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 firstname.lastname@example.org
Celebrate Potential by Making a Donation During Mental Health Awareness Month