mental health
The New Faces of Homelessness
Published November 09, 2009 @ 07:42AM PT
Today I am live-blogging from Rhode Island's "Yes We Will" Conference on Homelessness and Housing. The first workshop of the day will examine the "new faces of homelessness" - not necessarily new categories of people experiencing homelessness, but groups that have started receiving more priorities and attention from funders and policy-makers.
10:22 - I like the note that we're starting out on: moderator Mike Burk from the RI Dept. of Children, Youth, and Families notes that many of the groups facing homelessness we will discuss today are homeless as a direct result of policy decisions. For example, Rhode Island intentionally cut off services for foster youth at age 18; homelessness has become an unintended effect.
VA's Bold Goal: End Veteran Homelessness in 5 Years
Published November 04, 2009 @ 11:53AM PT
Yesterday, Secretary of Veteran's Affairs Eric Shinseki make a promise: to end veteran homelessness in five years. While many have been pessimistic about this goal, calling it "overly ambitious" or "over-simplified," we can all agree on one thing: it's about time.
It's all too easy to wear an American flag, put a "Support Our Troops!" sticker on your car, but then scoff at "bums" on the street. Few people make the connection: wearing the uniform actually increases one's odds of ending up on the streets.
Today, roughly 1 in 3 homeless adult men is a veteran, and 1 in 5 homeless adults have worn the uniform. Although veterans from Iraq and Afghanistan currently represent just 3 percent of homeless veterans, they are winding up on the streets at rates faster than vets from previous wars.
But perhaps the Obama Administration's bold commitment will reverse this unacceptable trend. According to CNN, the Secretary Shinseki's plan includes trying to leverage existing education and jobs programs, boosting the ability of veteran-owned businesses to compete for federal contracts, and spending an additional $3 billion on medical services and homeless programs.
While it's hard to predict if this infusion of money will amount to success, the most encouraging part of the VA's plan is that they are embracing new and innovative approaches. Rather than increasing shelter budgets, more funding will be directed towards homelessness prevention. The new VA plan increases its current homelessness prevention budget by $400 million, 85 percent of the funds benefitting health-care costs. This finally acknowledges that veteran homelessness is often the result of untreated health problems, like mental health issues and substance abuse.
"My name is Shinseki, and I am here to end veteran homelessness."
If the Secretary's opening line during his remarks to the National Summit on Homeless Veterans is any indication of his gusto, then we're off to a good start.
Recovery is a Beginning, Not an End
Published September 15, 2009 @ 05:31AM PT
For many people who experience homelessness, substance abuse can be either the cause of their homelessness or a result. Many addicts never recover from their addictions. For others, the road to recovery can be long, dark, and fraught with challenges. But the rewards after recovery can be powerful.
This month, in honor of the 20th Anniversary of National Drug and Alcohol Recovery Month, SAHMSA's online Homelessness Resource Center (Substance Abuse and Mental Health Services Administration) is featuring profiles in recovery. Imagine my delight to learn that our very own Change.org contributor, Steven Samra, is the first featured profile. They couldn't have made a better choice.
Given his impressive accomplishments, it's hard to believe that Steven has only been out of recovery since 2000. In fact, Steven's life before 2000 is starkly different than today. Perhaps the reason Steven is such a powerful advocate for the homeless is because he's been there, he's struggled with addiction, and he's not afraid to share his experiences for the sake of helping others. He told SAHMSA that being an advocate for the homeless has really changed his life, "People listen to me. I have built credibility by sharing my life experiences and for the first time in my entire life, I can look in the mirror without loathing and disgust. I have some self respect."
If you're a fan of Steven's work here on Change.org (I know I am!), I urge you to read his story at the Homelessness Resource Center. He is an inspiration to me, to those he works with, and to those in recovery who need to learn this important lesson: Recovery is not an end. In fact, for people like Steven, recover is just the beginning.
[Image from Sir Merv's public Flickr photo stream.]
Many Veterans Still Fighting for Health Care
Published August 31, 2009 @ 09:05AM PT
Today, there are more Vietnam veterans living on the streets than the number of soldiers who died in that war. The plight of many of these men and women is directly linked to the lingering effects of PTSD and our failure to provide proper health care. Comprehensive health care reform will finally gives us the opportunity to do right by these brave soldiers and prevent a future generation of war veterans from ending up on the streets.
There are currently one million U.S. veterans suffering from Post Traumatic Stress Disorder (PTSD), a mental illness not even recognized as a mental illness during the Vietnam era (it was passed off simply as "shell shock"). This disorder can manifest itself in a number of ways that could ultimately lead to homelessness, such as depression or substance abuse. What's more, it may not be evident until years after the traumatic experience, which makes the all-important diagnosis and treatment difficult.
