Posted on August 16, 2011
This blog was written by VSH’s summer PR intern, James Denison
At one point during Richmond Registry Week, I was walking down Chamberlayne Road with a flashlight and a clipboard at the ungodly hour of 4:30 in the morning. Actually, that phrase “ungodly hour” seems ironic to me. It’s as if nothing good happens at that time, as if the only people out and about then are drug dealers, or gang members, or witches. But my team and I were out trying to locate homeless individuals before the sun rose, because they tend to be on the move early too.
We were out as part of the 1000 Homes for 1000 Virginians campaign, seeking to identify the most vulnerable homeless folks in Richmond, and looking for individuals sleeping on the ground or under bridges was a pretty good place to start. So the first thing I learned this week was how early homeless people have to get up. By 6:30 at the latest, they are generally awake and starting their days.
You’d think that folks would be grumpy or hostile about being woken up by a pack of strangers shining lights and asking questions, right? Well, a couple of people did want to go back to sleep. But for the most part, the individuals we met were perfectly willing to complete the vulnerability surveys, which took about 15 minutes. And to thank them for their cooperation, we made sure they knew where their next meal was coming from by giving out McDonald’s gift cards.
All in all, we surveyed more than 150 folks in three mornings, and about half of them fit the criteria for vulnerability, which was based on a combination of age, repeated homelessness, and chronic physical and mental health problems. Personally, I got to interview one man (I’ll call him Jerry) who was living under a bridge and had previously been involuntarily committed to a mental hospital. This means that at one time, he must have done something destructive enough to be classified as an imminent danger to himself or to others.
Previously, I wrote a blog about how overcrowded conditions in mental health facilities had led to hundreds of patients being turned away, which led to many of them becoming homeless. At the time, I thought I understood the issue; I thought I cared about getting these individuals off the streets. And I did. But as I watched Jerry mumble to himself and tell me about spirits and spells, the weight of his situation and the necessity of getting him into supportive housing was made real for me.
As a society, we simply cannot allow individuals like Jerry to be left out on the streets to fend for themselves. Jerry may be mentally ill and homeless, but his life is not worthless. With Richmond Registry Week and many other efforts, VSH is committed to standing alongside folks like Jerry in their hard times. The dream is that one day, Jerry and people like him will be able to spend their ungodly hours in the security of their own homes.
You can help make that dream a reality. To find out how, click here.
Posted on May 25, 2011
This week’s blog was written by Robin Gahan, Program Manager for the Virginia Coalition to End Homelessness and former VSH intern.
“Housing is a human right.”
“Homelessness is a public health issue.”
“This is not an issue of who is deserving or undeserving, but a matter of life or death.”
Statements such as these are heard now more than ever before as the growing concern about the vulnerability of persons experiencing homelessness is resonating across the globe. The examination of homelessness, housing, health, and mortality have increasingly appeared in the literature across a range of fields including social work, medicine, psychology, and public health. According to the National Health Care for the Homeless Council (2008), persons that are homeless are three to six times more likely to become ill than those who are housed and are three to four times more likely to die than the general population (O’Connell, 2005). As a social worker, I am called to challenge social injustice and feel passionately that a world that tolerates the death of people living on the streets without housing is unacceptable. While serving as an intern at VSH, I had the opportunity to see the Housing First philosophy in action, a philosophy that is client-centered and has successfully kept the most vulnerable people housed.
While there is a great deal of research available on the impact of housing for persons that are homeless with mental health and substance use issues, there are still significant gaps specific to housing’s impact on physical health. At VSH, the support staff expressed concern about the rate of resident deaths related to health issues. It became apparent that there are a number of formerly homeless adults who are aging and/or medically frail living in permanent supportive housing. While housing can decrease certain risk factors such as exposure to frostbite and hypothermia, long-term chronic illnesses such as end stage renal disease or diabetes do not decrease simply as result of being housed. With the support of VSH, I sought to conduct an agency-based needs assessment to determine the health needs of persons once housed to enhance existing services and increase the programmatic response to physical health needs of persons living in permanent supportive housing.
