Wednesday, November 26, 2014

Housing First is Harm Reduction

Safe shelter is a basic need; like food, water and air.  We don't tell people who are hungry that we will feed them just as soon as they complete their drug treatment program, or enroll in mental health services.  That would be cruel and frankly, criminal.  So why is it that some housing programs require people to do these things before we will provide them with safe housing.  It makes no sense to me.  The Housing First approach is based on the concept that a homeless individual's first and primary need is to obtain stable housing, and that other issues that may affect the person can and should be addressed once housing is obtained. It is the recognition that issues like mental health and substance abuse can be better managed and addressed when a person is in stable housing.  It is the concept that housing is used as a tool for recovery and not as a "prize" for compliance.  The thinking that a person can or will get clean and sober while they are living on the streets is false and dangerous.  The expectation that a person with chronic mental illness is going to stabilize on medication and attend regular appointments with a therapist is ridiculous.  To tell a person with a chronic health condition that they must comply with medical appointments and adhere to medication regimens or jeopardize their opportunity for housing is inhumane.  You cannot punish people into self sufficiency.


The Housing Readiness model means that we as providers, determine when the individual to be served has jumped through enough of our hoops and is "ready" to be housed.  I think this model is flawed in a number of ways, not the least of which is that the sickest and most vulnerable people are the ones who are left on the streets.  If we are serious about ending chronic homelessness and we want to prevent people from dying on the streets, we need to house the most vulnerable first. 


If I hear one more case manager or service provider tell me that, "Johnny chose to be homeless as  he did not meet his treatment or housing plan goals, and was discharged from the program," I think my head will explode.  Case managers will often talk about people being "non-compliant" with medical appointments, or that they stopped taking their medication medication, or the refused to go to substance abuse treatment so they are kick out of housing programs. Sometimes providers will say that when people are non-compliant with housing plans or medical plans, they need to experience the consequences of their behavior.  Death on the streets should not be the consequences for anyone for any reason. The fact that someone is not adhering to medical advice means their health is further compromised and discharge from housing only means that they are more likely to die on the streets. 
This approach makes no sense to me.


The Housing First model is evidence based.  There is a lot of research out there to support this model.  The research also shows that when people are in stable housing situation, they are more likely to engage in mental health services, health outcomes improve dramatically, people are more likely to seek recovery from substances and overall mental and physical health outcomes improve.


Someone who has been a mentor to me says that the first rule in caring for people is to "Do no harm".  This is a mantra that is taught to healthcare professionals around the world.  I think if we are making decisions that can potentially cause harm to a person we serve, we need to rethink our service delivery model.


Just my opinion,


Much Love,
Jonathan

Tuesday, November 25, 2014

Accidental Panhandler

On Monday morning, after sleeping under the bridge, I was crossing the busy intersection at Eastern and Reno.  As I stood with my backpack and bag full of blankets and dirty clothes still wet from the last night's rain, a pick up truck pulled up to the intersection and stopped in front of me.  The window rolled down and a man thrust his hand toward me, holding a 5 dollar bill.  He must of thought I was panhandling.  The intersection was very busy and though I tried to tell him that I didn't need the money, he could not hear because of the traffic.  He began to shake the bill at me indicating that I should take it.  I took the 5 dollars and yelled a thank you.  I had unintentionally solicited five dollars from a total stranger.


People in Oklahoma City are very generous as shown by the kindness of the stranger at that intersection.  However, that kind of generosity can be more harmful than helpful.  I learned early in my career that people who are homeless generally know where to go to have their basic needs met.  Information about where you can get food, shelter, clothing, medical care, etc. is readily available from other homeless people as well as the network of providers.  Outreach workers give that information to folks daily and people are referred to appropriate providers.  If someone is panhandling, generally they are asking for money for something other than the essentials.  They often want money to support an unhealthy or dangerous habit or addiction.  Daily, people unknowingly help support these unhealthy habits by giving panhandlers money.  There are other, much better ways of helping.  You can purchase Real Change Vouchers from the Homeless Alliance.  These vouchers can be given to panhandlers instead of cash.  The voucher is good for a bus ride to a service provider to get food, shelter and clothing.  You can also make a financial contribution to one the agencies that provides support to the homeless community.  That way your dollar is going to go much further in helping someone who is homeless.


