Homelessness: Mental Illness And Substance Abuse

Homelessness: Mental Illness And Substance Abuse

There is more than meets the eye.
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633,782 people experience homelessness on any given night in the United States. More than one-fifth of the 610,000 homeless people in the United States suffer from a severe mental illness, according to the US Department of Housing and Urban Development. The majority of them have schizophrenia, bipolar disorder or depression, which are all manageable with the right medication and counseling, but will only get worse if left untreated. Without proper care, this burden costs the federal government millions of dollars a year in housing and services all while prolonging the treatment of their disorders. 38 percent of homeless people abuse alcohol while 26 percent consistently use drugs. The Substance Abuse and Mental Health Services Administration, SAMHSA, provides direct services within supportive housing settings for people experiencing chronic homelessness. A chronically homeless person has experienced homelessness for a year or longer and has a disability. The biggest feat to tackle while progressing towards an end of homelessness is funding for services. Continual financial support for SAMHSA will continue to be critical to ending homelessness.

Substance Abuse and Mental Health Association

SAMHSA is partnered with The National Alliance to End Homelessness, in their 2014 Policy Guide, the Alliance recommends that for the 2015 Fiscal Year, Congress should provide at least $100 million for SAMHSA Homeless Services to fund essential treatment services and permanent supportive housing for homeless suffering from substance abuse and mental health issues. If congress provides this money, while only part of their $3.6 million budget for FY 2015, SAMHSA will not only be able to provide essential treatment services but they will help to ultimately eradicate the current societal views on homelessness in the United States.

The Substance Abuse and Mental Health Services Administration's Homelessness Resource Center (HRC) is a learning environment devoted to spreading knowledge and sustainable methods to prevent and ultimately end homelessness. Their team of providers, consumers, policy-makers, researchers and public agencies at Federal, State, and local levels work in part with SAMHSA's Recovery Support Strategic Initiative. SAMHSA's homeless and housing programs work together in order to end homelessness by supporting individuals through a positive process of change while improving their personal health, living a self-directed life and working each day to reach their full potential.

“The National Alliance to End Homelessness evaluates policy and develops practical, cost-effective policy solutions. The Alliance works with the public, private and nonprofit sectors to build state and local capacity, leading to stronger programs and policies that help communities achieve their goal of ending homelessness.”

SAMHSA, along with the National Alliance to End Homelessness will work toward increasing awareness and understanding of mental health issues and substance use disorders. Promoting emotional health and wellness, addressing the prevention of substance abuse and mental illness. All while increasing access to effective treatment and supportive recovery. These common goals and initiatives will help SAMHSA support mental health fields with data collection from nationwide surveys, build public awareness on the importance of human behavioral health and its correlation with homelessness in the United States. SAMHSA will support innovation, improvement in mental health practices, engage in activities that support behavioral health system transformation. SAMHSA will bring these practices together with critical knowledge towards prevention in order to treat people with mental illness and addictions.

SAMHSA’s mission statement reads: “SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities…serves as a national voice on mental health and mental illness, substance abuse, and behavioral health systems of care…helps to ensure dollars are invested in evidence-based and data-driven programs and initiatives that result in improved health and resilience.”

These programs are highly effective and cost-efficient, filling important structural gaps and helping people experiencing chronic homelessness begin to access critical medical assistance. Research has shown that the most successful endeavors for the homeless population bring housing assistance together with mental support services. The Administration requested $74 million for SAMHSA Homeless Services programs in FY 2015, the same amount the program received in FY 2014.

With sufficient funding, SAMHSA will not only be able to provide effective resources for those suffering mental illness and substance abuse issues, they will ultimately change the current status quo on homelessness in the United States, ultimately ending current societal views on the homeless as portrayed in the media.

Homelessness in the Media

Charles M. Blow, a writer for the New York Times, wrote an article about societal views on homelessness in the United States. He states that we have placed negative stereotypes on poor people, especially those on the streets. We see the homeless as incompetent—people with poor intentions and even untrustworthy. Our urges have us looking the other way instead of offering to help those in need. He believes this is why we as a society are not adamant on Congress making a change, instead we focus on ourselves. We lack empathy, we do not look at the problem and try to find solutions, we turn the other way hoping it will disappear.

Paul Boden, the organizing director for the Western Regional Advocacy project, who was once homeless himself, speaks on his firsthand experience; he states that homeless people go unseen everyday, pedestrians simply ignore their existence. The majority of people that walk by ignore them or say something rude, looking and treating them like they are dirt. If they are lucky some people may have the decency to acknowledge their presence or apologize for not having any spare change or food on them. Everyone has their own perceptions on homeless people, and this has a direct effect on how we react to people we see living on the streets. Paul Toro, a Psychology professor at Wayne State University, argues that some think homeless people are lazy, don’t work hard for what they want, or even deserve what they get. The closer that poverty is to the face of people that aren’t in poverty, the uglier it is. And the unfortunate part is that often gets manifested as the person is ugly—not the poverty is ugly. And poverty is ugly. It doesn’t smell good.”

