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.
Posted on May 8, 2012
This blog was written by Georgi Fisher, case manager for HomeLink, a program of Virginia Supportive Housing.
For as long as I’ve worked in social work, I’ve had a difficult time grasping the idea of “housing readiness.” The idea behind housing readiness is that a person who is homeless should first conquer his or her demons and prove that they are ready for and, have in turn, earned the right to housing. While most homeless programs have operated off of this philosophy, this premise is one that homeless service providers have wrestled with for years. I’m not sure about you, but no one ever made me prove my ability to cook, clean, never make poor decisions, pay bills on time, and be the overall picture of perfection before they allowed me to have a roof over my head . If they had, I’m more than sure that I would never have been granted access to an apartment during my 20’s and probably never would have been given a house in my 30’s.
Virginia Supportive Housing subscribes to the “housing first” model, which focuses on bringing people directly from the street and into their own apartment. In this model there is not a period of transition from the street to a shelter, from a shelter to a transitional program, and from a transitional program to an apartment where a person has to earn their right to permanent housing. Here, the primary focus is to put an individual into permanent, stable housing right away. And this is where my role at Virginia Supportive Housing comes in. My name is Georgi and I was hired to work as a case manager for a brand new program within Virginia Supportive Housing called HomeLink. The HomeLink Program is one that was started to identify and house those most at risk of dying on the street. Since I first began to work with this program, many people have asked me why we put people into housing without asking them to clean up their credit, get a job, stop using drugs, follow directions, or otherwise be perfect. In the beginning it was difficult to answer this question, other than by just saying “because it’s right.” And then I met John.
John was one of my first client’s in the HomeLink Program and our first meeting was in the downtown Social Services building. I walked into the room and was met by a frail younger man wearing a heavy army coat and a hat that was pulled down over his eyes. The distinct odor of days without access to a shower and alcohol met me as I pulled a chair next to him. I introduced myself and John, without saying a word, slowly looked me up and down with a skeptical look on his face. He then said, “You and I aren’t going to get along.” Trying not to look taken aback, I smiled and said that was ok. The conversation didn’t necessarily go well from there. John was skeptical about my program and the fact that I was offering him housing with no strings attached. Several times during the first meeting he got up to walk away and I gently coaxed him back into the chair to talk with me. After an hour passed, we wrapped up our conversation and I asked John if he would want to go look at an apartment. He again looked at me with a bit of shock and skepticism, but advised that he did want to look at an apartment and we agreed to meet the next morning at a corner he liked to hang out at downtown.
The next day arrived and I pulled up to the corner to find my new client even more frail than the day before. His thin body was no longer wrapped in a heavy coat and the skeletal outline of his body was shocking. John seemed a bit more relaxed and opened up to tell me more about his history. He explained that he had been on the street for nine years and that he had been battling addiction. He also disclosed that, because of his addiction, he had burned many bridges with people in his life and that he had made the decision to separate from friends and family in an effort to protect them from further hurt. The shame was glaringly evident as he spoke quietly in the car next to me, head down and gaze pointed at the floor board of our van. After looking at an apartment, we set a date for John to move in just a couple of weeks away. He was quiet, but excited, and still a bit skeptical.
As I was driving him back to the place where he would spend his days, he disclosed that he had been feeling quite ill for weeks but did not want to go to the hospital. John, I knew, had AIDS and had, many times in the past, battled serious illness as a result of being on the street and not accessing proper nutrition or medical care. I offered to take him to the hospital to be looked at but he declined, saying that he did not like hospitals. I gave him my card and told him to call me if he changed his mind. Several days passed and John continued to decline to go to the hospital. Then, one night, right before I was leaving the office, I received a phone call from him saying that he would go. I immediately drove to pick him up but as we reached the hospital he, again, changed his mind. I offered to buy him a Frosty from Wendy’s and sit with him in the Emergency Room while he was evaluated. Looking surprised, he agreed and there we sat for hours, waiting for him to be seen. There were many strange looks as people walked by and saw me, dressed in my work clothes and John, dressed in his dirty army coat and stocking cap, sharing dinner and conversation together.