During the past five days, I have met many people who are living on the streets of OKC and very few of them panhandle.  Studies have been conducted that show that the majority of people who panhandle ARE NOT HOMELESS.  They are people that are preying on the generosity of people for personal gain.  We have seen examples of this in the media time and again.


Ultimately, giving to panhandlers does not address the issue of homelessness.  Supporting programs that provide housing and support services to homeless people does.


By the way, if the man who handed me the 5 dollar bill is reading this.  Thank you very much!  I am going to donate that 5 dollars to a homeless services agency.


Much Love,
Jonathan

Monday, November 24, 2014

Homelessness is Hard Work

When I started this endeavor, I had ideas about trying to access some homeless services to see how easy it was to do so; to objectively look at how my agency and other service providers delivered services and maybe offer some suggestions as to how we could do better.  Four days into this, I am finding that all I have had time for is trying to figure out where I am going to get food and shelter and how I am going to get around the city.  Truly, these things have consumed me.  I have not been able to engage in any meaningful activities; anything other than finding resources to meet my basic needs.  I have never been more tired, or sore in my life.  I have blisters on my feet and I am absolutely exhausted.  I have been exposed to the elements; been beaten by the wind and rain.  I have slept in places not meant for humans to sleep.  I have waited in line after line after line to do things that I normally do on a daily basis without any thought; things like eating and bathing.  I have had to ask permission to use the restroom.  It is humiliating and tiresome.  That is what I have experienced in the past 4 days.  The people I have met out on the streets deal with it day after day after day.  And we wonder why homeless people can't just get a job and stop being homeless.  Like they choose to be subjected to these daily difficulties that are all-consuming; like they enjoy the disdain and humiliation they experience.


Without exception, every person that has commented to any posts on social media or commented about this blog have been very supportive.  They have said "Thank you for what you are doing".  They have called me courageous and someone even called me a hero.  I am not a hero.  I am not courageous.  I have never heard anyone call a homeless person courageous or a hero.  As a matter of fact, homeless people are often referred to as weak and as failures.  Nothing could be further from the truth.  The people I have met over the past 4 days have a strength I could never have.  They have a resilience and fortitude that are foreign to me.  The next time you see a homeless person on the street, consider how much it takes each day for them to survive; to stand back up when they are knocked down again and again. 


Homelessness is hard work.


Much Love,
Jonathan

Addiction, Recovery and Homelessness

Many of you know this, and some of you may not: I am in recovery.  I don't want to go too much into my story, because again, this is not about me.  I will just say that in September of this year I was able to say that I had been clean and sober for 10 years.  I will also say that I have thought about using and drinking more in the past 72 hours than I have in the past 10 years.  Not to worry; I am not going to act on those thoughts.  I have some great people in my life that support me when things go south and I have the tools I need to stay sober today.  Having said that, I think if I had to continue living on streets, my resolve to stay clean and sober may wane considerably. 







Many people that I have met over the past 4 days struggle with addition.  They drink and use as a means of escape; to try to change the way they feel.  Saturday night I met a gentleman who is living on the streets, exchanging sex for drugs, money and a place to sleep.  He said in the beginning he had sex with strangers because he needed a place to sleep; now he does it to support his drug habit.  A drug habit that began as a way of numbing himself and his feelings of shame.  It is a vicious cycle.





Sometimes we have an expectation that people get clean and sober while living on the streets so they will be "ready" for housing and other services.  We label people who cannot get clean and sober as "non-compliant" and "resistive to treatment".  It is a myth to think that someone who is living under a bridge is going to quit using drugs or alcohol.  It is unrealistic and can be harmful.  People die on the streets while we are waiting for them to get sober.





