Seeking out mental health services can be difficult, both on a personal level and because navigating the system is tricky. For people experiencing homelessness, the odds seem stacked against them.
Everything down to intake — oftentimes a phone call to a provider — can be an obstacle. They may not have access to a phone. Insurance could be an issue.
There could be transportation or wi-fi woes. Scheduling might be dicey. A person without shelter may not know what they’re doing tomorrow, let alone next week or next month.
“It's not as easy as you would think … getting someone what they need,” said Jenny Sharp, a residential manager at Home Sweet Home Ministries (HSHM) in Bloomington.
Despite the odds, multiple area organizations — shelters, health providers, and even the county — are working to get unhoused and precariously housed individuals access to psychiatry and counseling. Home Sweet Home is among them.
Why it matters
McLean County Regional Planning Commission estimates that in 2022 there were 1,215 homeless people — adults and children — in the area. That’s the most recent number available.
The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates roughly 30% of people experiencing homelessness nationwide have a mental health condition.
At Home Sweet Home, CEO Matt Burgess estimates that number gets up to 40%. Burgess said treating mental health conditions can be essential for people experiencing homelessness. Secure housing, he adds — while important — can often overshadow other needs.
“If that's all we focused on, we'd get people into apartments, and then they would destabilize and wind up coming back to us,” he said. “We've seen that happen in the past.”
At Salvation Army Safe Harbor, residential services director Gaynett Hoskins said mental health conditions among residents are equally pervasive. Her staff is mental health first aid trained to help clients, but even without that insight, they know the signs.
“We’re actually able to see it in conversations because we’ve seen it so often,” she said.
When it comes to counseling, shelters can only do so much. The decision to seek out services lies solely with the individual. Hoskins said the McLean County Center for Human Services (MCCHS) visits weekly, so staff can encourage people to seek help.
MCCHS chief clinical officer Kim Freymann is one of the people who visits Salvation Army. She said the center also goes to Home Sweet Home.
“Maybe we'll make them feel a little bit more comfortable to go come up to us and start talking with us and say, ‘Hey, I have this issue, I have this problem,’” she explained.
Freymann added that the program has been successful, and new clients have come to MCCHS from the shelters.
Bringing the services to them
Home Sweet Home has tried to make services even more approachable by offering them onsite.
Carle Health psychiatrist Rachel Immen and Brightpoint Home Visitor Regina Cason-Collins host a weekly group at the Junction at Home Sweet Home ministries focused on Dialectical Behavioral Therapy (DBT), a form of talk therapy. Immen also offers psychiatry services, though not necessarily at HSH.
Burgess said having the DBT group is an asset.
“It takes some of the scariness out of it for folks,” she said. “This is their turf.”
He added that it may inspire them to make appointments outside the group later.
Home Sweet Home resident Savannah — whose last name is being withheld for privacy — said the sessions have helped.
“When you're in the group, it's like, nobody's analyzing, nobody's judging,” she said. “They're like, listening to what you have to say, and that really helps because most of the time, it's like, you know, no one really cares.”
Savannah said she and her family started attending DBT upon recommendation from HSHM staff. Soon, they’ll start family therapy too. She explained that her daughter has a mental health condition.
“She needs it, and the whole family needs it too, just to protect what we have,” she said.
Immen said she reached out to Home Sweet Home this year to get the partnership going. While building up her practice, she noticed a pattern in her patients. Few reported being precariously housed or unhoused.
“I kept wondering, ‘Why am I not seeing these folks? What's going on?” she said.
After asking around, Immen said she realized the problem.
“Generally, they just were not accessing mental health services because there wasn't a good route," she said.
The Center for Human Services was doing its work before Immen and Cason-Collins, but those referrals go directly to the center’s psychiatry program.
The county’s Frequent User System Engagement (FUSE) has offered services, including counseling, since 2019. It has a focus on helping those who are precariously housed. However, FUSE clients need to have had a certain number of interactions with the area shelters, jail system and emergency departments to qualify.
To date, FUSE has helped 32 people since its inception.
Different care for different needs
Sarah Stalter, assistant director of behavioral health coordination for the county, said this is not a bad thing. The program is widely considered a success.
“We really like not being able to be like a one-size-fits-all all kind of program, because the individuals come with such unique backgrounds and stories and needs,” she said, adding that there’s intentionally no set end date to the program.
Because of this, Stalter said care looks different for every FUSE client. So does therapy. It can be in an office, it can be walking, it can be in a car.
“For some individuals, especially those with certain types of trauma, sitting, facing each other, looking somebody in the eye can be very daunting and very difficult for therapy,” she said. “In the car, some people have an easier time opening up and talking about things.”
FUSE also always has trained staff by the phones, so if one of their clients is in crisis at 2 a.m., they can call and connect.
“You call 911, you're not sure always who's going to answer,” Stalter said. “For our clients, they know the people that are answering the phone. It's a much different dynamic.”
FUSE also has peer support specialists. These are people with lived experience in mental health and substance use, who can relate to the program participants directly.
Seemingly limitless obstacles
Still, only a small fraction of the area’s homeless population benefits from FUSE, and at a recent McLean County behavioral health meeting, Matt Burgess said Home Sweet Home and Salvation Army are near-constantly full, and there are wait lists.
Hoskins from Salvation Army Safe Harbor said waiting lists for counseling are also “out of control,” which can be discouraging.
“It's really up to us as providers to be as knowledgeable and aware as possible, and making sure that we do everything that we can to make sure everybody else knows as well,” she said.
It's also on the providers to understand the client. Cason-Collins, co-lead of the Home Sweet Home DBT group, said it can be hard for people who haven’t experienced homelessness to put themselves in the shoes of someone who has.
“We don't know all that's going on with each of the individuals that we work with,” she said.
But Cason-Collins and fellow co-lead Rachel Immen said they try their best.
“There's this huge struggle with making the connection happen, the operational issues to make the connection happen, and then after the connection happens, there's additional obstacles,” Immen explained. “Those melt away when you start to make a strong one-on-one connection and have good positive regard for each other and see that across our
