January 31, 2018

#LetsTalk about mental health and homelessness


She is a mystery.  She runs a footrace from the corner of Waterloo and Union but can’t catch Godot.  She bottles a letter every day that is carried away from the shore by the rising tides but does not reach the other side of the harbour.  She is Thunder Road’s saviour and we waste our summers (and winters too) praying in vain for her to rise up from The Village’s streets.  I’ve never met her but I am supposed to expect her and to wait for her today.  As soon as she arrives I need to let Mick know that she is there for him.  Mick does not know her name.  He has not met her.  He does not know what she looks like, how old she is, or what she will do when she arrives.  She is coming, though.  She is coming for him.  She is coming to make everything better.


The first time Mick* talked about her, I thought he was talking about his mother Kate*.  Kate is a sweet woman, I’m guessing about my mom’s age because Mick is about my age.  She calls me every so often, wanting to check on her son.  I want to respect Mick’s privacy when I talk to his mother, so I can only say things like, “I know he was ok the last time I saw him around,” or, “No, he has never hit me and I don’t think he ever will,” and offer to give him a message without confirming if he is actually here, how I know him, or whether I will ever talk to him again.  Kate understands the position I am in and seems to appreciate the conversation, even though I have to go out of my way to be vague.  Lately, she doesn’t want to leave a message by the end of the conversation.  She is afraid he will be angry when he hears her name.
Has anyone come to see me?  A woman maybe?  You need to let her know I am here and give me her message.  Who Mick?  Is she your mother?  No.  I don’t know.  Tell me if she calls.  I have my stuff for her.  She might be here today.  Did she send me any mail?
Mental health – particularly mental illness – occupies a large portion of my working life.  This is not a surprise.  An effect of mental illness is sometimes the horrible truth of homelessness.  Mick is not the only one of my guys who has a mental illness but, right now, his illness is the most pronounced.  I’ve known Mick for about a year-and-a-half.  I haven’t seen him for several weeks; he is still one of my guys. 
Mick does not always want to leave the shelter in the morning.  Let’s be frank here.  In the winter, few of my guys want to leave the shelter but with Mick it seems like something different is happening.  He wakes up early but is the last one to go to the shower, the last one to go to the breakfast window, the last one to ask for his bin, and the last one to leave.  Almost immediately after I met Mick for the first time, it became apparent that he wanted to stay close by.  He came to my office several times throughout the day after the shelter closed that morning.  He wanted water.  He wanted to chat.  He wanted to sit on an armchair.  Sometimes he wanted to talk to me.  Sometimes he wanted to talk to my colleague Theresa.  Sometimes he just wanted to know if someone was going to open the door.  The conversations were always mundane.  After a couple of days of these interactions I popped my head out the door a few times throughout the day.  He was always within sight of the shelter, seemingly minding his own business, hiding in plain sight.  If you didn’t know him, you wouldn’t notice him and nothing about him would indicate he is homeless.  A few days after that, he came back to the door.  Theresa gave him the water that he wanted.  Instead of saying thanks, he looked at her and said, “Just because I am articulate does not mean that I am alright.”  We don’t really know what he meant by this, but it was the first obvious sign that his mental health may have some complications.  He disappeared for a few months after this, came back, disappeared again, and came back again.  He disappeared again at the beginning of the winter and we haven’t seen him since.  The last time I talked to Mick was the same as every other time.  Nothing made me think he wouldn’t come back that night.    
Has anyone come to see me?  A woman maybe?  You need to let her know I am here and give me her message.  Who Mick?  Does she work somewhere else?  Has she helped you before?  No.  I don’t know.  Tell me if she calls.  I have my stuff for her.  She might be here today.  Did she send me any mail
One of the things that concerns me about Mick, and a few of the other guys that use the shelter, is that his mental health prevents him from taking care of himself.  The most obvious way that this is true is in regards to his mental health itself.  It is not that he is choosing to not go to see a doctor.  It is more that in his bones he knows that he doesn’t need to see a doctor.  Self-care is also an issue with Mick’s physical safety.  In the summer and early fall, Mick is fine.  You would walk past him and not have a second thought.  He’s in good shape.  He looks healthy, like he eats right most of the time, and maybe even works out a bit.  His flip flops and hoodie are not out of place on a Saint John street.
Mick does not like to be told what to do.  Few of my guys do.  I get why.  People – professionals, family, random strangers on the street – tell them how to fix everything that is wrong.  Everyone thinks they can solve their problems.  Very few actually understand their problems.  At times I may be one of those understanding very few but, honestly and more often than not, I am one of the people on the other side of that line.  I’m not and have never been homeless.  I don’t and have never experienced the sorts of mental health struggles many of my guys experience.  At times, the most and best I can do is offer a pair of gloves and a toque before my guys face a winter morning.  One day, though, even that offer was too pushy or direct for Mick.  He was emphatic.  He did not want gloves.  He did not want a toque to replace his ball cap.  He did not want a pair of shoes with an entirely attached left sole.  He left every morning for days after refusing an offer of warmer clothes.  This was different than when he wore his flip flops in mid-November.  I watched him walk away from gloves and into a -10 degree morning while I prayed he would eventually go to one of the other charities that have gloves tucked away for such moments.
