Say What?

Here are the 12 most head shaking things said or written to me, that I have encountered in 2015 thus far:

1. “We have to have police with us on outreach. They have to do a warrant check and search people for weapons and contraband before we can speak to the client. It helps make sure we are speaking to the right people and not engaging in homeless criminals.”

Florida is a precious place. Sometimes they do amazing things in supporting people that are homeless (Hillsborough County Sheriff’s Office). Sometimes they do things that make me think all homeless persons are doomed in that state. When a street outreach worker says stuff like this to me, I can’t help but think I should find another job.

2. “We do home visits a bit differently. We have clients come to our office.”

This was shared with me by a service provider from the Northwest when I was at the Alliance conference in San Diego in February. I could not convince them that unless the visit actually occurred in a person’s home it was not technically a home visit. I said to them, “I eat ice cream a bit differently. I eat gummy bears.” They didn’t get it.

3. “Once we started doing drug testing at the shelter we found there were no clients with substance abuse issues anymore.”

Thank you service provider from Oklahoma that emailed me this gem in response to a blog I wrote a LONG time ago about substance use and housing services. In following up with them I learned that no one that uses substances is allowed in the shelter. They have no idea where those folks go. They suspect outside. So testing may keep ANYONE that uses substances out of the shelter (with or without substance use issues) but excluding them from entering does not mean that you have solved substance use issues in your community. You are just no longer serving those people.

4. “Anybody can stay in the shelter for 14 days. Beyond that, they have to apply for and be approved for the discipleship program.”

Oh St. Louis and the New Life Evangelistic Centre (which you may have read about on our FaceBook page or Twitter feed). Shelters are shelters. Shelters are not supposed to be places to recruit new members for your congregation. Staying in shelter should not be contingent upon agreeing to participate in your ministry. Faith-based shelters like this give other amazing, high-performing professional faith-based shelters a bad rap.

5. “Homelessness is the sin no one likes to talk about.”

I am scheduled to speak at a state conference in Kentucky in a few months. One of the people in hearing I am coming sent me a long email outlining things they wished I would talk about. Just about everything in the email I disagreed with. This line, however, made me laugh out loud. Homelessness is the lack of an address. It is not a sin. However, even it was I guess restitution for it would be to get housing so that they are no longer homeless and no longer, ahem, “sinning”.

6. “We have a 100% graduation rate from our transitional housing program.”

This time, the Midwest. But let me be clear. Of all the people that completed the two years in transitional housing (13 people out of 85 that started in the program), all 13 of them were considered successful graduates. Fun with numbers, I guess. The way I calculate it, it is a 15% success rate. But hey, if you are only counting those that made it all the way through, well, I guess all 13 that lasted to the end made it to the end – and therefore 100% of all people that finished the two years in transitional housing over the past two years were successful graduates.

7. “Every city needs a transformative campus.”

This was said to me by a strong supporter of Robert Marbut’s approach (see places like Haven for Hope in San Antonio) which co-locates all homeless services into one central location in a campus type setting. The part I find amusing is that I have never met a homeless service campus that actually works well. I mean, even Haven for Hope has used OrgCode’s services to help train staff on how to go about ending homelessness. Anyone been to Phoenix lately? The campus there is riddled with issues that are much more difficult to solve than when there is distribution of services throughout a community.

8. “We have some people that have had more than 2,500 nights of shelter stays and are coming out as moderate acuity. Clearly there is something wrong with your tool if these people aren’t coming out as needing PSH.”

This happened in Utah where statewide the tool is used to great results. When I asked the gentleman how long they had been using the tool it turned out to be less than a year. When asked what they had done to get people out of shelter before the tool was adopted he didn’t know. It is not a tool’s fault that people with moderate acuity have not gotten out of shelter sooner. Maybe it is the staff at the shelter’s fault for not figuring out how to house people with moderate acuity in the YEARS they have had to do so with the same clients night after night.

9. “Your training would be better if it was all free and online.”

