Elevating What Works to Support the Unhoused In Santa Cruz County

We are all aware of the struggles to house people in our community. Through a growing focus, learning, and coordination we have made monumental strides as a community towards rapid rehousing, and yet some people visibly and consistently fail to access or succeed in housing.

For those working each day to help solve this issue, there is immediate recognition that part of the challenge of getting folks into stable housing lies in addressing the complexity and variation in need for those who are unhoused. Among our unhoused community, many who struggle the most often have an overlap of issues including addiction, trauma, and untreated mental health issues.

As we launch Mental Health Awareness Month, we want to share a ray of hope on this topic, provide some insight on elevating what works, and invite you to be part of the solution. 

Through the Volunteer Center mental health programs provided by Community Connection, we opened Pathways to Wellness, in partnership with Santa Cruz County Mental Health, as an 18-month demonstration project to assess what it might take to move the needle with people who were unhoused, had co-occurring Mental Health Diagnosis with a Substance Abuse Disorder and were treatment resistant.

Opening in January of 2019, Pathways operated fully as designed until March of 2020, then was converted to virtual services until it was closed due to budget restrictions related to COVID in October of 2021.

What we learned through this demonstration project about what works with treatment resistant people was profound.

Our idea was that intensive, strength based, wholistic programming that met people where they were and provided them with a pathway from the street to one of the many excellent local systems in place, would dramatically improve our community’s results with this population.

By design we provided participants with a safe, voluntary and therapeutic space 7 days a week to heal from street induced trauma, build their strength and engage in meaningful activities. We assisted participants in community integration through structured volunteering, work training and socialization activities and we identified the specific needs of each participant to stabilize to hone in on their greatest challenges of homelessness, acute mental health challenges and addiction. Finally, we helped participants avoid the loss of housing due to a substance abuse relapse and increased mental health challenges.

Ultimately our goal was to get folks on a stable path, reduce hospitalizations, and reduce incarcerations. The outcomes were strong. Every Pathways participant enrolled was polled for their record of hospitalizations and jail admissions 6 months prior to enrollment and for 6 months during/after enrollment. With 81 participants polled, 42% of had spent time in the hospital and 33% had been incarcerated in the prior six months. 6 months after participation only 6% reported hospitalizations and 7% reported incarceration. That is a dramatic decrease for a population of individuals who have the greatest number of barriers to success!


What allowed this program to be so successful?  We believe the Pathways Program has a story to tell us about our approach to “treatment resistance” community members. In large part, we believe the success of this program was due to providing daily access to intensive support and quality services.Participants naturally sought and successfully engaged in meaningful activity when they were provided with a safe space that included healthy food, peer navigation and a supportive structure. Participants gave consistent feedback to program staff about how much they relied on our space for their recovery. The simple foundation of removing barriers, stigma and access to resources transformed the lives of individuals living on the streets.  This whole person, strength-based programming operated fully outside of locked setting and was a by choice program rather than enforced.

Not only was this program successful and but it was also cost effective. Weekly costs for Psychiatric hospital care range from $9,500-3,000 and weekly jail time on average costs about 1,200 per person, whereas the cost of maintaining programming for Pathways participants on weekly average was $574.

Unfortunately, despite all of these positive outcomes of this cost effective data driven program, Pathways was forced to close due to a lack of continued supportive funds to maintain the project. As local conversations ensue about best approaches to rehousing community members and addressing the complexities of homelessness, we feel that examples such as the Pathways program demonstrate there is great potential for making different investment choices with our public funds.

We stand ready to partner to share our learning and advocate for re-investment in comprehensive supportive mental health programs. This pilot grant showed us that the Pathways to Wellness model works. The program significantly reduced the number of psychiatric hospital and jail visits, provided treatment resistant and high-risk individuals with a safe and therapeutic space to stabilize, and assisted participants in achieving meaningful treatment goals that enhanced long-term recovery. Now we need our community to fund it.

Ways to Take Action:

  • Letter and statements to the Board of Supervisors, City Council meetings and other funders to invest in what works, including restoring or sustaining effective programs.
  • Share our impacts and stories to raise awareness among Housing, Mental Health and Substance Use Advocates, providers and funders to inform policy and practice.
  • Request a speaker for Pathways to talk with your community group about what works.

Reach out to our staff at info@ccsantacruz.org

Celebrate Potential by Making a Donation During Mental Health Awareness Month


A familiar face waits patiently outside the doors of Community Connection in the early morning hours after another cold night of sleeping on the bench in the adjacent park. Similar to most participants in the Pathways to Wellness program, Jon enters the doors of Community Connection in search of a safe, warm and supportive space. Silently he signs in and searches for his first cup of warm coffee. After greeting everyone, he settles inside the “cocoon,” as the Pathways to Wellness group meeting space is affectionately called, puts his head down for a few minutes to rest, and waits for the first group of the day to begin.

Jon maintained this routine 5-6 days per week and in so doing, has became the most consistent, supportive, and longest-term participant in the Pathways to Wellness program. Despite the oppressive challenges of his situation, Jon used the tools, support and counseling provided by the Pathways program to maintain sobriety and stabilize his mental health challenges while experiencing homelessness. Jon made a decision to move himself towards a better quality of life off the streets and away from the struggles, dangers and triggers inherent in that lifestyle.

Even while sleeping on a bench night after night in a high-density drug using environment, Jon found motivation within himself every day to attend Pathways. First, Jon improved his wellness enough to receive a bed at the River St. Shelter. Jon simultaneously attended the Shelter and Pathways to Wellness programming in an effort to move towards his wellness goals of obtaining permanent housing, employment, and long-term recovery. Jon expressed interest in applying for a work training position at Community Connection to help further develop his employment skills and he took the initiative to develop his own resume and communicate to staff his commitment to vocational growth.

While most would describe Jon as reserved and quiet,  put a scrabble or chessboard in front of him and he becomes animated and competitive in his good-natured way while flashing his rare, bright smile. Jon enriched the Pathway to Wellness program through his consistent participation, dependable commitment to his work training position and peers, and his willingness to be a team player. Jon successfully completed the three-month work training position with astounding results. It was with no surprise that he was offered a permanent job with Community Connection as a Program Assistant due to his diligence and commitment. Jon is now housed, employed, and experiencing long-term recovery. As a blazing role model for his peers, Jon demonstrates the transformative power that recovery can have on an individual despite their challenges. As a valued Community Connection employee,  Jon’s story is an example of the impact the Pathways to Wellness program had in our community.

In Jon’s own words, “This program was my life. I felt really supported and grounded. I just want to give back now.”