Homelessness and Brain Injury Dave Katzenmeyer, Geoffrey Meyer, Kris Helgeson

People Incorporated Street Outreach What we do: People Incorporated Street Outreach Team and Drop-in Common 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 Participants The Intersection Between: Mental Illness and Physical Health Substance 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 participants  Making Appointments  Being available and flexible  Balancing caseloads and availability.  Needing additional time or attention  Finding the RIGHT providers  Awareness 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 Engagement Motivational Interviewing Techniques Engaging with Community Supports Advocacy Trauma Informed Care Harm Reduction

Engagement Strategies- Long-term Engagement  LONG-TERM ENGAGEMENT Complex situations take time Loss of trust usually engrained over years Common misconceptions: People will jump at “help” Housing will fix everything

Engagement Strategies- Motivational Interviewing Key Points  Motivation 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 Initiative  I can’t motivate you. Only you can motivate you. Black and White Thinking  Often the change we suggest is abstract thinking. Argumentative  Can’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 Advocacy  Explaining 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 Services  Probation and Parole Officers  Mental health and Chemical health Professionals  How 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 Trauma  How do our clients experience Trauma?  What different types of Trauma are there?  How do we recognize Trauma in our clients?  Complex Trauma  matters/201207/recognizing-complex-trauma  Other Types of Trauma 

Engagement Strategies- Harm Reduction Key Points  Accepts 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 Behavior  Abstinence is not an impulse Poor Judgment  Limited ability for long-term projection  Limited long and/or short-term memory Risky Behavior  Limited ability for long-term projection  Limited long and/or short-term memory

Questions? Contact Us! Geoffrey Meyer Division Director of Homeless Services People Incorporated Mental Health Services 317 York Ave, St. Paul, MN (651) Dave Katzenmeyer Supervisor Street Outreach, Homeless Services People Incorporated Mental Health Services 317 York Ave, St. Paul, MN (651) Kris Helgeson, MA LADC Supervisor Project Recovery, Homeless Services People Incorporated Mental Health Services 317 York Ave Ste 5E, St. Paul, MN (651)