Housing Mr. X

Posted on July 17, 2012

Chances are you’ve seen him. For more than two years, Mr. X has been a fixture at a major downtown underpass, gesticulating wildly to himself, vaguely menacing, unapproachable. Every city has its own Mr. X. The individual considered most likely to decline outreach, most resistant to housing and services, the Mt. Kilimanjaro of the homeless services providers system. In New York, you find these individuals in The Bowery. In Los Angeles, they reside at Skid Row. In New Orleans, it was the legendary Mr. Coleman. In Richmond, agreement was unanimous that it was Mr. X.

When the announcement was first made back in April of 2011 that the state of Virginia intended to join the national 100,000 Homes Campaign and that Richmond, led by Homeward and Virginia Supportive Housing, would be the vanguard city, VSH received multiple e-mails from concerned citizens wondering if Mr. X would be outreached. At the time, it was not at all clear that he would – or could – be helped.

Mr. X wasn’t always this way. With several years of college on his resume, he was clearly intelligent and had the potential to be as functional and productive as you or me. However, as we all know, sometimes it only takes one tough episode to send a life careening off the tracks. Mr. X’s descent into mental illness and subsequent homelessness was apparently rapid, but not beyond treatment, if only someone cared enough.

The VSH support services staff became officially acquainted with Mr. X last August during Richmond Registry Week. Multiple survey teams approached him that week, but he declined to cooperate each and every time. And yet, he clearly met the survey criteria of chronically homeless and medically vulnerable, especially on the basis of mental health concerns. In fact, on one occasion, VSH’s HomeLink Team Leader Lynn Aumack offered to bring him coffee and he refused, suspecting that it would be poisoned and threatening to “cut off the head of the Dalai Lama” if “the people in the red shirts” didn’t stop coming around.

Despite his erratic behavior, VSH staff continued to try to connect with him over the next several months.  Mr. X’s symptoms were so severe that it was extremely difficult to build rapport, and he declined all offers of housing and services repeatedly.  On at least two occasions the Richmond Police Department’s HOPE team and RBHA (Richmond Behavioral Health Authority) Crisis team were called in for an assessment, but both times the conclusion was that he did not meet the necessary criteria for involuntary hospitalization.

Lynn didn’t give up, though, and saw an opportunity at the beginning of June that resulted in another Crisis team assessment. This time, the outcome was that Mr. X was admitted for inpatient psychiatric treatment. With medication, Mr. X’s symptoms improved rapidly and he was able to engage with an APTS (A Place To Start) team member with the result that he agreed to move into permanent housing! On very short notice and in the hospital, the APTS team was able to rapidly process his intake into that program and finalize his housing placement.

Less than a week later, Mr. X moved into his apartment where APTS staff continued to provide him with intensive services. Recently, Mr. X appeared clean-shaven and neatly dressed in the offices of VSH headquarters, working with case managers to sort out his benefits. And, best news of all, Mr. X has been reunited with relatives and will soon return to his hometown to recover with the support of his family. And it all started with housing.

As VSH clinical services director Kristen Yavorsky remarked, all it took was someone driven by the conviction that he deserved better than a life under the bridge.

Hopeful, Optimistic….But Also Impatient

Posted on February 15, 2012

Three nights ago, the temperature plunged down into the teens and the wind chill factor was even colder than that. Most of us passed the night in the warmth of our heated homes. But according to Homeward’s most recent Point in Time Count, almost 1000 people in our very own community did not have a home in which to sleep that night and more than 100 were forced to sleep outside in public parks, on fire escapes, and in encampments by the river.

Statewide, more than 9,000 Virginians experienced homelessness that night according to estimates by Virginia’s Department of Housing and Community Development.  Can you imagine sleeping outdoors in that kind of cold? The truly sad part is that we know how to fix homelessness and a solution is within our reach. It’s called permanent supportive housing.

