The unique challenges of addiction treatment for homeless populations
How to help treat addiction for the homeless
Substance abuse is both a precipitating factor and a consequence of homelessness. Prevalence estimates of substance use among homeless individuals are approximately 20-35%; as many as 10-20% are “dually diagnosed” with an additional mental health diagnosis.
In the United States, less than one quarter of individuals in need of substance abuse treatment actually receive it; structural and interpersonal barriers to accessing substance abuse treatment are exacerbated by the realities of homelessness. Thus, homeless populations have a higher need for treatment than in the housed population, yet can expect to face more difficulties in accessing the help they need.
How can this need be addressed?
Kelly Goralski is the Women’s Program Director at the Bethel House of the Santa Barbara Rescue Mission, a Rescue Mission located in Santa Barbara, CA. Today, we explore the best practices in addressing this real and present problem – addiction treatment for homeless populations. We hope that you will find this interview interesting and that it will bring a better understanding of what kind of help is most suitable and effective.
If you have any additional questions, please share them in the comments section below. We do our best to respond to all legitimate questions with a personal and prompt response.
ADDICTION BLOG: By your best estimate, how many homeless men and women are currently in need of addiction treatment? Has this number increased, decreased, or remained the same over the fifty (50) years of your organization’s operation?
SANTA BARBARA RESCUE MISSION: I can only give you my estimation and it’s not scientific by any means. The homeless men and women that I see in this town in need of some form of alcohol or drug treatment is in my estimation about 85% and I’d estimate that the rest need mental health assistance.
I would say that this population has definitely increase over the past fifty years in part to to cut backs in mental health services and not enough non-profit rehabs for people who can’t afford Betty Ford or Passages Malibu.
ADDICTION BLOG: How many treatment programs in California currently work with homeless men and women? How many programs do you know of that exist across the U.S.?
SANTA BARBARA RESCUE MISSION: I looked up treatment programs in California that target the homeless population and I came up with five of them.
I have to be honest, I don’t know what the statistics are for other states in the U.S. with regards to providing drug/alcohol treatment for the homeless. I can be certain that it a much smaller number than what is needed. Drug/alcohol treatment is an expensive business and we need more non-profit treatment centers all over these United States.
ADDICTION BLOG: How does your mission connect (formally or informally) with these other organizations?
SANTA BARBARA RESCUE MISSION: We don’t connect formally. Informally, we try to support any program that is looking to help a person in need of drug and alcohol treatment. If someone is moving to another part of the state or if for whatever reason our program doesn’t fit their needs we will reach out and look for other referrals for that person. This disease affects society as a whole and we need to help support anyone that is looking to get into recovery.
ADDICTION BLOG: What are some of the best practices in screening individuals who take shelter in your mission and deciding on who is ready for a residential program?
SANTA BARBARA RESCUE MISSION: Our homeless shelter does not discriminate. As long as you can be respectful of others around you and aren’t violent, our homeless shelter is an open and loving place. If someone on our homeless line is really looking to get and stay sober they can ask to begin with some free outpatient services that we offer to the homeless and if that goes well then they can take that next step and apply to our residential program.
ADDICTION BLOG: Your residential program is one (1) year in length. What is the average graduation ratio? What are some of the reasons that men and women don’t make it to graduation?
SANTA BARBARA RESCUE MISSION: We recently did a survey and found that approximately 55% of our graduates were still sober 5 years out of program. That’s a pretty darn good ratio.
Some people don’t make it to graduation because they just aren’t really ready to stop using, or perhaps their caught stealing, or perhaps they can’t follow our guidelines around relationships. Living in a rehab with other people that are broken and trying to get healthy is not easy and you must commit to it completely and some just aren’t there yet.
ADDICTION BLOG: What are some of the keys to ensuring they stay in treatment? For example, what role do personal relationships play in enrolment?
SANTA BARBARA RESCUE MISSION: Relationships as far as them staying in program; it obviously helps if they have some family members that are supportive, if they have a strong sponsor in A.A. or N.A., if they can allow themselves to be vulnerable with their counselors and if they turn their will and life over to Jesus Christ. If they can’t give up the unhealthy and negative relationship from their past, then that is definitely a negative for them and their program.
ADDICTION BLOG: What about individualized treatment programs?
SANTA BARBARA RESCUE MISSION: As far as our program goes we take each person as an individual case. Each resident is treated as an autonomous human being and they each have their own individual treatment plan.
ADDICTION BLOG: What are some of the ways that men and women – formerly living on the streets – re-connect with family or create new family units in recovery?
SANTA BARBARA RESCUE MISSION: With some sobriety under their belt they can begin to reach out by phone, letter writing, or if the family is close by and safe for them they can begin to have visits. We offer a Family Day, as well that offers education and family healing.
Other “family” can be their new found friends and support in the family of N.A. or A.A. and, of course, they can begin to build relationships with people at their church.
ADDICTION BLOG: How are our social services failing us in the treatment of addicted, homeless men and women?
SANTA BARBARA RESCUE MISSION: So much in terms of funding has been cut for social services, in general. There aren’t enough mental health services, there isn’t enough free drug and alcohol treatment or outpatient programs. I believe that most people want to try and ignore the homeless population hoping that they’ll just disappear, but we know denial solves nothing.
ADDICTION BLOG: Why do you think that faith based organizations like yours are filling the gap in treating this demographic?
SANTA BARBARA RESCUE MISSION: Perhaps because Jesus Christ was homeless and wandered the streets, right? Love your neighbour as yourself! We try not to judge and have empathy. I have no idea what you have been through in your life and, therefore, who am I to judge? We try to keep an open mind and an open heart and treat others in a Christ like manner.
ADDICTION BLOG: Being a faith based organization, how can churches or individuals help in terms of prayer?
SANTA BARBARA RESCUE MISSION: Prayer is a powerful force and healer. I would ask all to please be in continual prayer for all homeless people and all of those suffering from drug and alcohol addiction. Pray for the Lords healing touch and that we’d all continue to turn our will and lives over to Christ.
ADDICTION BLOG: Is there anything else you would like to share with our readers?
SANTA BARBARA RESCUE MISSION: When you see someone homeless on the streets try not to judge and remind yourself that you have no idea where they’re from or what they’ve gone through in their lives. Pray for them and perhaps send them down to the nearest shelter or Rescue Mission for a hot meal, shower, and some human care.
Photo credit: The City of Portland, OR