SAMHSA’s work will create enough of a media buzz once they receive their large amount of funding. Once they have our attention we will see the work being done, we will no longer categorize all homeless people as lazy or ugly, as stated in the article. We will see them as sick people who need help. Addiction and mental illness are nobody’s fault; they just need the proper care that can be provided to them through SAMHSA’s work. We have seen similar success stories through other organizations in the United States, further supporting the confidence that SAMHSA will succeed with proper funding.

Other Successful Organizations

MHA, the Mental Health Association, was the first organization in Western Massachusetts to bring specialized permanent housing resources to homeless individuals using the Shelter Plus Care model. The Shelter Plus Care Program provides rental assistance and supportive services to homeless persons with disabilities and their families. The program provides assistance through four components: Tenant-based Rental Assistance, Sponsor-based Rental Assistance, Project-based Rental Assistance and Single Room Occupancy for Homeless Individuals.

MHA also introduced the highly successful Safe Havens model to the area. A Safe Haven is a 24/7 community-based early recovery model of supportive housing that serves homeless with mental illness and substance use disorders. Many of these people have not had access to traditional programs or health care, resulting in high use of emergency room and acute care services With around 25 beds the Safe Haven places no treatment participation demands on residents but expects them to transition from unsafe and unstable street life to permanent housing and to re-engage with treatment services. MHA has become an essential part of state and local plans to end homelessness by creating a variety of care services—from street outreach to preventive interventions and permanent housing. (Safe Havens, 2014)

MHA’s Housing First program successfully kept 95 percent of participants housed for one year or longer, which is higher than the national average of 85 percent. They recently held a golf tournament that helped to raise $27,000, just this small amount of funding allowed for MHA to expand their community and program resources, making them available to their patients. The MHA shows us the positive effects proper funding has on a statewide scale; they are a model for what is possible on a nation-wide scale on generating long-term solutions. (Ingersoll, 2013).

The U.S. Interagency Council on Homelessness (USICH) recognized the Tenancy Preservation Program (TPP) as a promising solution. The USICH is charged with coordinating federal agencies to identify and fund programs to end homelessness. The TPP, piloted by MHA in 1998 and now a statewide program, works with individuals and families at high risk of becoming homeless due to lease violations related to their disability. Housing is retained in 90 percent of the cases through court approved reasonable accommodations, skilled assessments, short-term interventions and well-coordinated linkages to services and supports that ensure housing stability. These organizations show how proper funding can have a positive impact on services in the United States and how similar results will happen with SAMHSA with proper funding.

The SAMHSA 2016 Fiscal Year Budget Request includes three new programs that draw on funds across the Mental Health, Substance Abuse Prevention and Substance Abuse Treatment appropriations. Any amounts spent or awarded will be tracked as distinct funding streams and will only be used for purposes constant with legislative direction and intent.

Once congress supplies SAMHSA with sufficient funding SAMHSA will be able to take their methods and make them accessible for those in need. Their most important aspect of their services is Motivational Interviewing their patients, this provides a foundation for assisting individuals with developing the rationale for beginning change in their lives. These resources provide basic information about the process of eliciting change talk and providing advice of motivational interviewing. Eliciting change talk is the consciously directive strategy on the part of the counselor for resolving indecision. Instead of the counselor advocating for change, which often puts the clients in the position of defending against it, motivational interviewing takes a different approach. The idea is to have the counselor enable the client’s communication of change talk, that is, for the client to present the arguments for change. There are four categories of change talk, they are; recognition of disadvantages in the status quo, recognition of the advantages of change, expression of optimism about change and ultimately the expression of intention to change.

Shared decision making allows an individual along with their healthcare provider to determine the best treatment and care. It is a fundamental process in primary care and behavioral health care incorporation; to make it imperative that those individuals with behavioral health conditions learn skills to participate in decisions with their healthcare providers. Emphasize change statements; provide affirmations and statements of hope SAMHSA’s work is more than a “band aid” for homelessness in the United States, but a large-scale change agent for the future.

More attention must be directed at how to better deliver appropriate mental health and substance abuse services to the homeless in America. While $100 million is not a large part of the $3.6 billion of SAMHSA’s budget for the coming year, it will be more than enough to get SAMHSA’s work progressing to where it needs to be in order to create long term systemic changes for homelessness in the United States, ultimately changing the status quo while providing long term housing for the chronically homeless. Sufficient funding is imperative if any change is to happen.

