Accidents Will Happen: The Need for Respite Care in Central Alabama

Firehouse accident 5.28.14

                                                                                                                                                            (photo courtesy of al.com)

There was a car accident in front of the Firehouse Shelter this morning and four men were injured in that accident. Of course my first thought was hope that everyone involved will be ok…but when I learned that the four men had been taken to the hospital, I began to wonder about something else–something I might not have been concerned about had the four men not been standing in front of an emergency shelter for men.

If their injuries are severe, where can they go for rehabilitation?  You see, we really don’t have many choices for people who are homeless when they are not sick enough to keep in a hospital but yet they are too sick to release them to the streets.

I don’t know yet about the extent of injuries for these men, but I have been informed that 3 of the 4 will need surgery. I’ve had two fairly major surgeries in my life; one was outpatient and the other required several days of hospitalization. For the outpatient surgery, I couldn’t be released without someone to “take me home.” When I got home, I went to bed and for several days afterwards had someone help me with basic living skills like bathing and preparing meals. With the inpatient surgery, the release was much the same…hospital released me to go home and rest and I was only released because I had someone at home who could care for me. I was lucky enough to have plenty of medical insurance, but what if these men don’t?  Hospitals can not afford to keep uninsured people indefinitely.

What happens for these men who probably call the Firehouse Emergency Shelter home? None of our emergency shelters are set up to accommodate much in the way of specialized medical care…not really even extended “rest.” There are individual beds for clients, but they are not in individual rooms, and sleeping in a common area with 50 or so other people in crisis really doesn’t contribute to a great deal of rest. Our local shelters make certain clients are offered 2 – 3 meals per day, but there is no one to prepare special meals. In several of our emergency shelters, volunteers prepare a meal for 50+ people and bring it to the shelter, and while that is generally a tasty meal, clients are certainly not asked what their taste preference is for that meal, and few individual dietary restrictions are observed.

With each of my surgeries, I was instructed to keep the incision “clean and dry,” and doing that required assistance to keep the dressing dry when I bathed and required assistance to change the dressing when necessary. Again, our emergency shelters are simply not equipped with extra staff members to help with bathing or changing a dressing. It is not because shelter staff don’t want to help, but they are responsible for the care and safety of 50 or more people at any given time…

Our community needs emergency shelters…but we also need something called Respite Care, and we have none. Consider taking a look at Center for Respite Care or this medical journal article or this Respite Care in Philadelphia, or this piece from the University of California.

Until we get Respite Care here, my sincere hope is that you will think about a time you needed extra attention when you were sick, whether that was with an accident or a surgery or just a nasty cold. Now focus those thoughts and feelings on the situation of these four men at the Firehouse Shelter…

One last thing…think about what our community could look like if there was a home available for everyone who wanted one…

 

Michelle Farley

Executive Director, One Roof

Substance Abuse, Mental Health, and Homelessness

ntlpreventionweek

Substance Abuse, Mental Health, and Homelessness

This week (May 18-May 24) is National Prevention Week, an annual health observance intended to increase awareness of, and action around, substance abuse and mental health issues. Supported by SAMHSA (Substance Abuse and Mental Health Services Administration), this week is an opportunity for community members to collaborate with other individuals, organizations, and coalitions to promote prevention efforts, educate others about behavioral health issues, and build and strengthen community partnerships. Watch this video to learn more about National Prevention Week and SAMHSA’s efforts.

Why is awareness of, and action around, these issues an important component of One Roof’s work to prevent and end homelessness?

Substance abuse and serious mental illnesses are factors that may contribute to a person experiencing homelessness. When we educate the community about issues related to homelessness, we note that people in our community experience homelessness for various reasons. A person may experience homelessness because they:

  • lack acceptance from family, friends, and community members
  • lack a safe space free from physical, sexual, or emotional abuse
  • lack emotional and/or financial support
  • experience economic instability
  • are unable to plan for ongoing crisis
  • have aged out of foster care, left incarceration, left hospital or psychiatric treatment without appropriate discharge planning and supports in place
  • abuse substances / self-medicate due to underlying issues
  • live with severe mental illnesses
  • live with disabling physical and/or mental health conditions
  • live with HIV/AIDS

More specifically, a person’s substance abuse or serious mental illness may:

  • compromise existing support systems
  • be a result of non-acceptance and/or a poor support system
  • be a result of physical, sexual, or emotional abuse
  • limit their ability to be economically stable and self-sufficient
  • be a result of leaving foster care, incarceration, or hospital or psychiatric treatment without appropriate planning and supports in place
  • cause them to self-medicate (or continue to self-medicate) due to underlying issues
  • result in disabling physical and/or mental health conditions
  • cause them to engage in high-risk behaviors that may result in a positive diagnosis for HIV

One Roof knows that a significant number of people experiencing homelessness in our community are living with serious mental illnesses and/or substance abuse. According to our 2014 Point-in-Time count, 1,329 people experience homelessness in central Alabama on any given night. Of these 1,329, nearly 32% reported living with a serious mental illness and 31% reported living with chronic substance abuse. It is our responsibility to advocate on behalf of clients, educate our community, and coordinate services to make sure these vulnerable individuals receive the best care possible.