100 Pounds and Soaking Wet

He was huddled on the outside the closed gas stationed in the pouring rain with no coat and only a thin blanket to cover him.  The temperature was in the low 30's but with the wind, it felt much colder.  When I approached him he appeared scared and turned away.  I have been here before, but his is a face I don't recognize.  I never did get his name.  He would not tell me.  I offered to get him to an emergency shelter and he shook his head "no".  Finally, when I asked him if I could get him something to eat he responded in the affirmative.  I took him to the Waffle House where he gorged himself on pancakes and coffee.  With the blanket off of him, I could see how thin he was.  Very thin and soaked to the core.  He left a trail of water from the door of the diner to his seat.  They don't usually let him in, because he usually has no money to buy food.  After he ate, he left the Waffle House and I followed him out.  I asked where he would sleep tonight and he shrugged and started to walk away.  I gave him my business card and asked him to call me.  He did not respond.  He walked away in the pouring rain heading toward downtown OKC. 




This is one of the people I met last night in the cold rain at a busy intersection off of I-40.  I cheated last night.  Part of the challenge of the week on the streets was not to purchase anything, but I brought a credit card in case of an emergency.  This boy was hungry.  It was an emergency.  This story is not unique.  It happens on a daily basis in our city.  We see this all of the time when we are doing street outreach.  People alone, cold and hungry and not connected with services.  Emon Chavers, our Outreach Program Coordinator will tell you that successful outreach requires that we build trusting relationships with the people we serve.  Many of them have been abandoned and forgotton.  They have had their trust violated in the past by people that were charged with caring for them.  Regaining that trust is vital to success and difficult to establish.




There are some people that we have worked with for years and we are just now at a point where they are open to us helping.  Street outreach is about developing trusting relationships for the long haul. There is another individual living out at the same intersection that we have been working with for almost 4 years.  We will call him Frank.  Frank has been sleeping under a bridge for the past 2 years.  Prior to that he was sleeping in a tent behind a truck stop.  Frank is in a relationship with a woman who is a commercial sex worker; a prostitute.  The money she receives in exchange for sex and the money he gets from panhandling is what they live on.  Never enough to get off the streets.  Again, we have been working with him for 4 years, and it was not until this past year that he has even considered allowing us to help him.  This morning when he woke up, we talked about getting him into housing.  It has taken a long time to get to this point and it came from Emon and the rest of the great outreach team doing what they said they were going to do, when they said they were going to do it.  They have earned his trust and now, hopefully we can move to the next phase and help him get off the streets.




Last night was one of the most humbling experiences I have ever had.  I didn't sleep much.  It was so noisy under the bridge and so incredibly cold.  It is something that I will never forget.  I hope I don't forget how it felt.  How miserable I was.  The look in that young man's face.  Heartbreaking.




We can fix this.




Much Love
Jonathan

Sunday, November 23, 2014

Transportation

It seems like every meeting I attend and we start talking about barriers to accessing services for the people we serve, the issue of transportation is brought up.  It continues to be a barrier for homeless folks in our community.  I travelled to NW 39th and Penn yesterday and spent the night in that area. 
Be The Change has conducted outreach there for the past couple of years and that is where our Ground Floor Youth Resource Center is located.  I took the bus there and forgot that there is no bus service in Oklahoma City on Sundays.  I had to be back at Reno and Shartel at 10:00 this morning.  That was a very long walk.  Since I started this undertaking, I have developed a number of blisters on my feet and I have shin splints.  I have probably walked 30 miles in 2 days.  The folks I have met walk everywhere.

This is not an indictment of the transit system in Oklahoma City.  Metro-transit has recently undergone a rebranding as Embark and they have changed some routes and have some smart phone apps that make it easier to track location of buses, arrival times, etc. (most of our folks can't afford smart phones).  They are certainly working on addressing barriers related to transportation in out community.  Oklahoma City is very large and spread out.  A vast majority of people drive in our city, so there is not as big a demand for public transportation as there might be in comparable cities.  However, limited operating hours and routes can be crippling for people that rely on the bus system for work and other transportation needs.  If you work after 8 in the evening or on Sundays you are pretty much out of luck.  Not sure what the answer to this conundrum is, I just needed to rant a little.

