Hope for the homeless is a reality

Jacksonville's social services sector may be underfunded, but that doesn't mean the needs are being abandoned.

This community is blessed with outstanding individuals working with the mentally ill. There simply aren't enough of them.

One of the outstanding role models is Richard Christensen, professor in the division of Community Psychiatry at the University of Florida College of Medicine-Gainesville. He also is director of Behavioral Health Services at the Sulzbacher Center.

That doesn't mean he's stuck in a classroom, though. He walks the walk several times a week with the homeless downtown and at the Beaches.

All of this work has been noticed as well. Christensen has received the University of Florida's highest teaching award, the Hippocratic Award, he has been named an Exemplary Teacher in 2011, 2012 and 2013 and he has been selected as one of the best doctors in America for 15 consecutive years.

Members attending the JCCI study on mental health were treated to his low-key intelligence recently as he explained some of the issues involving barriers to mental health treatment.MEETING THE HOMELESS

On any given night, it's estimated there are about 2,800 homeless people in Jacksonville. Christensen says that is vastly underestimated.

For many, mental illness is both a cause and a consequence of being homeless, he said.

"The fall down the ladder is so much faster than the climb back up," he said. "It doesn't take a lot for a person with a serious mental illness to wind up on the streets."

A person with a serious mental illness like schizophrenia has a much increased chance of being on the streets.

Once homeless and mentally ill, everything is disrupted. The basics of life - work and housing - are interrupted by active mental illness. The safety net of friends, family and relatives is lost. Family members often are burned out and need a break.

Once on the street, stress kicks in. The homeless are under assault from the weather, attacks and worry.

The places these people wind up - emergency rooms, crisis units and jails - are designed for stabilization but not recovery.

Often there is a poor handoff of a person from jail to mental health services.

And the mentally ill have great difficulties navigating the barriers in the health care system. Inconveniences for most people become impossible for the mentally ill.THE HOPE TEAM

A system has been created for this group of people: outreach through a Hope Team, shelter, medical and behavioral health and housing and supportive services.

The Hope Team looks for ways to connect with the homeless.

"It's not always what's accessible but what's acceptable," Christensen said.

People who may not want to hear about medication or treatment to start, might be willing to come in for a shelter bed. He agrees with the "housing first" approach that people need a reliable place to stay before they can move on to treatment.

In effect, Jacksonville has created a medical home for the homeless through a federally qualified health clinic at Sulzbacher. People can obtain primary care, psychiatric services, behavioral health care, addiction treatment and case management.

These people have enormous difficulties with transportation. Often literacy is minimal and social skills are lacking. They have great difficulty going one place for primary care, another for mental health.

In response, Christensen said Jacksonville has a one-stop shop for homeless people with severe needs. There are consistent providers who know the patient and have electronic medical records.

The focus of recovery has to be centered on a person's dignity, that person's healthy self.

That is why the news media's references to "the homeless" robs them of their individual identity and their dignity and turns them into stereotypes that allow society to turn away, Christensen said..

"There really is no typical story for a person who is mentally ill," Christensen said. "Everyone has a different pathway into being homeless."

He quoted author Elisabeth Tova Bailey, whose book "The Sound of a Wild Snail Eating" chronicled her struggle with chronic fatigue syndrome, a physical condition that often is difficult to diagnose and treat.

"Illness isolates; the isolated become invisible; the invisible become forgotten."

The mentally ill too often are hidden in the shadows. For too long that has been the case in Jacksonville where mental illness is the community's greatest unmet human need. This JCCI study has gone a long way to shining a light that will not be extinguished.NATION IS CHANGING- One in 10 Americans are foreign-born.- One in three Americans belong to a minority group.- Many minorities mistrust or fear treatment, have inadequate insurance coverage or poor services.- More African-Americans are misdiagnosed with schizophrenia than any ethnic group.Source: Upenn Collaborative on Community Integration.VETERANS- Veterans far from a VA medical center may receive treatment through telemedicine.- Suicide prevention staff work with veterans: (800) 273-8255, press 1 for Veterans Suicide Hotline.- For homeless veterans: (877) 424-3838.- For the Veterans Administration Guide to mental health services: website: tinyurl.com/ o7eok69