“Permanent supportive housing works,” states John Dearie, board member with the Virginia Coalition to End Homelessness, in his recent RTD op/ed piece. “Eighty-five to 100 percent of the tenants in…Virginia’s PSH programs have not returned to homelessness. The National Alliance to End Homelessness recently identified the emergence of PSH programs as the single most important factor in reducing chronic homelessness in America in recent years.”

Even more important, according to Dearie, is the fact that the permanent supportive housing model delivers dramatic savings to the community. “A 2010 analysis of Virginia Supportive Housing’s A Place to Start initiative showed that the program had dramatically reduced this hopeless and costly cycle [of chronic homelessness], saving the local community $320,000.”

This is really good news because it means that political consensus is possible. At a time when politicians can’t even agree on the color of the sky, Democrats and Republicans are joining forces to support legislation that paves the way for policy amendments, funding, and eventually, new PSH developments.

Dearie goes on to say, “Much more work remains to be done. According to VCEH, another 7,000 PSH units are needed to end homelessness in Virginia. That’s a daunting number, but it can be achieved. And Virginia has already made impressive progress.”

At Virginia Supportive Housing, we are hopeful and optimistic…but we are also impatient.

Hopeful because we know that permanent supportive housing is what solves homelessness and we work toward that solution each and every day.

Optimistic because advocacy for this evidence-based model is slowly but surely growing, both across the state and across the nation.

Impatient because, for the people who are sleeping outside in frigid weather, that solution can’t happen soon enough.

To read John Dearie’s complete op/ed piece, click here.

To read what the National Alliance to End Homelessness has to say about permanent supportive housing, click here.

To find out more about the work of Virginia Supportive Housing, click here.
To support VSH, click here.

Work Harder, Look Deeper

Posted on February 8, 2012

This blog was written by VSH’s volunteer resources manager, Alison Jones-Nassar.

If you saw this individual standing on a street corner, you might be tempted to avert your eyes and hurry past him, maybe even cross the street to avoid him.

We all tend to do that when we encounter people who appear dishevelled or dirty or just somehow….different. Unpredictable situations make most of us uncomfortable, and we don’t like to feel awkward or stupid, much less threatened.

But as this powerful Tribute to Robert Wood demonstrates, we sometimes ignore the people in our community who seem to exist “on the margins of society” at our own expense and end up missing out on a rare opportunity to be enriched.  

The gentleman pictured here was well-known to the citizens of Kent, Ohio. For many years, he accessed the town’s social services and regularly participated in the hot meals program. In this loving tribute, published on the occasion of Mr. Wood’s death from unspecified causes, Kent Social Services Manager Christie Anderson notes that “perhaps eccentric people are incarnations of God, for they challenge us to look deeper for their divinity….some people, more than others, require us to work harder at extending grace to them because they evoke fear in us.”

Anderson goes on to say, “This is the lesson that I have taken from knowing Robert Wood. He taught me, and others in the Kent community, that we mustn’t be quick to judge another human being. When we take the deliberate steps to set aside our fears of people perceived as different, a world of discovery opens for us. Mutual understanding begins when we lower our defenses and encounter our common humanity.”

Reading this, I was reminded of an encounter I had last week. One of our A Place To Start clients (I’ll call him Kenneth) had expressed an interest in serving as an office volunteer, and last week he gave several hours of his time to help with our move to the new headquarters.

Kenneth is a full-grown man about my age and taller than me. His gaze can sometimes appear unfocused and every time I see him, he seems sweaty and slightly agitated. I remember thinking that his facial expressions seem somehow child-like. Consequently, I felt rather awkward and unsure of how to interact with him. I had to be sure he would perform the tasks he was there to do (dismantle old manuals, carry trash out to the dumpster, shred documents), but at the same time I didn’t want to make assumptions or come across as condescending. 

“Kenneth, you doing okay? Kenneth, how’s it going?” My questions pertained to the work at hand, so I was surprised when, after a trip to the dumpster at the back of our building, he gave me the broadest grin and declared, “Boy, it is such a beautiful day outside, isn’t it?” In fact, I had been too preoccupied with all my to-do lists to notice the weather. With complete sincerity, he went on: “Ahh, it’s just gorgeous, and the breeze feels so nice! It’s a perfect day for a nice long walk!”

