Mental Health Services for the Most Vulnerable
STREET OUTREACH SERVICES AT ADULT AND CHILD HEALTH Integral to Adult & Child’s organizational mission is delivering “life-enhancing physical, social, and behavioral healthcare services” with hope, compassion, and creativity. The Homeless Outreach team at Adult & Child embodies that mission through the core belief that all persons deserve access to needed health and social services and that no one should fall between the cracks. “The Outreach Team at Adult & Child Health is responsible for saving lives throughout the year. They are real-life heroes, especially during inclement weather, as their focus is to provide needed supplies and conduct wellness checks on individuals exposed to harsh weather conditions,” said Jennifer Disbro, Vice President of Behavioral Health Services. Adult & Child began providing outreach services in 2011 with just one staff member providing outreach to individuals experiencing homelessness in Marion County. By the end of 2022, the program had grown to include six full-time positions under two different funding opportunities to meet the growing needs of the community. The team continues to find new and innovative ways to serve Central Indiana’s unhoused neighbors, which has included forging a partnership with Wheeler Mission. The two agencies welcomed a site visit by Zoe Frantz and LeeAnn Jordan of the Indiana Council of Community Mental Health Centers in fall of 2022 so that Zoe and LeeAnn could see firsthand how the organizations’ partnership has been impactful to persons experiencing homelessness. Staff from A&C, Wheeler Mission, and Indiana Council meet for a site visit. “Wheeler Mission is grateful for the long-standing collaborative partnership with Adult & Child Health. Through the years, our relationship has deepened and evolved to address the complex needs of those we serve across a widening spectrum of services and support,” said Colleen Gore, MSW, Chief Program Officer for Women’s Programming at Wheeler Mission and Adult & Child Health Board Member. “What began as a coordinated outreach approach has expanded to co-located mental health services and now involves discussions to provide supportive housing service. This flexible process is integral in promoting sustainable life change for some of the most vulnerable members of our community.” A DAY IN THE LIVES OF OUTREACH STAFF A typical day begins with a team meeting and the development of a daily plan for outreach. A large part of the day involves following up on referrals, which could come from a number of different sources. Outreach staff can become connected to individuals through city-wide outreach efforts, from staff who have stopped into local camps or locations identified by partnership efforts, through other shelters, and through their established walk-in office hours. Other Adult & Child staff make internal referrals to the outreach team as well. The team packs items for the day, including blankets, water, snacks, and Narcan. They head out into the community prepared to attend to any potential needs of those they serve, from food or medical requests to unplanned crisis scenarios. During outreach walk-in hours at Adult & Child Health, the team triages the needs of individuals as they arrive, with the goal of creating a coordinated entry access to complete housing assessments. However, during these hours, the team also links individuals to primary care and behavioral health and assists them in accessing crucial identification documents that may include birth certificates, ID cards, social security cards, and more. EXPANDING SERVICES THROUGH PARTNERSHIPS & EXTERNAL PROGRAMS The Outreach Team partners closely with a variety of external organizations and programs within the Central Indiana community. Some of these partnerships include the IMPD Homeless Unit, Wheeler Mission Men’s and Women’s Shelter, Horizon House, Homeless Initiative Program (HIP), the Coalition for Homeless Intervention and Prevention (CHIP), Adult Intervention Center (AIC), and the Marion County Prosecutor’s Office’s Quality of Life Program. A new partnership for the team, the “Wellness in Transit” initiative with IndyGo, began in May of 2023. Through this initiative, staff set up a table at the Carson Transit Center on Tuesdays from 1 to 4 p.m. This functions like a mini clinic, where staff are able to conduct rapid triages, assessments, behavioral health referrals, and more. TEAM STRENGTHS & PASSION “Adult & Child’s Outreach team members are incredible at engagement. They have a real ability to connect and build trust with individuals with significant untreated mental health issues,” said Brian Paul, Adult & Child Homeless & Housing Resource Team Leader. The team is diverse in their past work experience, which helps in the many situations they encounter out on the streets. Individual team members have medical backgrounds, rural outreach experience, legal backgrounds, and mental health/substance abuse treatment experience. The team is also made up of excellent community collaborators who often provide trainings to many of Adult & Child’s community partners. One recent training involved working with Wheeler Mission’s case managers on how to navigate the legal system. The Outreach team exemplifies one of Adult & Child’s values of “meeting people where they are”—often very literally. The team regularly meets individuals within the community in locations that include shelters, camps, and other places not meant for human habitation. Each Outreach team member is an advocate for persons experiencing homelessness as it relates to systems, services, and resources. They know most individuals they serve by name, take time to learn their story through a person-centered approach, and help each individual set goals. When someone is ready to be connected to services or resources, they are quick to respond. The team follows best practices and utilizes harm-reduction approaches. “It is such a joy to go out and get to know these folks. They are amazing individuals. Their connections to one another; how they allow us to be a part of who they are and their community,” said Susan Hobson, Street Outreach Professional. “We build some really deep, amazing relationships with the folks we serve. It’s a community of care going both ways.”
