Community Connections is the recipient of multiple SAMHSA grants, including a grant from the Services in Supportive Housing (SSH) program of the Center for Mental Health Services. The SSH program funds grantees to provide intensive services to prevent or reduce chronic homelessness.
She was one of the most expensive people in the city.
This is how Dr. Sam Bauman describes Susan*, a recipient of services from Community Connections in Washington, D.C.
When the Assertive Community Treatment (ACT) team from Community Connections first met Susan, she was suicidal. She was struggling with medical problems and was experiencing homelessness. And although she was asking for a lot of assistance, the ACT team decided they would give her everything she requested.
The ACT model is typically structured so that individuals meet with every member of the ACT team in the community. Susan was especially connected with two members of the team, who worked intensively with her over a long period of time. As a result, she is now stably housed and has finished her second semester of college.
Today, Susan is no longer the most expensive person in the city. And it is success stories like these that Dr. Bauman points out to describe how the program works.
“Community Connections,” he says, “is the most intensive community-based program in the United States.” It is also the largest not-for-profit mental health agency serving men, women, and children in Washington, D.C., combining a commitment to quality mental health care, research, and education. The organization’s mission is to provide innovative and compassionate mental health, addictions, and residential services for D.C.’s most vulnerable citizens.
The ACT team takes a collaborative approach, and Dr. Bauman is a strong advocate of the team approach. There are five ACT teams in total, and each team includes a case manager, a nurse, a vocational specialist, a doctor, a peer specialist, and someone who can navigate language barriers.
ACT team members are in the community seventy-five percent of the time. “We are going to meet you where you are at, and we are going to be equal partners,” says Dr. Bauman. “And we have seen some miraculous things happen [with this approach].”
Having a trauma-informed model of care is critical for Community Connections. “We know that some 90 percent of the people we are working with have endured trauma in their lives,” explains Dr. Bauman. “We must operate with a trauma lens.” He explains that being trauma-informed is not simply a training issue, but a paradigm shift. Every member of the agency is trained to be trauma informed and has trauma-specific skills.
His own definition for working with a trauma lens centers on respect and perception. “I try to understand the whole perception of the person I work with. I respect you because I know that you are the expert on you.”
Motivational Interviewing is at the core of the agency’s trauma-informed model of care. “If someone said, ‘I would really like a job and I would like to drink every night until I can’t see straight,’ I might say, ‘Well, you might feel relief if you do that, and that is fine,’” says Dr. Bauman. “But we can talk about other ways to operate, and we are going to help keep you safe.”
Trauma-specific skills are particularly useful in working with women with histories of abuse. For instance, when an ACT team arrived at a newly housed woman’s apartment, she indicated that she did not want to sleep in the bedroom. She told them, “I feel more comfortable sleeping in the living room.” While staff without training may have found this perplexing, Dr. Bauman’s team was able to understand that she had valid reasons for this preference. For example, she may have been abused in bedrooms in the past.
Being trauma-informed has also led to changes in how people experience the physical space at Community Connections. For example, the hallway between intake and the next stage of services used to be dark. It was challenging for many people receiving services. Now, they have made changes to correct this. And because an overwhelming number of people accessing services have experienced trauma, staff do not touch anyone without asking permission.
The peer specialists at Community Connections have also played a critical role in strengthening the trauma lens at the organization. Their stories and understanding of trauma and recovery have been invaluable in shaping the agency’s trauma lens and in relating to people who are seeking services.
Dr. Bauman’s team works with each other and the people they serve holistically, including their families and communities. “If you believe in a person’s spirit, you can make a difference and you can make this work,” he says. “But you have to have the whole team with you.”
*Not her real name. Her name has been changed to protect her privacy.
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