A few minutes later, we carried a load of boxes out to the trash together and Kenneth suddenly rushed toward the dumpster. “Oh no, look at that beautiful plant that someone threw out! That’s a little piece of paradise right there!” At that moment, I looked at Kenneth and saw what he truly had to offer for the very first time.

Tom Allen, in his February 5 Faith and Values column, urges us to move beyond competition and the judgment that we all engage in as we compare ourselves and our accomplishments (or failures) to everyone around us. “There’s something very liberating about accepting, and trying to live, the fact that we’re all brothers and sisters, children of God. It frees me to want, and to work for, what’s best for others in my life. It frees me to celebrate their successes, and to love them without jealousy. Most of all, it frees me from the constant strain of having to be ahead of them. I can just be with them, and we can travel together. What a huge relief.”

We tend to dismiss the Kenneths and the Robert Woods of the world because they don’t conform to our standards of what is “normal” and “acceptable” and “successful” and “beautiful.” Kenneth in particular, with his experience of chronic homelessness and his mental illness, can barely manage a few simple responsibilities without close supervision. What could he possibly teach any of us?

Later that day, as I left the office – and every day since – I have made a point of looking up at the sky and the trees and noticing the feeling of the sun and wind on my skin. “You’re right, Kenneth, it’s actually a really nice day.”

If we are only willing to look a little deeper and work a little harder, we will be rewarded with priceless gifts. It is definitely worth the effort.

For Individuals Experiencing Mental Illness & Homelessness, VSH Brings Stability & Security

Posted on June 21, 2011

This blog was written by VSH’s summer PR intern, James Denison.

According to a 2009 study from the Substance Abuse and Mental Health Services Administration, 20-25% of America’s homeless population suffers from some sort of severe mental illness. That means one out of every four homeless individuals is struggling with schizophrenia, bipolar disorder, or another paralyzing mental instability. Statistically speaking, one out of every four homeless persons may be hearing voices, having hallucinations, or suffering from mood swings.

For some of these individuals, their mental illness is severe enough to warrant a temporary detention order to a psychiatric hospital. Because of the “danger of imminent harm to themselves or others”, they could legally be committed for inpatient treatment. Yet all over Virginia, psychiatric hospitals are turning hundreds of patients away each year, simply because they don’t have room for them. If they don’t have family to stay with, these individuals end up trying to fend for themselves on the streets. Without the care and treatment they need, they exist in constant danger of harming themselves or being victimized by others.

How did things end up this way? Mental institutes are downsizing, but that is not the heart of the problem. Smaller, community-based facilities were supposed to pick up the slack as a more humane way to treat patients with mental illness. However, that hasn’t happened, and persons with mental illness are paying the price. At Virginia Supportive Housing, though, we’re striving to ensure that individuals experiencing homelessness are properly cared for before they reach a point where they need to be committed.

At VSH, we believe it is unacceptable for anyone to be homeless, especially someone suffering from mental illness. Our program, A Place To Start, provides stable housing and comprehensive mental health services to chronically homeless individuals in the Richmond area. Thanks to a committed team of clinicians, case managers, a nurse, and a psychiatrist, APTS has housed 62 clients since December 2007. All but one of APTS’s clients have not returned to homelessness.

APTS has shown how compassion, empathy, and determination can bring people off the streets and save Richmond money to boot. In addition, the greatest benefit of APTS comes from watching our clients move from instability and fear to security and peace. As our psychiatrist Jeannette Schoonmaker put it in last week’s blog: “The thing that makes my day is when I’ve seen people come into the program who are really desperately depressed, hopeless, and don’t know where to turn. And in a few months, I can ask them how they’re doing, and they say, ‘I’m happy. Life is good.’ That’s flat-out amazing.”