I imagine that John knew, in his heart, that if he went to the hospital he might never get to come back home. He had battled with severe pain and nausea for weeks but never wanted to go to the hospital because of fear of the unknown, denial, and, on a deep level, fear about how people would treat him knowing that he was homeless, an alcoholic, and HIV positive. John was admitted into the hospital that evening and, for the next two months, he remained there. Battling sepsis, an infection in the blood, and meningitis, John lay weak and in pain in his hospital bed. Every day I, or one of the two social workers on my team, would go and sit with John. We would talk about the weather, about his day, about his illness, about his hopes to go to his new apartment, and, toward the end, about the many joys and many regrets that he had about his life.
Always with gratitude, John began to open up about his life. He shared about his long-term relationship with a young woman and the three beautiful children that had come out of that relationship. He shared about how he and his partner battled addiction, he to alcohol and her to heroin, and how their youngest son was born addicted to drugs. He shared the guilt that he and his partner fought with daily about his son’s exposure to drugs. John then shared that their baby boy passed away at just 31 days old due to birth defects caused by his partner’s substance abuse. He spoke about the deep rift that his son’s death had left in his family and how, a few months after the baby’s death, his partner had left him a note apologizing for harming their son and explaining her deep sadness. He found that note and his partner after she killed herself. He described the panic, the despair and the anger that he felt, now being alone with two children. It was there, he explained, that his addiction took a dramatic turn and there that he began to lose touch with the world.
Several weeks after our first meeting, I found myself sitting in John’s hospice room, gently washing and shaving him with another social worker from my team. John was unconscious, now in a coma state, but it was a final act to bring dignity to a man who so many had looked past or given up on. We played Teddy Pendergrass, his favorite musician, on a CD player next to his bed, changed him into a clean gown, and tucked him into fresh linens. For many people, these steps would be carried out by family members enjoying the last moments with their loved one. But for many other people, these moments wouldn’t be shared with anyone. For our clients, their last moments would have been alone, under a bridge or in an abandoned building, without care or comfort and, most likely, without ever being identified after their death.
Having the pleasure and privilege of being John’s social worker taught me quite a bit about life and its value. More importantly, John finally gave me an ability to answer the question that so many had asked me regarding the housing first model – why? Now, I can easily say “because of John.” Without a housing first model, John would have never been identified for intensive case management and would have, most likely, continued to refuse care and treatment. And, though John was never able to move into his apartment, he died surrounded by people who loved and cared for him.
John’s death could have been prevented. With early identification and intensive case management, John could have received necessary treatment and follow up that would have ultimately saved his life. That is why we believe in and practice a housing first model. I now carry a case load of individual’s who are struggling with AIDS, advanced cancer, heart disease, acute kidney failure, mental health and substance abuse, among a host of other medical and psychological diagnoses. Since I started working with HomeLink four months ago, I have buried two clients and am actively preparing for the death of a third. I realize, with every new person that I meet, that the investment in a housing first model will eventually move from providing compassionate end of life care to providing important interventional care that will allow for our client’s survival and reestablishment into the world.
So, housing first is about ensuring survival, practicing compassion, and realizing our own imperfections. Jesse Jackson once said, “Never look down on another person unless you are helping them up.” Every day I know that, when I offer my hand, I am helping another person up.
Posted on April 3, 2012
This blog was written by VSH’s volunteer resources manager, Alison Jones-Nassar.
For those of us who have never been homeless, I think it’s hard if not impossible to understand the complex mixture of feelings that is experienced by someone who has been homeless on the day their nightmare ends and they move into permanent housing. On Thursday, March 29, it was my privilege to witness one person’s private journey as she turned the key in the lock of her brand new apartment home.
It was a perfect day for a move. The sky was a beautiful cloudless blue, the sun was warm and the breeze was mild. The woman (I’ll call her Sandra) who presented herself at the office of The Crossings at Fourth & Preston, our newest development in Charlottesville, looked about my age. Her face was worn but she seemed almost giddy as she practically skipped behind the property manager to the elevator. She lunged for the button and I laughingly told her she reminded me of my 13-year-old. “I can’t believe I’ll be taking this elevator up and down every day,” she said rubbing her hands in delight. “It’s going to take a while for that to get old.”
