About 2,500 homeless people bed down nightly in King County's alleys, doorways, and vacant lots, according to the most recent One Night Count. Chronic mental illnesses keep many of these "rough sleepers" from trusting service providers enough to make use of available help.
Seattle's Union Gospel Mission (SUGM) is launching an innovative volunteer project to shepherd homeless people with mental illnesses toward the services and housing they need.
Mike Johnson, SUGM special projects director, thinks it's high time for a concerted new approach. "American mental-health systems are based on a person’s willingness to engage in care," he told me. "It’s very difficult to impose care services on a person." Individuals must consent to medical help, but many with mental illnesses don't think they're sick.
"A guy at our shelter said in a perfectly lucid way that he didn’t believe he had an illness; he just had a different opinion," said Johnson — which was that the government is turning everybody into robots. "For him it was true. So why would he let strangers give him medicines to affect his brain?"
Conservative estimates are that more than 15 percent of homeless single adults suffer from severe, chronic mental illnesses. Schizophrenia in particular drives many homeless people to “choose” an unsheltered life despite its miseries and menace. Of course, they’re not really choosing it. The gang of ghosts that took over their minds questions their every move, perhaps warning them against spending time in buildings, where people or things can corner them and pounce. A young relative of mine, disabled by untreated paranoid schizophrenia, won’t even spend his food-stamp allowance: “Why should I eat when it’s Big Brother telling me to?”
Small wonder that many with mental illnesses who refuse treatment use alcohol in efforts to self-medicate their symptoms and mitigate the feeling of social isolation that lets symptoms multiply.
Johnson has created a systematic, volunteer-driven plan for developing sociable relationships with these individuals that can gradually move them toward the services they need. "Building the trust it will take for a person to accept care" requires the efforts of volunteers in the community, he said. "The time-intensive nature of the work renders it too expensive to be done by paid professionals."
Project volunteers will receive three kinds of preparation in the first, outreach phase. Harborview Hospital mental health chaplain Craig Rennebohm, who has pioneered one-on-one companioning of individuals with mental illness on the streets, will provide training in how to form bonds of trust with people in a carefully limited in-public relationship. A Mental Health First Aid training will certify volunteers in the special skills and knowledge they need to work with a mentally ill person. Then SUGM will support volunteers as they go out in pairs and trios to build relationships with a very few individuals. "Two or three trained volunteers reaching two or three homeless people" is Johnson's core concept.
The outreach phase will take many months with each person. Said Rennebohm, "Probably 50 percent of the people I work with get off the streets within a year. Many begin to build trust quickly; others take years." It depends on the nature of the illness, he said, as well as on how traumatic their experience of homelessness has been. "The more trauma, the more frightened they are by their symptoms."
After trust is established (this may not be possible in every case) comes the second phase: stabilization. Volunteers will maintain their relationship with each person as he or she moves into one of SUGM's temporary shelters, accesses health services, and participates in ongoing treatment. In the third phase SUGM will partner with local churches to provide each person with permanent supportive housing plus continued companionship from individuals in the wider community, along the lines of a successful model sponsored by Seattle's Plymouth Congregational Church, called Plymouth Healing Communities (I serve on the PHC board, as does Rennebohm).
Johnson calls the SUGM initiative "a beautiful corrective to our tendency to hire out things that really should be done by communities and extended families." In America "we tax ourselves and build agencies to solve problems that are really community problems. Then we wonder why they don’t work."
This project will work, with some dedicated volunteers.
This weekend: 12-hour Mental Health First Aid certification class, Friday (May 6), 6-9 p.m., and Saturday (May 7), 8 a.m.-5 p.m., at the SUGM women’s shelter Hope Place, 3802 S. Othello. Cost: $20 for materials [5/6/11 CORRECTION: $40]. Sign up with Timothy Tetrault, SUGM Search and Rescue Coordinator, 206-622-5177 ext. 112 (office), 206-498-7913 (cell), TTetrault@ugm.org.