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 Saves Lives and Money

Posted on January 26, 2011

This week’s blog was written by VSH’s Executive Director, Alice Tousignant.

Five years ago, we were all scratching our heads trying to figure out what to do with a certain segment of the homeless population who weren’t getting helped.  These were individuals who were chronically homeless with serious mental illness, many of whom also had a co-occurring substance abuse issue.  Truthfully, many of us had gotten to the point of saying that this specific population chose to be homeless— that was our excuse.  The thing is, no one bothered to ask them what they wanted and if they really did want to be homeless.  The bottom line was that the community, including Virginia Supportive Housing, didn’t know how to help them and we had almost given up trying. 

But then two things happened: we starting hearing stories from around the nation about how chronically homeless people were costing the community money—in other words, even though chronically homeless people comprise a relatively small percentage (about 15%) of the overall population of people experiencing homelessness, they were using a disproportionately high amount of the resources in the community.  We also started hearing about some best practice programs that were successfully housing this population, and these programs were gradually spreading around the nation.

One of these programs was Pathways to Housing, a program that began in New York almost 10 years ago.  After hearing about this program, I must admit I was very skeptical. Not only did I not really believe it could work, it also seemed very costly.  Then PBS did a special on a gentleman called “Footie” who they followed as he entered the Pathways program.  One of the things I vividly remember from the Pathways video was that they talked to individuals who had been living on the streets for years and asked them what they wanted most.  And, guess what they said?  They wanted housing.  They didn’t say they wanted to remain homeless.  That video turned my skepticism to amazement and optimism.  I remember thinking, “We can do this here in Richmond.” 

Working with many partners in the community, including Homeward, the Daily Planet, the Community Services Boards of Richmond, Chesterfield and Henrico and the Virginia Housing Development Authority, A Place to Start (APTS) became our Pathways to Housing in Greater Richmond.  The program was launched in late 2007 and began taking individuals off the street shortly thereafter.

APTS places individuals with an extensive history of homelessness and a serious mental illness into permanent housing and wraps intensive services around them.  APTS has a dedicated service team of professionals, including a psychiatrist, nurse, social worker, peer counselor, substance abuse counselor and employment specialist who provide services 24/7.  APTS also has a housing specialist who works with landlords to broker leases, get clients into permanent housing, and ensure that program participants and landlords are getting what they need.  

We knew the program worked because it was evidenced based, but we needed to prove it worked here in Richmond.  So, we undertook an evaluation funded through the Greater Richmond Chamber Foundation and conducted by the Central VA Health Planning Agency.  The research looked at hospital and incarceration data on 50 clients enrolled in the program and measured costs and incidents 20 months prior to program entry and 20 months after.  The research is complete and the report was released today.

While we knew the program would work, we didn’t know how well it would work.  APTS has taken 58 people off the streets in three years with a 98% success rate in keeping people stably housed!  Only one person has returned to homelessness. 

And APTS is saving the community precious resources.  The research shows that the program has saved the community over $320,000 in the first 20 months in hospital and incarceration costs alone. This does not even include other costs, such as ambulance costs, judiciary costs, and the costs to the homeless services system.

Has this program made a difference in the community?  Yes!  In addition to cost savings, it is making a big difference in the community. We’re taking people off the streets. Most of the folks in the program were unsheltered prior to entering the program and were counted as such in the community’s twice yearly count of individuals experiencing homelessness.  In July 2008, there were 148 people who were counted as “unsheltered homeless.”  In July 2010, that number had gone down to 119, which is a 19% reduction in two years!  Some of this reduction is due to APTS.

What about peoples’ lives?  Just ask Jerome who has been in the program for over two years.  He had been homeless for eight years, living in alleys, dumpsters, and under cars and bushes in Richmond. He suffered frostbite in both feet.  “I struggled like a dog.”  He said that he would have died if he had lived on the street one more year. 

And, there are many more stories like Jerome’s. Despite all that we have accomplished through VSH and APTS, there is still plenty of work that needs to be done. There are still people living on the streets who need to get into housing and get the help they need, and we can’t do that without the community’s support.  To support A Place To Start and the work of VSH to provide proven permanent solutions to homelessness, click here. Thank you!

Not all disabilities are created equal

Posted on August 3, 2010

On July 26th, there was a celebration at the White House to commemorate the 20th anniversary of the passing of the American’s with Disabilities Act (ADA), which for the first time protected the rights of people with physical and mental disabilities, and prohibited discrimination on the basis of disability in employment, public services and public accommodations

For those of you who don’t know, I am legally blind.  While I don’t consider myself disabled in the full sense of the word, I can get accommodations under the ADA.  However, since my handicap is physical it does not have nearly the stigma as mental illness.

As a matter of fact, I would venture to guess that many people don’t know that people with mental illness are covered under the ADA.  Working at Virginia Supportive Housing has taught me that people with mental illness are discriminated against in housing and employment more often than physically disabled people and many times their disability is far more debilitating.  People with serious mental illness often become homeless because of their disability and have a very difficult time getting into and staying in permanent housing.  It is estimated that nationally 20 to 25% of individuals experiencing homelessness have a serous mental illness.

At VSH, we are successful at helping people with mental illness obtain and maintain permanent housing because of the clinical nature of the services we provide.  We have seen many people whose lives have been transformed through patient and consistent services that are available to them, in some cases 24 hours a day, seven days a week.

Last week, I was especially heartened to see that Nathanial Ayers performed in front of President Obama at the commemoration of the ADA.  I was glad to see that Mr. Ayers was still doing well.  Mr. Ayers is a musician who was homeless for many years due to his mental illness.  He was befriended by Steve Lopez, a journalist with the Los Angeles Times who wrote a book, The Soloist, that eventually became a movie.  Mr. Lopez and a nonprofit supportive housing provider took the time to work with Mr. Ayers and get him into permanent housing where he is living with his disability with respect and dignity.  Another success story!

But there are still a lot of people out there who are disabled due to mental illness who still need compassion, respect and a place to live.  I hope all of us continue to work hard to make sure that persons with mental illness are afforded the same opportunities and rights that Mr. Ayers received so that in 20 years when we celebrate the 40th anniversary of the ADA there are many more success stories.

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