Um…hmmm…better? But you’d lose out on the jokes! And Jeff, Tracy and I offer such incredible presence and charisma! Plus, OrgCode would no longer be viable as a business if we didn’t get paid to do at least some things. We already do oodles of stuff for free and give away loads for free (like the resources on our website). But hey, going under is good food for thought. We will consider that.

10. “You know that HUD and USICH hate the SPDAT and don’t support it.”

Nope. They don’t hate it. I checked. In person. Spoke with Matthew Doherty. And Ann Oliva. And Norm Suchar. They don’t endorse any tool – nor should they. But they don’t hate the SPDAT. In fact, they have been very responsive in helping us make sure subsequent versions are even more closely aligned to their policy objectives.

11. “How do you sleep at night knowing how rich you are getting off the lives of homeless people?”

First of all, person from Los Angeles, I don’t sleep well at night. Thanks for your concern. Usually it is because I am wondering what timezone I am in. Sometimes it is because of my depression. Sometimes it is because I lay awake feeling guilty I am not at home with my family. Sometimes it is because I can’t shut off my brain and I am trying to figure out the next important thing that OrgCode should do. But given that I am not rich and never will be rich, I can assure you that is not the reason for my sleeplessness. Again, though, thanks for your concern.

12. “I heard you get 17 cents per SPDAT entry in HIFIS [HMIS].”

Where do rumors like this even start? So just to clarify things once again: the SPDAT is free. It always has been. It always will be. People pay for the training. They don’t pay for the tool or any future updates. There is no annual licensing fee. There is no money changing hands between HMIS vendors and OrgCode – whether that is in Canada where HIFIS is used or across any of the US communities using their own HMIS.

Speaking Up to Address the Stigma: Challenging The FaceBook Mental Health “Game”

I am a 40-something guy. Included in my friends on Facebook are folks that I have not seen since my high school years. Maybe you have some friends like that too. I like their life milestones and updates on their children. I like hearing stories about their own parents – many of whom I have not seen in over two decades. And I also like that they are a decent barometer of how the general public thinks about issues, given my day to day is entrenched in issues like homelessness, addiction, mental health, trauma, and family breakdown.

Recently, a FaceBook “game” was introduced by one of these high school pals. I have no doubt this is the sort of thing that may have made its rounds in your friend circles on FaceBook too. It goes like this:

You’re in a mental hospital. Use the first 7 people on your tag list in order..no cheating! 

Your roommate: 
Person licking windows: 
Person helping your escape: 
The doctor: 
Person running around naked: 
Person yelling nonsense: 
Person you went crazy with: 

A clean copy for you to fill out is in the comments..let’s see if yours is as true and funny as mine!

And it made my heart sink and angered me at the same time. I don’t hide the fact that I live with mental illness. Goodness knows I have found things to laugh at in my own recovery journey. But that is ME having a laugh at MY mental health. I suspect there are also peer groups that could appropriately share their experiences and chuckles with each other. BUT, it doesn’t reinforce stereotypes nor find delight in the compromised wellness of others. I mean really…person licking windows? Running around naked? The person you went crazy with? That escape is necessary rather than achieving important assistance? (If only people knew how difficult it was in most cities for someone to get admitted for care when their mental health is unwell.)

No doubt some folks are naive when it comes to mental health. Very few folks ever set foot in a mental health hospital or the psychiatric wing of a hospital. Very few very visit a mental health clubhouse or peer support group. Very few ever visit supportive housing for people that live with serious and persistent mental illness. Very few have ever spent significant time doing street outreach or being in a shelter where the shortcomings of mental health systems are so blatant.

Does that condone efforts to make fun of mental illness? No.

So, I pointed out that maybe finding jokes in this type of FaceBook game was insensitive and poor taste. What I encountered wasn’t a response that was considerate of this point of view, but rather, a pushback that I was too easily offended.

And I think that is a problem. It speaks to the ongoing efforts needed to get mental health out of the shadows and into the light, and to address stigma head on. Can you imagine the outrage if there was a FaceBook game that went something like “You’re in the barracks of the plantation” or “You’re on the train to Auschwitz” or “You’re in the Residential School”. Of course that would be completely unacceptable.