Matt Bane Shares Lived Experience in NAMI Keynote Session
Matt Bane was recently invited to speak at the 21st Annual NAMI Indiana Mental Health and Criminal Justice Summit on his personal recovery journey and the importance of peer support roles.
Mission Moment: School Based Interventions Lead to a Major Comeback
When a high school student was experiencing anxiety, depression, and trauma symptoms in January of 2023, Adult & Child’s School Based Services and Lola Mahner, LSW, were there to provide support. Lola quickly learned that despite the past trauma, current trauma was still ongoing. This client and their family were facing possible homelessness, along with a lack of access to healthcare and food. Considering all of these experiences, Lola’s first goal was to help the client regain a baseline and control over their emotions. This involved psychoeducation, providing their family with weekly case management and family sessions (which led to stable housing, healthcare, and food access), targeting peer and social functioning, and utilizing components of CBT and DBT to target thought monitoring and emotional control. This required the client to test their limits, to learn new coping skills and communication strategies, and to develop a different outlook on life. “This was no easy task and resulted in the client leaving the office due to intense emotions more than once, and them wanting to quit therapy on several occasions,” explained Lola. “I never gave up on them. Eventually, I was able to help the client learn that it is okay to have bad days, but these bad days did not define them. Through our therapeutic relationship, they learned how to cope, to communicate, to have more control over their thoughts and emotions, and this hard work paid off.” This client was nominated by their school for the “Comeback Kid” Award, given each year to a student who faced adversities and hardships that impacted their school functioning and abilities, and who demonstrated resilience in overcoming these obstacles by remaining successful in their academic career. Lola had the honor of being one of three individuals present at the award ceremony to support her client. “The smile on their face when they saw me there to support them is something I will never forget. When they gave their acceptance speech after receiving their award, my client introduced me proudly and stated, ‘My therapist is here for me today, and I just want to thank her for all the things she has helped me with over the past year. There were a lot of things I didn’t think I would make it through, and I did it with her help.’ This recognition is rarely something that mental health providers receive, and it will be a moment that I will remember forever,” said Lola. “This moment encompassed all the hard work that we did together. The validation and recognition that my client and I felt that day reminded me of my purpose in this job and was certainly a mission moment for both of us.”
Mission Moment: Reducing Anxiety to Help a Student Stay in the Classroom
Late in September of 2023, Dorian Villanueva, Skills Development Specialist, received a referral for a student experiencing severe separation anxiety that was impacting their ability to come to school and allow their parents to leave. The student eventually stopped attending school altogether. During this student’s intake, Dorian involved the student in coming up with a plan to attend school and spend a couple of hours with her for skills sessions. After a challenging first session, they worked out a schedule that utilized classroom visits where the student’s parents remained in the A&C office and Dorian attended class with the student. Over time, they were able to increase the student’s classroom time and school time, while decreasing Dorian’s classroom and session time and the parents’ presence in the building. “There really wasn’t anything we didn’t try with this student and their family,” Dorian said. She and the student worked together to build up coping skills and implement them into a morning routine to reduce anxiety before school. They modeled a classroom environment and completed activities to improve self-awareness, self-esteem, positive thinking, identifying triggers, self-calming ability, and problem-solving. Dorian was also able to coach the student’s parents on positive and negative reinforcement, extinguishing behaviors, psychoeducation on anxiety, and possible reasons for the student’s increase in anxiety. As of late January 2024, the student had been attending full school days without reporting any separation anxiety and even asked to go to bed earlier so school could come sooner. “This is really a testament to how much students across all backgrounds might benefit from our service,” said Dorian of the student’s success.
