Reach homeless where they live

Nobody needs a house call as desperately as those without the house. That’s long been evident to those on the front lines of dealing with Honolulu’s homelessness crisis, in which many of those living on the streets are confronting problems in their physical and mental health.

The particular challenges of mental illness are particularly vexing, because the ailment itself pushes patients further toward the margins. They resist going to shelters, where health-care professionals can more readily find them, evaluate their problems and direct them toward help.

This is why the recent and continuing outreach to the streets by teams of providers expert in medical and social services is such an encouraging development, one deserving of support. The collaboration involves the University of Hawaii School of Medicine, the Institute for Human Services, police and other city officials, The Queen’s Medical Center and others. Psychiatrists still in the residency stage of their training make rounds of homeless encampments to build trust with people living there, including those in need of medical help.

And starting on Sunday (see box), the community at large will have an opening to join in the outreach, in other ways. A national initiative to combat homelessness, 100,000 Homes, has come to Hawaii. Volunteers will undergo training on Sunday to begin the first phase: finding where the most vulnerable individuals and families are located on the streets — many of whom will be those with mental-health challenges — and doing a survey to know their most critical needs.

The collaborative approach is not really new, said Greg Payton, CEO of Mental Health Kokua. Along with IHS, this is among the 39 agencies that have formed the homeless provider network known as Partners in Care. It has been extending services for many months, including placement in permanent housing once health concerns have been stabilized with treatment. "Once we do that, they’re often suitable to transition to permanent housing," Payton said.

The 100,000 Homes approach springs from the recognition that homelessness is a community problem that must enlist the help of the community to solve, Payton said.

Nationally, various creative approaches are being tried, with some success. Largely, the process involves a kind of triage, identifying people most in need so they can be placed first.

Locally, state homeless coordinator Colin Kippen rightly observed that Hawaii’s exceedingly high housing costs present a special challenge. However, there are families who could be eased into a rental with a little support, Payton said. For example, 100,000 Homes Oahu could spark fundraising campaigns to enable some families and individuals to cover startup costs such as the first month’s rent and household supplies.

In addition, businesses can help to identify properties that could be converted or apartment buildings with appropriate units.

Making all this work will be a challenge, one that will likely extend over years, not months. But the medical and social professionals treating the mentally ill on the street, as well as those willing to power the volunteer initiative, are taking important first steps — or first 100,000 steps.