Has anyone come to see me?  A woman maybe?  You need to let her know I am here and give me her message.  Who Mick?  Does she have warmer clothes for you?  No.  I don’t know.  Tell me if she calls.  I have my stuff for her.  She might be here today.  Did she send me any mail?
Mental health – mental wellness, even – is a solid foundation.  Conversely, mental illness can be a significant barrier for people.  Both of these sentences become even more critical when a person is homeless.  For Mick, mental illness is a barrier.  It may be too strong to say that his mental health is absolutely the reason that he is not able to find and maintain safe and affordable housing; it is certainly not too strong to say that his mental health makes it much more difficult.
More than a month ago, Mick asked one of the overnight crew if he could talk to me.  This was new.  He never wanted to talk to me before; he didn’t ever seem to really want to talk to anyone.  He only talks when there is no other way to accomplish whatever he needs to accomplish.  He rarely initiates a conversation and, except for those first few meetings a couple summers ago, there is never idle chit chat with Mick.  Whenever he did engage with me, he always looked at me like he was suspicious that I was honest with him.  I set up a time to meet with him, curious as to what he wanted to discuss.  He told me he wanted to talk about getting somewhere to live.  I did not expect this, but maintained a straight face to hide my excitement.  The previous conversations I had with him about housing were initiated by me.  The first went badly.  We sat down to do a housing assessment interview and he refused to answer 13 of the 15 questions, getting progressively more angry every time a question was asked.  I didn’t bother asking the two remaining questions.  One was “Are you homeless,” and the other was about how he accessed showers, laundry, and toilets.  The fact that he stayed at the shelter answered both of those questions for me, so it seemed useless and mean-spirited to even bring them up.  The next very few conversations we had, also initiated by me, were along of the lines of, “Hey Mick.  Can we talk about getting you a place,” answered with an irritated, “I have my own plan,” from Mick.  This meeting was different.  Mick was coherent and clear spoken, not a surprise, but everything he said fit within the conversation we were having, a big surprise.  We had progress.  He said he may be willing to join a low-barrier housing program.  I promised to make the right calls for him. 
Then, “Can I ask you a question, Tony?” 
“Sure.”
“Are you with the FBI?  Am I talking to the FBI right now?”
“I promise you that I am not the FBI.”  He said he believed me.  That is not entirely true because he asked one of the overnight guys the same question the day before and another one the same question a couple days later.   
Has anyone come to see me?  A woman maybe?  You need to let her know I am here and give me her message.  Who Mick?  Does she have somewhere for you to live?  No.  I don’t know.  Tell me if she calls.  I have my stuff for her.  She might be here today.  Did she send me any mail?
Responding to mental health needs that people have is difficult at our shelter.  I am biased, most certainly, but I think we offer a good shelter in Saint John.  We operate on a “modified-wet” model, which means that someone can be drunk, stoned, or high when they arrive (though we would wish sobriety for all of our guests) but they commit to not using in our building.  Most of the guys honour this commitment most of the time and we believe in a God of grace so we build in second, third, and four-hundred-and-ninetieth chances to this model.  We also have several guests (guests always, never clients) that have one or more mental illnesses.  Our staff have tremendous compassion for these men.  That said, our staff are brilliant men’s shelter attendants instead of brilliant mental-health or addiction professionals.  My dream is that one day soon there will be easily accessible mental health care available for my guys at the shelter.     
I don’t know where Mick is right now.  He’s left for long periods of time in the past and I’ve heard rumours that he was arrested, so I am not exactly worried about him being stuck out in what seems to be a particularly cold January.  One of the oddities about my career becomes apparent when I hear that someone is in jail and I feel an immediate sense of relief that he is OK.  This is a feeling I did not even consider having prior to when I began working with homeless men in 2012.  We rely on the help of others – police, social workers, and health care providers mostly – to help keep Mick and others in similar situations safe. 
Has anyone come to see me?  A woman maybe?  You need to let her know I am here and give me her message.  Who Mick?  Will she help you Mick?
Mick hasn’t answered me yet.
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Outflow Ministry works to improve the lives of the 19.4% of Saint John citizens who live in poverty.  The work it does addresses the unemployment, hunger, homelessness, and medical costs of people in Saint John and strives to reduce each.   Its work is deeply motivated by faith in Jesus Christ and his lordship.  With each aspect of its work then, Outflow wants to help these Saint John residents know that they have a place not only in their city but also in the Kingdom of God.  To support Outflow Ministry, please visit www.outflowsj.com or call (506) 658-1344.
*Mick and Kate are real people, but I’ve changed their names and enough detail in this story to conceal their identities.

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