National Alliance to End Homelessness ~ Accommodating

All Families: Addressing Substance Abuse

Karen Batia, Ph.D.kbatia@heartlandalliance.org

July 2011

Heartland Alliance for Human Needs & Human Rights

Heartland Alliance ~ Philosophy of Care

Human RightsStrengths Based Assessment and

InterventionHarm ReductionTrauma Informed Invite, Recognize and Embrace

Differences

Heartland Alliance for Human Needs & Human Rights

Heartland Targeted Service Teams

ACCESS (ACT → Community Support Treatment Teams)

Street Outreach FACT Harm Reduction Housing/Residential International FACES (Refugee Mental Health) Healthcare Teams

Heartland Alliance for Human Needs & Human Rights

Family Assertive Community Treatment

•Strengthening At-Risk Homeless Families•Conrad N. Hilton Foundation; Polk Brothers; McCormick Foundation; Prince Charitable Trust; City of Chicago

Heartland Alliance for Human Needs & Human Rights

Who does FACT serve?

• Single mothers between the ages of 18-25 • Mental health disorder • Substance use, domestic violence• At least one child under the age of five

• The families must live in the city of Chicago

Heartland Alliance for Human Needs & Human Rights

The Team Approach

Services are provided where the participant is (shelter, street, friend’s home, family member’s home, store, hospital, treatment center)– Project Director– Child Parent Therapists– Substance Abuse Specialist– Housing Specialist– Senior Case Manager

Heartland Alliance for Human Needs & Human Rights

FACT Services

Mother

Comprehensive Assessments Therapy Vocational/Educational Employment Housing Groups Case Management Collaboration with other providers Parenting Psychological Psychiatric Health Education Referral and Linkages

Child/ren

Comprehensive Assessments Therapy (Child Parent Psychotherapy) Educational Case Management Collaboration with other providers Psychological Psychiatric Health Education LIOP/TOTS Early Head Start Referral and Linkages

Heartland Alliance for Human Needs & Human Rights

Harm Reduction

• A set of practical strategies that reduce negative consequences of drug use and other high-risk behaviors

• Incorporates strategies that range from safer use to managed use to abstinence

• Meets and accepts drug users on their own terms– Harm Reduction Coalition

Heartland Alliance for Human Needs & Human Rights

Principles of Harm Reduction

Risky behaviors are a biopsychosocial* phenomenon

Risky behaviors are initially adaptive

Behavior, set, and setting are central to understanding an individual’s actions

*Biopsychosocial- a general model or approach that posits that biological, psychological (which entails thoughts, emotions, and behaviors), and social factors, all play a significant role in human functioning in the context of disease or illness.

Heartland Alliance for Human Needs & Human Rights

Principles of Harm Reduction

People who engage in high-risk behaviors have the right to sensitive treatment, and to not be expelled for the very behavior that brings them to treatment

Treatment should be based on the development of a needs hierarchy

People who engage in high-risk behaviors can and do participate in treatment

Success is related to self-efficacy

Any reduction in harm is a step in the right direction

Heartland Alliance for Human Needs & Human Rights

Harm Reduction Values

We promote the human rights of all participants, including those who engage in risky behaviors.

Heartland Alliance for Human Needs & Human Rights

Harm Reduction Values

Normalize risky behaviorBe nonjudgmental, including avoiding

potentially judgmental labelsAvoid having preconceived goalsProvide choicesValue the individual’s information and

inputBe aware of power differences

Heartland Alliance for Human Needs & Human Rights

See small changes as successesBuild rapport and trust Recognize ambivalence as normalEmphasize the individual’s strengthsEmphasize personal responsibility for

outcomes

Harm Reduction Values

Heartland Alliance for Human Needs & Human Rights

Harm Reduction Applications

Safer driving – speed limits, seat belts, intoxication limits, air bags, defensive driving, abstinence….

Safer sex – education about condom use to prevent disease and contraception, avoiding risky sexual practices, abstinence….

Heartland Alliance for Human Needs & Human Rights

Harm Reduction Applications

Safer drug use – reduced use, avoiding risky routes of administration, drug substitution, safe using partners (designated driver), abstinence….

Safer parenting – education about pre-natal care, regular doctors appointments, education about healthy and normal development, making appropriate child care plans, safe sleeping habits, use of car seats, healthy eating habits….

Heartland Alliance for Human Needs & Human Rights

MHRI Technical Assistance Projects

Coalition building – Harm Reduction Housing Roundtable

Targeted training

Technical assistance (staff → policy development)

Board consultation

Advocacy