Many of our member agencies and service providers are working diligently to meet the needs of people belonging to these vulnerable sub-populations. Follow the links below to learn more about some of our agencies who specifically offer services to individuals with serious mental illnesses or who have substance abuse issues:

  • Aletheia House provides substance abuse treatment and housing to pregnant women, parents of families, and men who struggle with addiction and alcoholism.
  • AIDS Alabama provides substance abuse interventions for persons living with HIV/AIDS.
  • JBS (Jefferson, Blount, & St. Clair) Mental Health Authority offers housing to persons living with serious mental illnesses, as well as mental health screenings, medications, and a street outreach team.
  • UAB Community Psychiatry & UAB REACT provide treatment, housing, and services for people with schizophrenia, mood disorders, severe anxiety disorders and co-occurring substance abuse disorders.
  • UAB TASC (Treatment Alternatives for Safety Communities) is an alternative treatment program for individuals with substance abuse or mental health issues and who have been involved in the criminal justice system
  • The Foundry provides long and short term residential treatment to individuals struggling with substance abuse issues
  • Fellowship House provides substance abuse treatment options, including residential programs, to people struggling with addiction or alcoholism.

These are just a few examples of One Roof member agencies who do their best to provide resources to clients impacted by substance abuse or serious mental illnesses.  One Roof’s mission is to equip and empower our community to prevent and end homelessness in central Alabama through advocacy, education, and coordination of services. Preventing and ending homelessness includes serving community members who are experiencing homelessness and living with substance abuse issues and serious mental illnesses. Partner with One Roof and our member agencies to help end homelessness for these vulnerable subpopulations.

To stay involved and aware of One Roof’s efforts, be sure to like us on Facebook and follow us on Twitter and Instagram.

Point-in-Time 2014 Results

2014 PIT Tables

We are excited to share the results from the 2014 Point-in-Time study that was conducted in January. For a .PDF file of the data table and interpretation of results, click here.

We would like to extend a thank you, once again, to friends who conducted interviews with us this year as well as community members who have been involved with One Roof in the past.  Collecting this data cannot happen without you!  Make sure that when you’re reviewing the table you pay attention to the “unsheltered” count.  Point-in-Time volunteers are responsible for the total unsheltered count in our area!  Thank you for reaching out to 414 unsheltered individuals in our community so that we can better understand how to help.

The data in the table above gives a snapshot of who was homeless on any given night in 2005, 2007, 2009, 2011, 2012, 2013, and 2014 in Jefferson, Shelby, and St. Clair counties of Alabama.  The Total numbers are comprised of the sheltered and unsheltered numbers added together.  2014 results are highlighted in purple.

Please note that the sub-populations stand alone and do not represent additional people to those listed in theIndividualsTotal Persons in Families, or Total Personsrows.  Sub-population numbers represent every instance where the sub-population applied to an individual.Families are the number of homeless households we have seen with dependent children, and Total Persons in Families is the number of individuals belonging to those households.

This year 120 volunteers helped to conduct the Point in Time survey in the metropolitan Birmingham area.  This is the second year we were able to expand street counts to include parts of Woodlawn, Avondale, East Lake, West End, and other neighborhoods outside of downtown.  Volunteers are responsible for the total unsheltered count (31% of the total homeless population).

The sheltered numbers come directly from a database used by our service providers called PromisAL, which records services and acts as a tool to connect services in our homeless Continuum of Care.

Here are some highlights that we can see in this year’s data: 

  • Our count in January 2014 shows that overall homeless numbers have decreased by 140 individuals (a decrease of 10%) since January 2013.  From 2005 to 2014, there has been a decrease of 1,099 individuals (nearly a 55% decrease).
  • Homeless families (households) increased slightly this year from 2013 by 6%. There was a 35% decrease in the number of unsheltered families, but there was a 35% increase in families living in transitional housing.  This shows that in the past year, almost 1 to 1 those families have gotten into housing and are on their way to living a stable life in permanent housing.
  •  For someone to be chronically homeless, they must have experienced 4 or more episodes of homelessness within 3 years OR experienced continual homeless for 1 or more years AND have a mental or physical disability.  This population is the hardest to house and often the least likely to seek services.  Since 2009, we have seen a 51% decrease in the number of chronically homeless individuals in our community.
  •  Homeless veterans have been steadily decreasing over the past few years, and this year is no exception.  There is a national initiative to end veteran homelessness by 2015, and the good news is that all the hard work of our veteran’s agencies has brought us very close.  This year, there was a 10% decrease in the number of veterans experiencing homelessness, with the majority of those veterans (156 out of 174 total) in shelter rather than on the street.
  •  Despite slightly elevated numbers of people living with HIV/AIDS and experiencing homelessness, the overall number of these individuals has declined significantly since 2005, decreasing by 67%
  • Unfortunately, we have seen elevated sheltered, unsheltered, and total numbers of community members who are survivors of domestic violence and experiencing homelessness. Since 2013, the number of survivors of domestic violence experiencing homelessness has had a pronounced increase of nearly 46%.
  • We are also pleased to see a decrease, however small, in the number of people experiencing homelessness who suffer from chronic substance abuse.  However, we have also seen a 7% total increase in the number of people with a serious mental illness (395 in 2013 to 423 in 2014), with a 30% increase in the number of people with a serious mental illness who are unsheltered.

Please let us know if you have any questions or suggestions for improving our process next year, and thank you for your patience while waiting for the results.  Thank you for helping us to fulfill our mission to equip and empower our community to prevent and end homelessness through advocacy, education, and coordination of services.   Thank you for your work to improve the community we share.

We hope you have a great summer and that we’ll see you next year for PIT 2015!


Stacy Oliver
Community Outreach Coordinator
One Roof
stacy@oneroofonline.org

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