One Step Away: 'How can I help you in your recovery?'

Ending homelessness is about people. But it's also about systems and giving people choices. Ending homelessness does not have a one-size-fits-all solution because people experiencing homelessness have that challenge for so many diverse reasons.

One person may have lost employment; others have illnesses and challenges with members of their family. A person may have few long-term connections or relationships to a community because of being raised in foster care. Others have traumatic experiences occur, and the supports are just not available to assist in recovery.

Whatever the reason, our community's goal is for homelessness to be rare, brief, and non-recurring in anyone's lifetime. A primary theme of Philadelphia's behavioral health services, overseen by the Department of Behavioral Health & Intellectual disAbility Services, is to build services that are unique for each person.

One of the paths out of homelessness for people in our community is the "Journey of Hope" programs. Named by an early graduate of the programs, they offer persons experiencing homelessness an opportunity to gain recovery from addiction and other disabilities and to have priority access to supportive housing. The programs serve single men and women, coming from a life living on our streets.

The programs were born in a few key events in 2006 through 2008. In 2006, staff from the Office of Addiction Services partnered with street outreach services to engage people living on our streets. Often when people were able to access treatment, they stayed for a very short period of time.

The response of our Office of Addiction Services director, Roland Lamb, was to ask if it was true, that people wanted to stay on the street in a snowstorm rather than access treatment. When he learned that was indeed the case, his response was "Well, then our programs need to change!" When asked about joining a treatment program, a man living on the Parkway responded, "Why do I want to go to your 28-day program? When I leave the program, I am still homeless. When I drink I am less aware of how awful my life is. Why do I want to be more aware of that?"

Finally, in 2008, Philadelphia began a process called Homeless Death Review in which the service histories of persons who died while homeless were closely examined. The team quickly learned that persons were more likely to die from active addiction than any other cause of death, by far. A response was needed.

All of these efforts and events came together to address a need for transformation of current addiction treatment. The Journey of Hope programs were built to address all of these issues. As one early participant stated, "I almost need to recover more from my homelessness than from my addiction." So the programs were created to facilitate recovery from addiction, from trauma, and from a life on the streets.

The programs are a part of the health and healing systems of North Philadelphia Health Systems (NPHS), Resources for Human Development (RHD), and Horizon House. All in all there are 121 opportunities at any one time. All persons who wish to enter the program are referred by street outreach teams and assessed at the Behavioral Access Center of Girard Medical Center. Generally, programs are over 90% full on any given day. Many staff at the programs are either formerly homeless themselves or worked in homeless systems for many years.

North Philadelphia Health Systems Clinical Supervisor Tony Moses was the director of the Ridge Shelter (Philadelphia's largest men's shelter that closed in 2012) for many years. When the opportunity to engage people around recovery and ending homelessness was available, he was the perfect fit for the new program. In describing what is different about these programs, Mr. Moses says, "We believe in allowing the participant to drive the vehicle, while the staff become passengers in the car, in the Journey of Hope Project, individuals have the ability to write their own recovery plan and work on the goals that are important to them."

For staff requirement, he highlights that "we look for people who have compassion, empathy, and respect as core values, and we can teach the other stuff to them." Historically, there were limited resources to address a person's treatment needs, as well as, long term housing needs.  Even when resources did exist, they were not coordinated in a manner that focused on the individual. The Journey of Hope programs are able to bring those needs together in an integrated fashion and address them.

At the end of 2014, the Journey of Hope project, through its three providers, had over 2,240 admissions since its inception in December 2007.  Some persons came in and out many times before recovery really took hold in their lives. Unlike many traditional treatment programs, each admission was looked upon as a victory and another chance for a person to improve their lives. Many graduates moved onto needed medical care, Housing First programs, or even some to nursing homes, or boarding homes. All moved onto to their choices of options.

Over the past seven years, 59% of persons who entered treatment from street homelessness completed treatment and were able to move onto some type of stable housing after residential inpatient treatments were complete. In 2014, alone, 80.5% of those who entered completed treatment.

Thanks to the city's partnership with the Philadelphia Housing Authority, 443 persons over seven years moved to permanent supportive housing with a Housing Choice Voucher and supports from DBHIDS. Primarily, those supports were the incredible case managers from the city's Behavioral Health Special Initiative Program. With these resources, individuals have transitioned from street homelessness and addiction to recovery, self-sufficiency, and independent living.

Perhaps most exciting is so many of them are able to re-enter the workforce and give back to those who remain on the streets. With a peer support focus, Journey of Hope graduates are now outreach workers, recovery coaches, and staff in a variety of programs throughout the city. Others have moved on to employment opportunities of their choice outside the behavioral health field.

A great example is how after 18 years of Homelessness, Stanley Sturgis is now employed with the Mental Health Association of Southeastern PA as a recovery coach and outreach worker. Stanley has six years clean and sober as of April 17, 2015, and formerly worked at other Journey of Hope programs, including Horizon House's Susquehanna Park. He says of his experience, "The compassion and love that they showed me from the door was amazing. The day I came to Journey of Hope I had nothing, and by nighttime I had three pairs of sneakers, a full wardrobe, deodorant, toiletries. Everything I needed. They were so understanding. I felt free enough to just be myself. I had never done long-term treatment before, so having the ability to sit still for a year or more and work on me was exactly what I needed."

Another Journey of Hope graduate, Caleb Jackson had a seven-year history of chronic homelessness. He has a bachelor's degree from the University of North Carolina and was a teacher in the Philadelphia school system for several years before his battle with addiction and homelessness. He was living in the SEPTA concourse and came to Journey of Hope Project by way of Project Homeless Connect, an initiative to engage the chronically homeless and connect them to resources such as behavioral health care, medical services, and housing. Caleb now has five years clean and sober, is living independently again, is a case manager, and is working back in the Journey of Hope program that he completed at North Philadelphia Health Systems (NPHS) Miracles in Progress. Mr. Jackson has recently been accepted into the MSW program at University of Pennsylvania's School of Social Work Policy and Practice.

He says of his experience at the Journey of Hope program, "Staff asked me, 'How can I help you in your recovery?' I wasn't used to that approach. I began to trust them and began to express my key concerns. The staff were key. I could tell that they actually cared. And they were not intimidated by my size or my anger. I had gotten kicked out of other programs because of my size and my anger. They weren't shocked by my attitude. They had a general compassion for us. They were concerned with my health and my diet. They allowed me to adjust and do things at my pace."

These and many other persons who are formerly homeless have a story to tell.  Each person has a unique path out of homelessness but can give courage and hope for those still struggling with homelessness. While no one story is exactly the same, certain themes come through, that each person is an individual and how one person is able to leave homelessness behind will not work for everyone. That having someone (family, partner, children, church, community, staff) who truly care about that other person is essential. Those persons who have experienced homelessness are survivors and their strengths and gifts need to be acknowledged and valued. Throughout the program, we have learned, even those who seem "too far gone" can recover. Because ending homelessness is about HOPE.