It is also unacceptable to make it more difficult for anyone already struggling to come to grips with their mental health or share their mental health with others if there is entertainment that takes delight in reinforcing stereotypes, or mocking people for behaviours that may stem from mental illness.

But this cannot just be people like me that live with mental illness that speak up and say that finding humour in games like this is offensive. It requires everyone to have a sensible discussion to point out that mocking people for their mental illness is not different that mocking people if they have cancer or kidney disease or a heart condition. Sickness is not comedy.

Nice and Ineffective

Let us put an end to people, organizations and communities being really nice, but ineffective. Inappropriately trained and nice is no way to solve a complex social issue. Well-intentioned uninformed people remain uninformed people. And all the niceness of the world does not take us even one step closer to solving a complex social issue.

Shame on any industry that confuses having a big heart with having a big head. Don’t know the theoretical underpinnings of one approach to service over another? Stop practicing. Don’t understand how to collect and use data to evaluate and inform practice? Stop practicing. Don’t know the main currents of thought and practice and how to execute that knowledge? Stop practicing.

Or start learning. Please. A really big heart may be killing people.

Today in your city, if I were to go to an emergency room, I bet there would be people in a waiting room of some sort. Goodness, I hate that. It is so sad. Don’t worry. I have seen my share of House, MASH, Doogie Howser, and ER – plus I love TLC medical shows. I will throw on a lab coat or some scrubs and go down and start practicing medicine immediately. No? What do you mean I should be trained first? I have had my gall bladder out and my appendix, plus my hip has been reconstructed. I am a person with lived experience. Not enough expertise? But c’mon, people are suffering there waiting. No? You want standards of care? Certification of expertise? Years of practice and experience? I am NICE, dang it! I care! No? Not enough? Huh.

Yet arguably there are people experiencing homelessness, economic poverty, domestic violence, housing insecurity, immigration hardships and the like in your community that have deeper, more in-depth needs that the folks that I would encounter in an emergency room. And who do you turn to for help? Sadly, in too many cities, well-intentioned, big-hearted but untrained volunteers and untrained staff. Well-intentioned but uninformed people. There is no doubt in my mind this makes matters worse, not better. It exacerbates the complex social issues. It ruins people’s lives when people try to provide service when the service providers are untrained. When someone confuses “common sense” with “education, practicum experience, and standards of service” we are essentially suggesting that we don’t care if people receive quality, professional services to alleviate their issues.

And what happens? People get worse, not better. Voluntary responses grow, not shrink. People get band-aids instead of solutions. I think it is about time we invested in the services people deserve and invest in professionalizing services rather than remaining nice, but ineffective.

Sheltering Shelters

Sometimes shelters are amazing. They do incredible things to help people achieve housing quickly and appropriately. Sometimes shelters are the antithesis of ending homelessness. It is healthy to create a voice for people on the frontlines that are confronted with these challenges to share their experiences so that we can all understand where to support and push for reform. I invited Jessica Douglas to contribute to this blog based upon a recent experience. I hope it is illuminating for you and leads us all to greater examination and professional change in sheltering services when it is warranted. Thanks Jessica for such an important guest blog.

I’ve gone back and forth in my head all afternoon with different ways to go about writing this blog. Since this is my first blog, I wasn’t sure what was acceptable or what would get someone’s attention. But then it dawned on me – honesty. Yep. That’s what I came up with. Sounds pretty boring, but I’m going with it.

Let me start out by saying, I’m a pretty approachable person. Recently described by a co-worker as being calm and centered, today I was pushed to the brink of going completely unprofessional on another provider. In all of my professional adulthood, I have never wanted to go completely “postal” on another person. When is it acceptable for a provider to “shelter”, and I don’t mean put a roof over their head, an individual to the point where they can’t leave the facility to go have lunch with someone?