Through secondary data analysis, I found that since 1997, 30 known residents have had serious health issues that resulted in their death, almost 50 percent of which have occurred in the past three years. The mean age of residents at their time of death was 55 years old. Second, I administered a modified version of the Vulnerability Index, designed by Dr. Jim O’Connell and Becky Kanis. I found that all participants surveyed reported having a disability, 75 percent reported a substance abuse related disability, 63 percent reported mental health disability, and 75 percent reported a physical disability. The most frequently reported physical illnesses included hypertension, arthritis, diabetes, and heart disease. Other responses included kidney disease, hepatitis C, osteoporosis, COPD, asthma, stroke, epilepsy/seizures, and emphysema.
I then conducted eight qualitative interviews with current residents in order to engage in more open dialogue and learn how each individual defined their own health and their perception of need. From the interviews, the following themes emerged: (1) loss and changes to physical ability, (2) impact of physical health on mental health, (3) access to services in the community, and (4) satisfaction with support and additional needs. Overall, those surveyed expressed high levels of satisfaction with agency support received. However, when asked how health needs could be better met, participants provided suggestions that would require services to more directly address health through increased on-site health screenings and classes, available medical equipment, and on-site medical expertise such as a registered nurse. In conclusion, it is hoped that the dissemination of this study will be utilized to enhance existing services and increase the programmatic response to physical health needs of residents living in permanent supportive housing.
I am deeply grateful to the men and women with whom I had the pleasure to interview for my study. Thank you for allowing me the opportunity to share your story, to better understand your needs, and for providing authenticity to a highly controversial issue. I would also like to thank all of the social workers, peer specialists, and support staff that assisted me in collecting data, selecting residents for interview, and patiently tolerated my barrage of emails. Last but not least, a sincere thank you to Kristin Yavorsky, the VSH Director of Support Services who not only brought this issue to the forefront of my mind, but whose wisdom and support of my learning process allowed me to take on this endeavor.
Posted on February 15, 2011
As the rhetoric in Washington heats up over the annual budget, it seems as if most lawmakers are still applying the same old equations to the problem of reducing the deficit. While it may be appropriate in some ways to cut spending by cutting services, many of us know that short-term savings now very often translate into long-term spending increases later. This is especially true for services that benefit vulnerable populations. When very low-income individuals lose access to fundamental programs that they can’t otherwise afford, the overall financial burden to the community actually increases. This is just an economic reality that we desperately need to face.
As the budget conversation moves forward (or not), it is important to remember that there is more than one way to save money. In January of 2011, Virginia Supportive Housing skillfully demonstrated this fact when it released a report on the success of one of its programs, A Place To Start.
A Place To Start is an innovative program that serves chronically homeless individuals who have serious mental illness. By providing permanent housing and support services for these individuals, the report clearly shows that a substantial amount of money can be saved. Given the report’s outcomes, only one conclusion makes sense. When it comes to homelessness, the solution is cheaper than the problem. We need to invest in – not cut – services that get the job done right.
The APTS report specifically tracks the costs associated with four “events” common to chronically homeless individuals: emergency room visits, hospitalizations, arrests, and incarcerations. The occurrences of these events were documented among the program’s fifty-two participants during a forty-month period (twenty months prior to entry into the program and twenty months following entry into the program). A comparison of the two time periods reveals an astonishing $320,000 in savings to the community.
According to the National Alliance to End Homelessness, more than 112,000 individuals experienced chronic homelessness in the US in 2009. It’s easy to extrapolate this local data to conclude that if fifty chronically homeless individuals cost the community $320,000 over a twenty-month period, then 112,000 chronically homeless individuals must cost taxpayers at least $716,000,000 just in terms of those four common events. This is real money being spent right now without much to show for it. On the flip side, if these individuals had access to permanent supportive housing, the country could and would save at least that much within less than two years. Although that doesn’t completely solve our deficit woes, it does go a very long way AND it addresses a problem that our country has been struggling with unsuccessfully for decades.
So yes, lawmakers, let’s exercise fiscal responsibility by reigning in spending. But let’s do it in a way that won’t backfire on us three or five years down the road. There is a way, right now, for us to reduce the enormous cost of homelessness. Do the math. Invest in permanent supportive housing.