By Hilary Klassen, The StarPhoenix October 5, 2013 - Most of us have never lived on the streets, but probably feel some compassion, and possibly ambiguity about those who do. Those suffering from mental illness end up in surprising places; warehoused in prisons, in and out of homeless shelters, or on the streets.
Mental Illness Awareness Week shines a light on the plight of sufferers and hopes to remove the lingering stigma associated with it. Mental illness has many faces and some of them find support at the Lighthouse Supported Living in Saskatoon.
The Lighthouse is a homeless shelter that also provides supported living and affordable housing. Its clients have typically experienced disruptions in development and lack of basic supports.
"Many of the chronically homeless have had significant disruption in their lives, i.e., trauma, abandonment, mental illness, addictions. These conditions interfere with healthy personality development and subsequent functioning. There is an erosion of a basic sense of security," says Bueckert, Clinical Social Worker at the Lighthouse.
A significant segment of the homeless population struggles with mental illness. "I would think 75 to 80 per cent of our clients are mentally ill," says DeeAnn Mercier, Lighthouse Director of Communications. However, that number includes those with acquired brain injuries, cognitive impairments, developmental delays and other non-standard definitions of mental illness. "So we have a wide variety of clients here who can really benefit from some stable housing that gives them a large sense of independence but also has a support network built in," she adds.
Community services for the mentally ill exist for a broad spectrum of needs. But attempting to access these services can be daunting. There are mental health, addiction and financial services, and psychiatrists, physicians and pharmacists are involved. "The services are all kind of separate and segregated," says Bueckert. "It takes a lot to sort all that stuff out if you're a consumer of these kinds of services. It's a big challenge to know how to deal with all of that," he says.
The Lighthouse tracks these services for their clients, enabling an integrated approach. "Part of our case management is to try to sort through a lot of that and make sense of the systems, develop connections for clients and foster relationships," says Bueckert.
The Lighthouse provides a continuum of care designed to lead clients to independent living. For many, the entry point is emergency housing, whether it's the women's shelter or the stabilization unit. From there, clients can transition into supported living, complex needs, or affordable housing.
A newly dedicated floor in the Dubé Lighthouse will address complex needs. "The Health Region came to us and said, 'we would really like first dibs on some of your rooms because when our clients go there they fall off the radar'," says Mercier. She hastens to add that in this case, falling off the radar is a good thing, because clients stabilize and stop using all the services - like emergency, hospital, prison, etc.
"The Health Region gave us some funding to renovate this floor and also to have a higher level of staffing," says Mercier. In addition to having a clinical social worker in Bueckert, they will have an addictions staffer, another social worker and a nurse for the complex needs floor. Of the nine rooms set aside, eight are long term beds (one year) and one is a mental health respite bed. If you have no place to live after a year in complex needs, you can stay and transition to supported living.
Bueckert oversees the complex needs floor. "Essentially we have a partnership with Mental Health Services to assist in housing some of their harder to serve clientele," he says. "These are people that maybe have gone through their approved homes and so on, and for whatever reason, have not been able to stay in those homes; some of them have addiction issues, they all have significant mental health diagnoses so they need some fairly close monitoring and medication management and a lot of case managing."
Clients at the Lighthouse may find that the approach there is a little less structured and intensive than the approved homes they've been in, and it's a better fit for some. They have a little more independence but there's still a safety net of supports and services.
Bueckert directs programming throughout the facility.
Programming can help clients uncover some of the barriers to independence they may have. There's a weekly recovery group, an AA group, anger management classes, people skills classes, and leisure activities. "In addition to planned activities we'll sit down and meet with individuals whenever they have a crisis or an issue, the door is always open," says Bueckert.
Bueckert says he used to do "nice middle class" therapy. "I had a private practice where you sit down for an hour every week. This is not like that," he smiles. And although it's not as tidy, "it's where the rubber meets the road," or rather the street.
"Mental illness is such a huge issue and I think the more we can put community supports in place, the less frequent the use of emergency services and inpatient services -which are necessary as well. But what people really need is a sense of belonging, they need some supports on an ongoing basis, they need community, and so that's really what we're trying to create," says Bueckert.