On the way to her unit, she stopped to admire every pristine detail, from the light fixtures to the paneling. It was as if she did not want to arrive too quickly, as if she was savoring every exquisite moment of anticipation. Her hands shook as she slipped the key into the lock and, as the door swung open, I suddenly realized I was taking part in a deeply intimate moment, both bitter and sweet in equal measures.
It is not unusual for joy to express itself sometimes as tears, at other times as dancing. This new tenant erupted into both as she tentatively walked into the apartment, clasping her hands and rocking from side to side. The spacious room barely seemed able to contain her overflowing feelings of happiness and relief. Almost immediately, she threw open the window and took in the view below. What was she seeing? What was she remembering?
What does “home” mean to any of us? Comfort? Stability? Family? Peace? Surely for Sandra, just a year younger than me and a mother like myself, it meant all that and so much more. “I have worked all my life. I did everything I was supposed to. How did I end up this way? How did this happen to me?” I did not ask questions, but some details emerged. She had moved around a lot in her life. She had a daughter living up north that she had not seen in several years. She had been evicted from her last apartment and it seemed as though she had been living for a while in her car. She joked about it, calling herself “residentially challenged.” But later she bristled with resentment as she talked about the assumptions people made that she had become homeless because of “poor life choices.” She made a point of distancing herself from downtown “hangouts” and other homeless individuals who frequented those places. “That’s not me.”
We worked all morning, loading her car with boxes and bags that she had been able to store at a local church. It was the familiar things we all accumulate: plastic hangers, a box of kitchen knives, books, stacks of neatly folded clothes, a set of luggage given to her by her grandmother when she was fifteen. As we delivered the last of it to her apartment, Sandra turned to me and said, “I thought I was going to have to do all this by myself today, that I wouldn’t have anyone to share it with. Thank you!”
I can’t say with any confidence why so much terrible misery exists in the world. Do all things really happen for a reason? Does everything truly happen “exactly the way it’s supposed to”, as we who are so blessed like to insist? All I know is that, if we can heal even a fraction of that misery by responding with kindness and compassion when the opportunity comes our way, then maybe there is redemption in that – for the ones who suffer and for us too.
When I drove to Charlottesville that morning, I had no idea what the day held in store for me. I thought I would be taking a few photos and distributing some donations, but it turned out to be so much better. For that, I am the one who is thankful.
Posted on February 21, 2012
This week’s blog was written by VSH volunteer Amanda Roose of Foursquare Family Life Center.
“It has been almost one year since I have been volunteering with VSH, and my life has been messed up in the best of ways because of it. One of the most rewarding things I have gotten to be a part of has been our weekly game nights with the tenants at South Richmond. It’s such a simple thing, bringing games and snacks and sharing stories, but it has opened up friendships that I cannot fathom living without. These aren’t just random people I share a coke with anymore, they are real people with real stories and real hearts, and they matter to me. In my normal routine I would have never passed by my new friends, but stepping out of my routine and building relationships with them has probably changed my life more than theirs. Last August I was a part of Richmond Registry Week on a survey team. Seeing Richmond’s invisible people firsthand hurt me on many levels, but what gave me hope was that I was doing something to solve this problem. The homeless are more than statistics to me now. They have faces, names, and voices that are aching to be heard.
“Teams from my church have painted the inside and outside of a family’s new home. We have done construction and gardening. We have had pizza and bingo nights. We have shared life and shared hope. We have had Thanksgiving dinner with them and spent Christmas day with them. We have donated house supplies for new tenants moving in. We have been a part of solving homelessness alongside Virginia Supportive Housing. It may not have always been convenient, but it has always been rewarding and worth it. Life is too short to live for myself, so I have resolved to be second, and put others first. I am so grateful for the team at Virginia Supportive Housing who have dedicated their lives to seeing others get a fresh new start, and that they let us be a part of the restoration.”
If you would like to find out more about how to give the gift of your time to VSH, visit our web page or take a look at volunteers in action. Then send an e-mail to [email protected] to attend the next orientation on March 13!
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.