The other issue that I find interesting is that it seems like EVERY organization has a van to transport people; every church, mosque and temple; every social service agency; every government agency.  But many of those vehicles remain parked and not in use for large parts of the day.  All these vans and still unmet transportation needs.  Hmmmm.  Be The Change relies on other agencies (Homeless Alliance, Expressions Community Center, etc.) to meet some of the transportation needs of the folks we serve, but it seems that we could figure out a way to use the transportation resources we already have to meet the community's transportation needs.

Kyle Pettit, who works for City Care at the Oklahoma City Day Shelter shared a situation that illustrates the issue.  He was working with a person who was homeless living on the streets.  The gentleman applied for, interviewed for and was hired for a job some distance from where he was sleeping.  He was going to have to take a bus to get to work.  On the first day of work, he got up extra early to shower at the Day Shelter and put on his uniform for his new job.  He was ready in plenty of time to make it to work.  He made it to the bus stop, bus pass in hand.  However, the bus was late and there was a problem with his transfer to another bus and he was 15 minutes late for his first day at work and was fired on the spot.  Very frustrating for someone that has worked so hard to try and improve his situation. 

I have talked with folks who are addressing the transportation problem.  I know we can figure it out.

More later,
Jonathan

Saturday, November 22, 2014

Us and Them

Many groups experience the "Us and Them" phenomenon.  You know, being treated differently because of the color of your skin, or your accent, or your gender, or your sexual orientation....It happens.  Unfortunately it is a reality in our world.  As a white male, I recognize my privilege.  I see it when I go to dinner with friends and the hostess directs all of questions and comments to me because I am the only white person in the group, or the only male.  I certainly don't want to generalize and say it happens all the time, but I am aware that that type or prejudice exists; assumptions being made based on the color of your skin, the gender that you present, your age, etc. 

Last night when I was walking around downtown with Johnny, he experienced that feeling.  We would walk by a restaurant as people were looking out the window.  They would smile at me and when they saw Johnny they would look away.  Johnny hasn't shaved in a while; probably because he does not have consistent access to facilities.  He hasn't washed his clothes in a while; probably because there is no washer and dry under the bridge he calls home.  In many people's eyes, Johnny is always "them".  Those other people.  The ones not like us.  We often draw a line between ourselves and those who are homeless.  Again, the assumption from uninformed people is that homeless people have somehow chosen their lot in life; that they somehow deserve to be homeless because of choices they have made or things they have done in their past. 

A few months back, I was working with a young lady (we'll call her Carrie) that was a commercial sex worker; a prostitute.  Carrie began offering sex to strangers for money when she was 16 years old.  She lived in a camp in central Oklahoma City and when we began to discuss how she could move from the streets into her own home, she really balked at the idea.  We talked all the time about how difficult life was for her on the streets, so I didn't understand why she was so resistant to talking about housing.  She said what I often hear from the community and even service providers;  She said "I choose to be homeless".  It has been my experience that most people that say, "I choose to be homeless" actually mean they don't think they deserve anything better.  After talking with Carrie about it for some time, she revealed that she felt unworthy of help.  She said she didn't deserve a better life.  She said that she chose to be a prostitute and therefore she deserved to be treated as less than.  I, of course, don't buy into that.  I believe all people have value.  I believe all people should have the opportunity to have a better life.  Carrie finally said the thing that really moved me.  When I asked her about why she began in the sex trade, she said "It is the only thing my mother ever taught me how to do."  We want to blame her for experiences in life.  We want to label her "them".  I think it makes "us" feel better about our choices and experiences. 

There's really no "us" and "them", only "we".

Much Love
Jonathan