Caroline Easton believes that letting homeless individuals know they are valued is an essential ingredient to integrating them into our community. She is leading an endeavor to help make that happen.
Easton, a professor at Rochester Institute of Technology’s School of Behavioral Health Sciences, recently received $1.4 million in federal funds to make addiction treatment and mental health services accessible to the homeless through videoconferencing and email.
RIT will train doctoral interns in its Priority Psychology Internship Program to work with clients at the House of Mercy homeless shelter in Monroe County. The Department of Health and Human Services grant makes RIT’s clinical psychology internship one of the first programs in the area to include formal training in telepsychology for homeless individuals.
RIT’s clinical partners—Rochester Regional Health; Hillside Children’s Home, where interns administer addiction treatment; and Coordinated Care Services, where interns provide consultation and program evaluation—are also involved in the effort.
The Priority Psychology Internship Program offers clinical and research experience for doctoral degree holders in clinical psychology. Interns learn to administer Easton’s integrated approach to treating co-occurring addiction/substance abuse and domestic violence among male offenders. For this grant, Easton’s team will recruit interns across the country to train here through the internship. Her hope is to attract some of the best candidates to Upstate New York.
A recent report from the National Alliance to End Homelessness shows that 91,897 people across New York were homeless last year. In Monroe County, nearly 835 people have been homeless on any given night. Opioid addiction and overdose fatalities further exacerbate the situation.
The Beacon posed a few questions to Easton about the grant:
ROCHESTER BEACON: How will the training in telepsychology take place? What are your goals?
CAROLINE EASTON: Interns will learn about HIPAA compliance and clinical guidelines as it pertains to providing telehealth services to homeless individuals with chronic and persisting drug use and mental illness. Didactic training seminars and intensive supervision will occur as well as experiential training. This will take place at RIT and the homeless shelter. Experiential learning will take place by a twofold process: 1) provide in-person intakes and 1:1 therapy services on-site at the homeless shelter, and 2) after an initial alliance, continued telehealth therapy will continue from RIT’s onsite clinic to the shelter’s wellness room.
ROCHESTER BEACON: What kind of response do you expect? Will the homeless take to this type of intervention?
EASTON: We expect the following response: to engage the homeless individual in an intake session and to stabilize psychiatric distress. Our goals are 1) to engage clients into an intake (and) 2) complete the intake.
ROCHESTER BEACON: Shelters most likely see the homeless come and go. How will you keep track and measure outcomes?
EASTON: Given that there is a subpopulation of clients that are transient and we may never see them beyond the first session, we provide harm reduction, crisis management directly after the intake. Our goal is to reduce harm. Our additional goals are to motivate and attempt to engage the homeless with linkages to Rochester Regional Health’s Mobile Health Unit that drives to the shelter two times per week offering medical care and dental care. There are many untreated medical, dental and psychiatric disorders. We are working with the homeless and attempting to engage them to the next level of care. This will be a crucial and important part of continuation of care. Bringing a menu of treatment services to the homeless is essential to decrease the obstacles they face in receiving care (e.g., transportation, integration of care).
ROCHESTER BEACON: When it comes to homelessness as an issue, where does Rochester stand? What do we need to do to help these individuals and reduce the rate of homelessness?
EASTON: According to the U.S. Department of Housing and Urban Development (2011) approximately 26 percent of homeless adults staying in shelters have a serious mental illness. This percentage increases to approximately 46 percent when substance use disorders are included, highlighting the need for both mental health and substance use treatment for homeless populations. It has been estimated that there are more than 5,000 homeless individuals living in Rochester each year. Approximately 500 homeless in Rochester receive meals at shelters each day. RIT’s interns will be trained to provide pro bono tele-behavioral health services to homeless individuals and families staying at a local homeless shelter (House of Mercy). On a weekly basis, telehealth services and in-person sessions will be offered and include the following: harm reduction, crisis management cognitive behavioral therapy; motivational interviewing; trauma focused therapy; and grief counseling.
Much more is needed to help reduce the rate of homelessness. This can be achieved by funding longer-term housing for homeless clients, especially those with chronic and persisting mental illness. Having more vocational and employment services is also needed, which would be an optimal wraparound service that is linked to longer-term housing. Helping homeless individuals know they are valued and achieve their sense of purpose is an essential ingredient to helping this marginalized group resurface as a healthier member of our community.
Smriti Jacob is Rochester Beacon managing editor.