see on someone many years her senior. Rachel was the victim of a life that she never envisioned nor desired. She was angry and scared. Most of all, she needed help.

I now know that one does not need to be a great thinker or renowned scientist to make a difference in the world. Rachel did not need a marvel of modern medicine. She did not want someone to lecture her about the “deleterious” effects of injection drug use. She really only wanted to get well.

Acute early detox-related treatment for injection drug use is not standardized. Earlier that day, Rachel and her family tried to see their family doctor. That doctor told them not to come, because she would not treat Rachel. They tried going to a doctor recommended by a friend, but again the services they requested were not available. Finally, in desperation, Mrs. Smith phoned the needle exchange program at our clinic. She heard that we had limited resources. She said she wanted to come in anyway.

What Rachel and her family needed was someone who would listen to their concerns, and show them that they were not alone. What they wanted from me was a listening ear and a concerned advocate.

What I learned from this remarkably strong family was that I make a difference just by being present to the suffering of another person. I learned that the “little things” (a smile, the gentle touch of a caring hand, an open heart) comfort the biggest of worries and sorrows. I learned that taking time to care about another means that I need to be present to suffering. Most of all, I learned that life’s most significant lessons come in the most unlikely of ways.

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Patty Wuddell on Bearing Witness

by Wendy Grace Evans
June 06, 2011

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Patty Wudell is the Executive Director of Joseph’s House. in Washington, DC. Here, people who are formerly homeless and dying of HIV/AIDS can come to live and receive compassionate care. Patty spoke with HRC writer Wendy Grace Evans to share reflections on her work at Joseph’s House.

Here at Joseph’s House we have had a heartbreaking—more than heartbreaking, a life changing—experience. About a year ago, a 21 year old woman came to us for respite care. We welcomed her. Her name is Melissa (not her real name). She had advanced AIDS, and was expected to die. She had a three year old and a two year old. She was so very sick and so deeply and profoundly full of anguish and depression, and then she became well. She was here at Joseph’s House for five months. Little by little she started to eat and put on weight. Once she started feeling better, she was willing to take HIV/AIDS medications. She got even stronger. Her children came to stay with her, even overnight. She never thrived, but she got well enough to go home.

For her, home was not a homeless shelter. It could have been; there were so many people living in her mother’s apartment. She and her children had a mattress on the living room floor. There were so many people living there with incredible needs, so much anguish. Her brother and sister had been convicted of killing another sister’s boyfriend and were also living there. The young woman stayed in touch with us. We heard she was in the hospital again, but by the time we arrived she had already checked herself out. Then, four weeks ago she was referred to us for hospice care again. So now she is 22 years old and dying.

Last night at our dinner table, we spent time with this courageous young woman, her great grandmother who is 93, her grandmother, her mother, her children, their father, sisters, cousins, and their babies. Joseph’s House was full of people who really love her and are doing the very best they can. The first time she was with us, we didn’t know her family. Now her family has been here sleeping overnight, in her room, and on couches in the living room. We feed everyone all the time. What I find so moving is that when she first came back to us, I just felt rage—rage at AIDS and poverty, rage at these social issues. But I found that my rage just didn’t feel quite right. It distanced me from Melissa.

I didn’t want that, so I found myself sitting with this little girl and holding her kids on my lap and talking to generations of women who have never had any material security, and yet, they have each other. They have resilience, and they do more than the best they can. They really say yes to each other. I don’t have rage anymore; I have love. I have admiration, sadness, humility, and gratitude to have the chance to have some actual time with these women, time at the table. My first impression of Melissa was that she was isolated and she was. But my initial impression that she wasn’t loved was misinformed. Now, it’s both much sadder and much better to know about the love in her family that has been here since she contracted AIDS as a child. There is more love than anything else. We are part of that love, too. It is moving to be a part of the support for our young volunteers who are Melissa’s age. How do you support them? Well…we do.

This past weekend we anticipated that she might die. I was on call. Our nurse practitioner, Priscilla had a wedding across the country and she called to talk to Melissa’s mother and grandmother. What really moved me is that she happened to call at mealtime. Melissa’s mother said to us, “I cannot believe the love that is here. It doesn’t matter what shift or who is working, there is always love here.”

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