For a few months now, I’ve been out in the field, meeting with clients and other providers! I love it! It’s where I’m most comfortable: interacting with individuals on the streets and those who have been recently housed. What I do not like is providers who feel as if they are “protecting” their clients by monitoring their every move. How is this benefiting those individuals? Well, in my professional opinion, it’s not. It is, however, benefiting the facility because they are able to count them as widgets.

It’s not allowing them to grow as a human being, to give them the opportunity to obtain a job, meet new people (outside the facility), to find an apartment or a home. SAY WHAT?!? A JOB? A HOME? It’s as if those are words not to be discussed, because as I heard a resident say today in the lobby of this shelter (as he was signing 3 pages of rules), “This is my home away from home”.  How sad is it that this facility has residents thinking this is their final destination?

Today I was told I was not allowed to pick up a client because she didn’t have prior permission to leave the shelter. Mind you, this person did have permission to leave with me 2 hours later than when I tried to pick them up. I was told that she was not allowed to just leave whenever she wanted to that it had to be approved. Yep, you heard that right, a person who is not in JAIL or on HOME CONFINEMENT, has to have permission to come and go. Oh, and yes, this person is 18 years or older. This isn’t the first time we’ve had issues with picking this person up and taking them out to enjoy a nice day away from the shelter. Every single time she is dropped off she is interrogated by staff, and other residents, who want to know if she was given money and/or what did she do.

I was also told that I couldn’t just move her out whenever I wanted to, proper staff had to be present to make sure nothing left the shelter that wasn’t hers, meaning she couldn’t leave during the weekend. Without given a chance, they already expect the worst of the every person who walks through their door looking for a safe place to stay. They expect to be stolen from. They label everyone who enters, possibly in the midst of the worst crisis they will ever experience; being homeless and having no one must indicate that you are a thief.

The most disturbing thing I was told today, the thing that pushed me over the edge, is that we were “going behind their back”. We went behind their back to do what is best for this individual, move her out of a situation where they are hindering her ability to grow as a young adult, and moving her into STABLE HOUSING. SHOCKING, right? Why the best interest of this individual isn’t their top priority, I may never know. What I do know, we at WVCEH are doing the right thing, we are moving her out, into her own apartment at the end of the week where she will receive intensive case management by people who truly care about her and success.

Moving the Needle with Reluctant Funders/Politicians

This week we got two separate notes asking for a blog. They are related themes.

In the first note it asked for a blog about when communities have to make tough decisions on funding to move the needle forward. In that community they are taking loads of flak politically and in the media for changing funding to focus on ending homelessness. City Councillors are considering a motion to continue to fund services for another year to allow impacted organizations to transition. This after consultation and community engagement for the past 18 months to prepare for the transition.

In the second note it asked for a blog about what to do when communities have been moving forward to align funding to end homelessness rather than ineffective programs, but that those organizations most impacted have strong political connections, and those politicians are now exerting considerable pressure to reconsider what is best.

MOVE THE NEEDLE!

Consequences suck. Political involvement/interference sucks. Backlash from service providers sucks.

Sometimes “suckage” and “rightness” are directly related. The more “suckage” there is sometimes directly indicates that you are doing the EXACT RIGHT THING.

Service managers and COC leads have a responsibility. The responsibility is to achieve the greatest amount of effectiveness through service providers in the amount of funding available. They are also responsible to ensure that there is monitoring and oversight. When things are awry it is the service manager/COC best positioned to move the community towards system change.

There are good change processes and bad change processes. But let’s face it – change is always hard. What service managers need to appreciate is that the interest of a politician is different than the interest of a service manager. A service manager wants to end homelessness. A politician wants to keep constituencies happy – including non-profit organizations in many instances. Service managers live and breathe data and evidence and best practices. A politican lives and breathes optics, public image, and community engagement. Does that make one right and the other wrong? No. It does, however, means that there is not always alignment.

If you want to figure out how and why the politics of the right and just decision plays out the way it does, answer me this question: on a scale of 1-10, what is my favourite color in the alphabet?

You guessed it – it makes no sense.

