Rose Salveson plays the keyboard at her home. For Salveson, music is a way to express herself.

At the age of 18, Rose Salveson was new to Seattle, recently divorced and homeless. It wasn’t the first time she faced hardship in her life. Both of her parents died when she was young, and Salveson felt the loss of them at a young age led her to a toxic relationship.

Salveson found herself caught in the cycle of homelessness. She received help from multiple organizations that work with people experiencing homeless and stayed in different shelters, but her struggles continued. She is always positive and looking out for others, but the childhood trauma of losing both parents meant she lacked the tools to take care of herself in a sustainable way. 

Eventually, she was connected with rapid rehousing services through New Horizons in Seattle. Once she settled into an apartment, the case manager suggested she seek therapy.

“He saw something in me that at the time I kind of was avoiding,” Salveson said.

Salveson became a client at Friends of Youth, a youth-oriented social services organization, where she would learn a lot about herself and her emotions, and begin the journey to process the hardships she had experienced. Therapy allowed her to prioritize self-care and show up for herself, which would end up helping break the cycle of homelessness.

“It was really my decision if I wanted to follow through with actually tackling my mental health or go on with my toxic positivity and just go through life on autopilot,” Salveson said. “I started going to Friends of Youth because I knew I wanted something better for my mental health.”

At Friends of Youth, Salveson worked closely with Kimberly Rixon, a clinical supervisor and therapist. “She’s awesome because she’s not only a counselor that talks. She’s a listener — she listens the whole session,” Salveson said of Rixon, who helped Salveson to not just talk through her past experiences, but to tune into experiences. 

This was a struggle for her. When her dad died of cancer, Salveson tried to make everyone around her feel better, never focusing on herself. The same was true after her mom died in a car accident. She always felt that she had to be strong, but now she has learned that strength can also mean being vulnerable.

“I had to learn that strength is not just, ‘Oh, I can handle this.’ It's, ‘I can cry in vulnerability,’” Salveson said.

Rixon helped Salveson to see that the reason she might struggle with this is because she didn’t have an adult to lean on growing up.

Salveson is just one of the many people who have benefited from the services of Friends of Youth. Youth with mental health conditions are incredibly vulnerable to houselessness. According to a December 2018 report from A Way Home Washington, a nonprofit focused on ending youth homelessness, about 1,200 young people become homeless each year after being discharged from publicly  funded inpatient behavioral health treatment programs.

And the implications for youths’ wellbeing can be huge, since the experience of being houseless seems to correlate with worsening mental health. According to the 2018 Greater Los Angeles Homeless Count, approximately one in five youth experiencing homelessness reported also having a serious mental illness.

Organizations like Friends of Youth understand that prioritizing mental health for youth who have experienced homelessness is essential to better outcomes. That is why their work extends beyond connecting people with housing to providing youth with mental health services they need to help break the cycle of homelessness.

“Friends of Youth serves youth and young adults across all walks of life,” said Brooke Drennon, director of Youth and Family Services at Friends of Youth. “We have residential treatment, shelters, transitional living and outreach. And we have recognized as an agency that mental health plays a huge role in all of those aspects and that we need to be serving the whole person, not just specific things that they’re facing from day to day.”

Drennon supervises Friends of Youth’s outpatient mental health and substance use counseling programs. “When we are working with youth and families, our therapists and staff really try to work with the family and the youth to recognize their full potential and see what they already have within themselves that they can bring out,” Drennon said.

Drennon said Friends of Youth staff are frequently seeing mental health symptoms exacerbated by COVID-19, impacting conditions like complex trauma, anxiety and depression. “Youth and families that come into Friends of Youth face an array of issues,” Drennon said. “They are dealing with interpersonal relationships with friends. They are dealing with complex family issues — abuse, neglect, different levels and layers of trauma.”

To address these challenges, therapists like Rixon meet with their clients regularly, and together they identify and strive for goals. In particular, Rixon primarily works with Friends of Youth clients who have complex trauma conditions. 

“Everyone has core beliefs about themselves and about the world that are formed from their early experiences,” Rixon said. “So, it's not unique to youth who have more trauma.” 

It’s just that youth who have more trauma might have more dysfunctional beliefs, she said.

Rixon sees her role as providing tools to help young people have autonomy and independence with their lives. She helps clients focus on what they need to improve in the present and what pieces of their past might still be impacting them.

“When youth meet with our therapists, they develop a treatment plan and they identify goals that they want to work on,” Drennon said. “But ultimately, regardless of what those goals are, our therapists are working with them to identify strengths, build them up, and really recognize their full potential and what they can bring to the table.” 

Much of her work is focused on helping clients function as adults day to day. 

“At the end of the day, the goal for us with our clients is that clients will leave here recognizing their full potential and be able to live a successful life without needing us anymore,” Drennon said.

Rixon said there is more awareness now about mental health, which has helped to decrease stigma, but it is still present and contributes to clients’ sense that something is wrong with them. 

“I think there is maybe a sense of, if you're going to therapy, you're going to be told all this stuff you’re doing wrong as a parent or as a person. And as therapists, we really try to approach that in a way that's really collaborative — not like, what are you doing that's wrong, but what would you like to be different?” Rixon said.

Because of the stigma around seeking help for mental health, Drennon said clients often struggle to dig deep and figure out what is going on for them. Therapists work to create a space where there are no judgments and youth can open up about their concerns without holding back. Drennon said it is her goal that everyone who comes to Friends of Youth feels supported and able to share. Moments of success and steps forward inspire her to keep doing this work — from seeing a child laugh for the first time in office to watching a young adult go to college.

A hand holds a photo of Rose Salveson when she was 18 and experiencing homelessness.

A photo of Rose Salveson when she was still experiencing homelessness. Salveson became homeless when she was 18.

Friends of Youth’s school and community-based programs are funded primarily by the county and the state. All outpatient services are covered through commercial insurance or Medicaid. But for those who don’t have insurance but still need services, Friends of Youth also offers a sliding scale.

Private partners like Premera Blue Cross also step in to make sure Friends of Youth has all the resources they need to fulfill their vital role in the community. 

Paul Hollie, head of Premera’s Social Impact program, understands how behavioral health intersects with all aspects of health. “Behavioral health has always been a pillar of our program, including youth mental health,” Hollie said. “Dealing with the pandemic has allowed for a broader understanding of the deep impact trauma and instability has on our health. It also has spurred more meaningful conversations about the importance of mental health.”

Premera’s Social Impact program is a key driver of the company’s mission to make health care work better by identifying and bolstering important efforts already underway within communities. Hollie said it goes beyond just financial backing to being a partner; it is important to stand next to an organization and adapt to help fill their needs.

“It isn’t Premera’s role to dictate how to solve the problems affecting our community,” Hollie said. “We’re here to support the tremendous work of organizations like Friends of Youth. They understand the needs of the communities they serve, and we want to help ensure they have all the resources they need.”

Clients can access therapy through Friends of Youth both in-person or online. 

“Oftentimes that first phone call asking for help or support can be scary and we have welcoming people on the other end of the phone that will be glad to talk to you and get your information,” Drennon said.

While it can be intimidating to pick up the phone and reach out for help, it can also be life-changing. It was for Rose Salveson. 

“You're not just another case to them,” she said. “You're a person that is … worthy of a good life … Where I'm at today has been so much a part of what Friends of Youth has allowed me to see for myself as who I am.”

More information is available on the organization’s website or by calling (425) 869-6490.