Sgt. Gil Riviera, for example, experienced a frightening PTSD-induced flashback on the streets of New York City, 30 years after returning from Vietnam. It was only then, after a potentially dangerous incident, that Riviera received the mental health care he needed.
Today, returning war veterans are guaranteed only five years of medical care after returning from war. After that five-year window, the burden of proof is on each veteran to prove their illness in order to receive proper care. After filing a claim in a veterans service office, they must use "supporting documents, deployment records, employment records, documents of medication problems and anything else to strengthen their case," according to Medill. If that's not enough, each veteran must provide documented evidence of where they were stationed during their service and whether there was combat in the area.
In other words, we trust our soldiers to put on the uniform and potentially make the ultimate sacrifice, but we don't believe them when they ask for medical or mental health assistance.
It's not hard to see why many veterans don't even bother getting involved in the system. A 2007 Harvard study found that over one million American veterans do not have health insurance. In addition, 3.8 million members of veteran households are uninsured - and that number continues to grow.
As the nation continues to discuss comprehensive health care reform, we cannot forget that universal coverage will improve the delivery of critical mental and physical health care to the men and women who have worn the uniform. At the same time, we will do right by our next generation of veterans from the wars in Iraq and Afghanistan, preventing thousands from ending up on the streets.
The Trauma of Homelessness
Published July 29, 2009 @ 07:58AM PT
When we hear the word "trauma" we might associate it with shell-shocked veterans, loss of a loved one, or perhaps a bad car accident. But trauma is extremely applicable to homelessness, since it can be both a cause and effect of living without a home.
The first presentation I'll be live-blogging today is about trauma-informed care. This session was presented by Kathleeen Guarino from the National Center on Family Homelessness (but representing the Homelessness Resources Center). Today's topic: traumatic stress in people experiencing homelessness and how to treat it.
9:15am - Round-the-room introductions. Roughly 100 people present from around the country (and Canada!) who do a lot of impressive things. There are people from Texas, Alaska, and even a representative from Miriam's Kitchen in DC (remember this debocle?).
9:17 - We all deal with stress, but it becomes traumatic when it is an overwhelming experience, something that involves a threat, or an event that leaves a person feeling helpless and fearful.
9:23 - Question: How many people in the room serve homeless people with more than one traumatic stressors? All hands in room go up.
9:24 - If you serve the homeless, you aren't just meeting basic needs, you are dealing with people struggling with traumatic stress issues.
9:26 - Talking about the physiology of the brain - how humans are wired to respond to stress. Fight, flight, or freeze. Discussion about how we see these reactions in the homeless population.
9:33 - Talking about examples of "fight" response: verbal aggression... Is this only in Boston?
9:36 - Traumatic stress in a nutshell: When the body's physiological responses (fight, flight, or freeze) do not have the intended effect. A ha. I get it.
9:43 - A few things that influence the way people react to trauma: history, current functioning, culture, and nature of social supports. Many homeless kids are already behind the normal functioning level for their age, so when a traumatic event occurs (like homelessness), they're already more likely to react poorly.
9:54 - Trauma-informed care is about how we understand and act towards people. Removing judgement, for example, through small changes in language can have a big effect.
9:58 - I'm really enjoying the commentary from the crowd in this session. We just had a small discussion about people who cope with trauma through substance abuse. One formerly homeless woman in the crowd acknowledges that it was the patience of her service providers over seven years that saved her life. Powerful.
10:00 - "Homelessness is not an acute trauma, with a definitive beginning and end. It is life. Which makes it more difficult to treat."
10:02 - A note about people serving the homeless: "If [service providers] are not impacted by the traumatic experiences of their clients, I wonder if you're not fully connecting. It becomes overwhelming, so self-care is absolutely necessary."
10:09 - Talking about culture - how messages from our youth stay with us forever. A few good anecdotes from people in the room: "Nobody will ever be better than you, nobody will ever be less than you," and, "I cried because I had no shoes, until I met a man who had no feet."
10:12 - Your culture can also be a negative. A few common cultural quips on mental health: "You're fine, don't tell anyone you're sick." or "Mental illness is a spiritual problem - pray."
11:19 - Back from break. I'm late and missed some good stuff... whoops!
11:22 - Funny, something as simple as a sign-in policy for a shelter can make someone with trauma feel a "loss of power," regardless of how good the rationale is for such a policy. Explaining the need for such a procedure ("We need to know who is in the building in case there's a fire.") can have a big impact.
11:24 - Anyone can be "trauma-informed." It simply means knowing that someone has experienced trauma and understanding that there may be lingering effects.
11:35 - Two important things about trauma: recovery from is possible and healing happens in relationships.
11:42 - To wrap this session up, here's a relieving and enlightening observation: At the end of the day, you have to be enough. Read that again.
