In the United States, veterans make up 33% of the male homeless population. Close to 70% served their country for three or more years. Three out of four homeless veterans experience alcohol, drug, or mental health problems. According to the U.S. Department of Veteran Affairs (VA), 45% need help finding a job and 37% need help finding housing.
Mike Kabisch is an Intensive Case Manager and Veteran Specialist with Project REACH in Seattle, Washington. He knows the inside of this story. He works to develop and build trust with veterans who suffer from chronic homelessness, chronic substance use and mental health issues, Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD).
Mike works with veterans who served in Vietnam, Iraq, and Afghanistan. A study published in 2006 in the Journal of the American Medical Association documents that 19% of veterans returning from Iraq reported a mental health problem. These newly returned veterans may be at risk for homelessness.
Alcohol and drugs are often used by veterans to mitigate the effects of TBI and PTSD. As a result, many are prone to living “off the grid” and are less likely to engage in services. It is Mike’s job to reach out to veterans like this and to find points of engagement. Points of engagement may begin with a handshake and a cup of coffee.
“Many of these guys have self-medicated for so long and the drugs they have chosen are so hard to kick,” explains Mike.
Mike describes accessing VA services as “like threading a needle.” This is in part because of the bureaucratic nature of the services and the fact that many of his clients do not have honorable discharges. Yet, he has many success stories to share. He speaks about his work with veterans with a compelling and genuine enthusiasm.
“One guy I am working with lived in the woods for a really long time. He has a real history of anger. He has finally learned to trust me and has minimized his drinking. He doesn’t have withdrawal symptoms any longer and he is not beholden to the bottle.”
Mike believes that Intensive Case Management (ICM) has been very effective with veterans. Intensive Case Management is a harm reduction model that meets clients where they are, works on relationship building, goal setting, and provides wraparound services for the whole person.
“Sustainability is about trying to provide a place where at the end of the day, the people I am working with know that someone cares about them. I am trying to provide dignity through relationship building, kind words, listening, and letting them be heard, but I am also very outcome-driven. I want to achieve something, so we work on setting goals together and for these guys it is often housing.”
Mike says there is really nothing that he will not work on with a client. This willingness to address the whole person is central to the work of ICM for Mike.
“Implicit in ICM is that building relationships with clients is critical to helping the individual facilitate positive change. ICM allows us to deal with the whole individual and to not take shortcuts with relationships. ICM provides the time and space to meet with veterans and build rapport on his or her time. A housing case manager or drug and alcohol counselor may only get to see a piece of the individual and in a very specific context. This is not the case with REACH.”
Mike shares a story about an older man who was well known in the community and struggled with extensive alcohol use.
“We were able to get him into 1811 Eastlake* and some days he was totally sober there. He was finally in his own place where he could drink, and he lost interest in it. He died housed as opposed to being on the street. He was an older guy and people were taking advantage of him on the street. He was a really nice guy.”
Mike receives referrals from a wide variety of institutions including hospitals, jails, and other veteran services groups, and he works closely and regularly with 12 veterans. He believes that he provides an important human connection. “It doesn’t take an extraordinary person to do this work. No. A little bit of kindness and respect goes a long way.”
*1811 Eastlake is a Housing First Project that is part of the Downtown Emergency Service Center in Downtown Seattle. It aims to improve the lives of its residents through reduced alcohol consumption, better heath care, and increased stability. It has also proven to reduce residents' use of the community's crisis response system, reduce public nuisances, and encourage residents to undertake and follow through with alcohol treatment.
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