Cover Image Credit: contextflorida.com

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I'm A Christian And I Have A Tattoo

Stop judging me for it.
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Like most people, I turned 18 years old during the course of my senior year of high school.

I'll never forget the months prior to my birthday, though, because I spent hours making a decision that would be with me forever, the decision of where I would go to get my first tattoo and where that tattoo would go, and of course I spent a lot of time deciding on the font, the colors, and all of the other aspects of the tattoo I wanted.

Throughout this time, two things stood firm 1) the fact that I was going to get a tattoo, and 2) the six letter name that it would consist of.

Now, three years later, I'm 21 years old and I still get the occasional dirty look at church on Sunday or in line at Walmart, and more often than not this look is accompanied by the following words: “Why would you do that to your body when God says not to?"

A few weeks ago at a new church, a woman came up to me and said, “How can you consider yourself a Christian when you have that blasphemous thing on your foot?", I simply smiled at her and said: “God bless you, have a good week." I let it roll off of my back, I've spent the past three years letting it “roll off of my back"… but I think it's time that I speak up.

When I was 8 years old, I lost my sister.

She passed away, after suffering from Childhood Cancer for a great deal of my childhood. Growing up, she had always been my best friend, and going through life after she passed was hard because I felt like even though I knew she was with me, I didn't have something to visually tribute to her – a way to memorialize her.

I, being a Christian and believing in Heaven, wanted to show my sister who was looking down on me that even though she was gone – she could still walk with me every day. I wanted it for me, for her. I wanted to have that connection, for her to always be a part of who I am on the outside – just as much as she is a part of who I am on the inside.

After getting my tattoo, I faced a lot of negativity. I would have Leviticus 19:28 thrown in my face more times than I cared to mention. I would be frowned on by various friends, and even some family. I was told a few times that markings on my body would send me to hell – that was my personal favorite.

You shall not make any cuttings in your flesh for the dead, nor print any marks on you: I am the LORD.
Leviticus 19:28

The more I heard these things, the more I wanted to scream. I didn't though. I didn't let the harsh things said about me and my choice change the love I have for the Lord, for my sister, or for the new precious memento on my left foot. I began to study my Bible more, and when I came to the verse that had been thrown in my face many times before – I came to a realization.

Reading the verses surrounding verse 28, I realized that God was speaking to the covenant people of Israel. He was warning them to stay away from the religious ways of the people surrounding them. Verse 28 wasn't directed to what we, in today's society, see as tattoos – it was meant in the context of the cultic practice of marking one's self in the realm of cultic worship.

26 "You shall not eat anything with the blood, nor practice divination or soothsaying. 27 You shall not round off the side-growth of your heads nor harm the edges of your beard. 28 'You shall not make any cuts in your body for the dead nor make any tattoo marks on yourselves: I am the LORD. 29 'Do not profane your daughter by making her a harlot, so that the land will not fall to harlotry and the land become full of lewdness. 30 'You shall keep My sabbaths and revere My sanctuary; I am the LORD. 31 'Do not turn to mediums or spiritists; do not seek them out to be defiled by them. I am the LORD your God."
Leviticus 19:26–31

The more I have studied my Bible over the past few years, the more I pity those who rely on one verse in the Old Testament to judge and degrade those, like myself, who made the decision to get a tattoo for whatever reason they may have for doing so.

This is because, you see, in the New Testament it is said that believers are not bound by the laws of the Old Testament – if we were, there would be no shellfish or pork on the menus of various Christian homes. While some see tattoos as a modification of God's creation, it could also be argued that pierced ears, haircuts, braces, or even fixing a cleft lip are no different.

24 Therefore the Law has become our tutor to lead us to Christ, so that we may be justified by faith. 25 But now that faith has come, we are no longer under a tutor."
Galatians 3:24-25

In Galatians, we read that the Old Testament law was created to lead people to Jesus. However, we know that Jesus has come and died on the cross for our sins. He has saved us, therefore we are no longer held to this law in order to have a relationship with the Lord. Our relationship with Him comes from believing that Jesus came to Earth to die on a cross for our sins, and repenting of our sins – accepting Jesus as our Savior.

I am a Christian, I have a relationship with the Lord that is stronger than it has ever been, and - I HAVE A TATTOO.

I have a beautiful memento on my left foot that reminds me that my sister walks with me through every day of my life. She walked with me down the red carpet at my senior prom, she walked with me across the stage the day I graduated from high school, and she continues to be with me throughout every important moment of my life.

My tattoo is beautiful. My tattoo reminds me that I am never alone. My tattoo is perfect.

Stop judging me for it.

