Homelessnessand Brain Injury
Dave Katzenmeyer, Geoffrey Meyer, Kris Helgeson
People Incorporated Street Outreach
What we do:People Incorporated Street Outreach Team and Drop-inCommon Mental Health Diagnosis we encounter: Anxiety, Depression, Schizophrenia, Bi-Polar I and II, and a variety of Personality Disorders.Substance Use Disorders: Meth use, Heroin, Alcohol, Marijuana, Bath Salts, Prescription Medication.General Demographics of our Clients and ParticipantsThe Intersection Between:Mental Illness and Physical HealthSubstance Use and Mental Illness
Substance Use and Homelessness
“A common stereotype of the homeless population is that they are all alcoholics or drug abusers. The truth is that a high percentage of homeless people do struggle with substance abuse, but addictions should be viewed as illnesses and require a great deal of treatment, counseling, and support to overcome. Substance abuse is both a cause and a result of homelessness, often arising after people lose their housing.”From National Coalition for the Homeless.
Barriers to Care for the Homeless
Have you seen my client?Sheltered and un-sheltered clients and program participantsMaking AppointmentsBeing available and flexibleBalancing caseloads and availability.Needing additional time or attentionFinding the RIGHT providersAwareness of brain injury, homelessness, substance use disorders, physical health, mental illness, trauma……..
Engagement Strategies
Taking a Person Centered Approach;What does that mean in the Homeless Community?Long-term EngagementMotivational Interviewing TechniquesEngaging with Community SupportsAdvocacyTrauma Informed CareHarm Reduction
Engagement Strategies-Long-term Engagement
LONG-TERM ENGAGEMENTComplex situations take timeLoss of trust usually engrained over yearsCommon misconceptions:People will jump at “help”Housing will fix everything
Engagement Strategies-Motivational Interviewing
Key PointsMotivation to change is elicited from the client, and is not imposed from outside forces.It is the client’s task, not the counselor’s, to articulate and resolve his or her ambivalence.Direct persuasion is not an effective method for resolving ambivalence.The counseling style is generally quiet and elicits information from the client.The counselor assists the client in examining and resolving ambivalence.Readiness to change fluctuates and is affected by the interpersonal relationship with the counselor.The therapeutic relationship resembles a partnership.
Engagement Strategies-Motivational Interviewing
Lack of Motivation and InitiativeI can’t motivate you. Only you can motivate you.Black and White ThinkingOften the change we suggest is abstract thinking.ArgumentativeCan’t argue with yourself as easily as you can argue with me.
Engagement Strategies-Engaging with Community Supports
Building a network of help around the client/participant to better enable to “flow” of care.Who are the Care Providers equip to help clients with Brain Injury and also experiencing Homelessness?Learning where and how to connect client to better services.Services and referral “telephone” to other providers to maximize effectiveness
Engagement Strategies-Advocacy
Homelessness and AdvocacyExplaining how they need help; how if may be different form others.Brain Injury and navigating the complicated system of Community Supports and Social Services on their own.County ServicesProbation and Parole OfficersMental health and Chemical health ProfessionalsHow to teach our clients, ourselves, and those around us how to better advocate!
Engagement Strategies-Trauma Informed Care
What is Trauma Informed Care?Primary and Secondary TraumaHow do our clients experience Trauma?What different types of Trauma are there?How do we recognize Trauma in our clients?Complex Traumahttps://www.psychologytoday.com/blog/compassion-matters/201207/recognizing-complex-traumaOther Types of Traumahttp://www.samhsa.gov/trauma-violence/types
Engagement Strategies-Harm Reduction
Key PointsAccepts that behaviors are part of our world and works to minimize harmful effects rather than ignoring or condemning them.Recognizes a continuum of behaviors from abstinence to severe abuse and that some levels of behavior are safer than others.Establishes quality of individual and community life over abstinence of all behaviors as criteria for interventions and policies.Calls for a non-judgmental, non-coercive provision of services and resources to people who participate in behaviors and the communities in which they live.Ensures that people who participate in behaviors or have a history of participating in behaviors have a voice in the creation of programs and policies.Affirms the people themselves as the primary agent to reducing harm to themselves and their community.Recognizes the realities of poverty, class, race, social isolation, past trauma, gender, and other social inequities affect people vulnerability to and capacity for effectively dealing with harm.Does not attempt to minimize or ignore the real and tragic harm associated with behaviors.
Engagement Strategies-Harm Reduction
Impulsive BehaviorAbstinence is not an impulsePoor JudgmentLimited ability for long-term projectionLimited long and/or short-term memoryRisky BehaviorLimited ability for long-term projectionLimited long and/or short-term memory
Questions? Contact Us!
Geoffrey MeyerDivision Director of Homeless ServicesPeople Incorporated Mental Health Services317 York Ave, St. Paul, MN 55130(651) [email protected] KatzenmeyerSupervisor Street Outreach, Homeless ServicesPeople Incorporated Mental Health Services317 York Ave, St. Paul, MN 55130(651) [email protected] Helgeson, MA LADCSupervisor Project Recovery, Homeless ServicesPeople Incorporated Mental Health Services317 York Ave Ste 5E, St. Paul, MN 55130(651)[email protected]
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