In an era of believing (continuously) that we can charge less taxes and get better services, public servant after public servant; CoC lead after CoC lead is being asked to do more and better with less. They research. They go to conferences to learn. They consult. They consult again. They agonize internally on how to go about making huge changes. They educate. They put out information. They host information meetings. The form committees. And then form committees that come out of committees. And still? Politicians seem hell bent on maintaining the status quo or spending even more money to work through the change.

A weak public servant or COC lead caves to the pressure. They continue to fund the status quo. The give up. Change that was meaningful was in their grasp. What they don’t know is that political issues have a cycle. The one year of additional funding is about saving face in the present. Two years from now, political leaders will be patting themselves on the back for the decisions made at your pay grade.

A mentor of mine once pointed out to me that which I see more and more the older and more experienced I become: if you cannot critique content, you critique process. Chins up, my friends. Moving the needle is the bravest thing you will do in your entire careers. And it is the right thing to do. They only want to come up with transition funding or question what you have done because they know you are actually doing the right thing, but they need some political cover.

Yes, the VI-SPDAT & SPDAT Meets HUD’s Coordinated Entry Expectations

As you may already know, the VI-SPDAT and SPDAT (and variations related thereto) on the most widely used assessment tools in homeless services. They also meet all of HUD’s expectations for coordinated entry, if you have read what HUD has recently shared. Let me walk you through it.

HUD says the assessment tool should be phased and situationally applied. If you have attended any training on the VI-SPDAT and SPDAT, you know the situations in which the tools should be applied, when they should be avoided, how to triage, and how to assess further.

HUD says the assessment tools should not result in a homeless household having to tell their story over and over again. We totally agree. There is nothing trauma-informed about a homeless person or family having to re-live their homeless story over and over again. The assessment should follow the person. If you are providing service and assessment using the VI-SPDAT and SPDAT, you know that one of the fundamental aspects of the tools is that the assessment follows the person and is shared across providers.

HUD says the assessment tools should only capture necessary information, and that the information collected should be based upon evidence. The VI-SPDAT and SPDAT rely on almost 300 peer reviewed published pieces of literature, government reports that have a sound methodology, rigorous testing, and a range of data points. They are intended to result in informed, objective understanding of current vulnerability and future risks to housing instability.

HUD says people being surveyed should have the autonomy to refuse to answer questions. Not only does the VI-SPDAT and SPDAT rely upon informed consent to complete, the opening script for the VI-SPDAT and the structure of the questions are clear that participants can skip or refuse any question they do not wish to answer.

HUD says the tools should be person-centered and help inform consumer choices. We totally agree and are frustrated when any community uses the tools incorrectly. The VI-SPDAT and SPDAT provide data. They help inform decision-making. They do NOT make decisions. They do NOT force people into one type of housing or program.

HUD says assessment tools should be culturally competent. Almost 900 different households have been directly involved in the creation of the tools, incorporating a broad range of races and ethnicities. The tools have also considered and involved a range of different experiences as it relates to gender identification, sexual preference, citizenship status, etc.

HUD says the tools should be user-friendly and capable of being applied by non-clinical staff. Both the VI-SPDAT and SPDAT have been created so that non-clinical staff can be used. And because so much of the language of the tools has been informed directly by people experiencing homelessness, the words used and results are intended to be user friendly to program participants.

HUD says assessment tools should provide meaningful recommendations and avoid long waiting lists. The VI-SPDAT and SPDAT recommend the type of housing and support intervention that should be considered. These tools do NOT make decisions, they provide decision assistance (it’s even in the name of the tools!). That decision assistance is data for recommendations and consideration. We also, as anyone knows that attends VI-SPDAT or SPDAT training, are against assessment for assessment sake. Action should follow.

HUD says the tools should be sensitive to persons with lived experience. How is this reflected in the VI-SPDAT and SPDAT? As previously mentioned, people with lived experience have had a direct voice in the creation of the tools. They have also been informed by a broad range of experts to ensure sensitivity to lived experience. Finally, experts in trauma and abuse were retained to review the VI-SPDAT and SPDAT, and inform the components on Trauma and Abuse to help decrease the likelihood of anyone being retraumatized through the experience of being assessed.