Cover Image Credit: Courtney Johnson

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What The Trump-Kim Summit Means For The World

Are we headed towards world peace or World War III?

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On Tuesday, June 12, 2018, President Donald Trump and North Korean leader Kim Jong-un met in Singapore for a historic summit. North Korea agreed to destroy a nuclear engine testing site and eventually denuclearize completely, although it did not commit to anything specific. On the other hand, the US agreed to remove its military presence in the South and quit playing the "war games" that have angered the North for so many years. But how will the outcome of this summit affect our world as we know it?

What does this mean for China?

China has geopolitical, economic and security interests in the Korean peninsula. Xi's government has repeatedly shown its support for a denuclearized Korea, but the thing it fears most is a collapse of the North Korean regime, which would send millions of migrants into China.

One positive thing about the peace deal for the Chinese is that the US alliance with South Korea could be weakened in the coming years, as the US agreed to end its military presence in the South to allow Kim to denuclearize.

However, there are two other things China has to keep in mind. First is the prospect of a reunified Korea under a South Korean or Western-backed government. This would diminish China's influence in the area, especially considering many influential countries in the area, like Japan, Taiwan, Singapore and Indonesia, are democratic. Second, China needs to keep its border with North Korea secure. President Trump has emphasized this in the past, and this would keep unwanted migrants from passing through to China. To keep the North Korean regime from collapsing, along with the border, economic sanctions on Kim's regime may need to be relaxed a little.

What does this mean for South Korea?

Many South Koreans remained optimistic about the summit, since approval for Trump and Kim is at an all-time high, but some are wary of Kim's intentions. Will he actually go through with denuclearization? Since the US is ending its military presence in the South, South Koreans may feel less secure, especially if they don't know if Kim will keep his promises. It only makes sense that after decades of being at war with their neighbors, South Koreans are extra cautious. In addition, both the South Korean government and US forces in the region were surprised by Trump's intention to demilitarize.

What about the United States?

While the plan is to denuclearize North Korea once the US pulls out of the Korean peninsula, things could change dramatically, considering that Trump has made plenty of inflammatory remarks towards Kim and his regime in the past, such as calling him "Little Rocket Man" and claiming he has a bigger nuclear button. We've seen how North Korea reacts to criticism (remember The Interview back in 2014?), and we know Trump has trouble controlling himself on Twitter. Without military presence in the South, the US could be in big trouble. If we wanted to keep a strong force in the region, we would really have to depend on Japan for military cooperation, but Japanese approval of the President has dropped in recent years. In 2017, 24 percent of those surveyed had confidence in the US President, down sharply from 78% in 2016 and 85% in 2009.

What about North Korea?

This could go either way for Kim's regime. It appears that the North is trying to aim for international cooperation after a unified Korean team competed at the 2018 Winter Olympics in Pyeongchang, Kim's meeting with South Korean president Moon Jae-in, and the summit with Trump. However, they could just be trying to make their international image look nicer while they continue to resist democracy and commit hundreds of human rights violations every day that nobody can see. We can't hold North Korea accountable for denuclearization, either; accountability is nearly impossible in a totalitarian communist dictatorship that brainwashes its people out of sheer fear and closes them off from the rest of the world. How will we know if Kim ditches the nukes? Our only way of knowing is through North Korean state media, and we can't verify their claims for ourselves. Anything said by the North's government should be taken with a grain (or a whole pinch) of salt. But maybe Kim is different from his father and grandfather. Maybe he'll try and change things for the better.

My takeaway (this is MY opinion, skip past if you don't want to hear it):

The intention of this summit is clearly positive, but how do we know if North Korea is going to denuclearize? It was great that the leaders of the two countries actually met and shook hands instead of directing threats and insults at each other through Twitter (Trump) and state television (Kim).

That doesn't mean Trump isn't a complete idiot, though. He was praising the genius, leadership and talent of Kim. "He's got a very good personality, he's funny, and he's very, very smart," Trump said in an interview Tuesday night after the summit.

Sure, Kim can crack a good joke and is a smart guy, but did our President forget that this is the same man that had some of his family members assassinated. His human rights record is astonishingly horrible. His government throws thousands of people in labor camps (some because their family members committed the crime), encourages state-sponsored rape and torture, allows their people to starve to death, and doesn't allow citizens to leave the country, have a dissenting opinion, or have any contact with the rest of the world. Nice guy, right? Forget his denial of basic human rights to his people and personality cult.

All in all, the summit was a positive step towards change and cooperation, which is much better than the two leaders with large egos throwing insults and threats of nuclear war at each other. Now the one thing we need to worry about: can we trust North Korea and hold them accountable for ending their nuclear proliferation?

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instagram.com/realdonaldtrump

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