A Place To Start Brings Care and Comfort to Forgotten Lives

Posted on June 14, 2011

This week’s blog was written by Dr. Jeannette Schoonmaker, a psychiatrist with Virginia Supportive Housing’s program A Place To Start.

I’ve worked in many places. I have a good deal of experience with mental health services in many different forms. So my coming to A Place To Start was because I saw it as being more efficient, more comprehensive, and a better program than others. The major difference we have is the piece where we provide housing at the outset of the program.

Providing housing up-front as quickly as we can brings us the opportunity to have people where we can find them, hopefully day after day. We can start to access what their needs are and start to build a relationship with them. If you don’t have housing, so many obstacles pop up. For instance, if you’re trying to make an appointment with social services, odds are they’re going to ask for your address, and you’re not going to have one. So you need a place to get mail, and transportation too. It’s amazing, the basic needs that can’t be met without an address, an ID card, and a birth certificate. If you don’t have a birth certificate, you can’t get an ID card. If you don’t have an ID card, you might not be able to go to the Daily Planet and get clothes or a shower. So many basic services rely on these three essentials, plus transportation. We come in at the ground level and start with basics. Once we’ve got those established, we focus on the things clients have not been able to access or may need, like medical or psychiatric services.

Bad luck is an equal-opportunity handicap. And if you talk to our clients, they’ve had bad luck at every different stage of their lives. But nobody chooses to be homeless. If you’re in a shelter, you’re out at 5 or 6 walking around all day and trying not to be noticed. It’s a long day to walk around and try to be invisible. Homeless people try not to be noticed because other people are often not comfortable around them, and often policemen will arrest them for “trespassing”. When you’re on the street you’re not safe. And you certainly aren’t feeling secure when you’re wandering trying to stay out of everyone’s way all day long and hoping you can find somewhere to sleep.

In this program, it takes a lot of contact with clients. We need to convince them, for one thing, that this program isn’t like all the others, where you get dropped for missing one appointment, or when you give your info and they say, “We’ll call you”. What homeless person has a phone with minutes on it? That’s one of the advantages of our program, we have enough manpower to truly take care of and service people’s needs. We can stay with them, make things happen for them, and build that sense of trust, that trust that there is something better to be had.

Some of the people we see have been not treated effectively, and we have to try to get in there and make that better. And if they’re reluctant to take their medication, we’ll go to their apartments and help them take it there. We all become family pretty quickly. A lot of these patients, they do not have a lot of family support left, so we tend to fill in and help them learn to use community resources. So there’s a lot of educating, a lot of walking with people to help them find resources.

One thing that’s different about our program, again, is that we stay with the person, we don’t give up. We are very persistent and very sincere in saying we will not give up, we will stay here with you. Everyone makes mistakes, everyone has bad luck, everyone makes poor choices, and there are consequences. But we’ll be with you through that. We don’t walk away when things get tough. And I think that constancy of availability of someone to be with you and listen and try to be helpful is crucially important. And that’s something I’ve seen more in VSH than in other places I’ve worked.

It’s probably because we have that access at the housing level to get them set up, with furniture, with groceries, with medication. So it becomes more comprehensive and more effective. Case managers are out every day picking up clients, bringing them here and to social services, to the food bank, wherever. Whatever it takes. A while back, one of our clients became interested in computers. So our clinician spent a day with him going to Best Buy, picking out a computer, and helping set it up. And that’s the ultimate goal, that we can get them out there, teach them, and watch them fly off. After 3 years, we’ve got 2-3 in school, probably 6 working part time, and others who are volunteering and want to work. Folks just want to get back in the mainstream.

The thing that makes my day, is when I’ve seen people come into the program who are really desperately depressed, hopeless, and don’t know where to turn. And in a few months, I can ask them how they’re doing, and they say, “I’m happy. Life is good.” That’s flat-out amazing.

APTS is a good program, and it works, and I hope we can have more and more people come into it. Hopefully, there will be more and more people in the area not having to look forward to another day on the park bench, wondering where they’re going to be tomorrow.

To learn more about how A Place To Start helps its clients and its community, click here

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