Providing Mental Health Services for Families Impacted by

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Transcript Providing Mental Health Services for Families Impacted by

Providing Mental Health Services for Families
Impacted by Psychological and Physical
Homelessness
Kimberly Bradley, PsyD
Center for the Vulnerable Child
Children’s Hospital & Research Center Oakland
National Conference on Ending Family Homelessness:
Building Healthy Families
Oakland, CA
February 9, 2007
Acknowledgements
Collaborators:
Children’s Hospital & Research Center Oakland
Cheryl Zlotnick, RN DrPH
Tammy Tam, PhD
Physical Homelessness is associated with:
• housing instability
• food insecurity
• lack of adequate clothing
• lack of adequate health care
Psychological Homelessness is
associated with:
• the impact of generational homelessness
• social isolation: lack of connection, lack of stable
attachments/ relationships
• a history of chaotic, haphazard, and sporadic
experiences
• trauma, victimization and multiple losses
Systemic Circles of Influence on the Family
Social
Services
Health care
Public
Entitlements
Legal
Education
Child Welfare
C.O.R.E. Program Framework
Program Approach:
• social justice
• cultural responsiveness
• family preservation
• public health
Services Provided:
• therapeutic, direct-care services at 3
different levels: child, mother and family
• collaboration with other agencies
• helping families navigate systems
• psychoeducation
•referral to community resources
Mental Health Practices
• family assessment on the roots of homelessness for the
family: situational or generational homelessness;
psychological or physical; emotional or economic
• meet family where they are
• provide emotional support through individual, family
and/ or group therapy
• provide parent education, counseling and support
• educating systems on the needs of homeless families
• advocacy for homeless children and families
• creative treatment plans that meet the individual needs
of the family
• crisis intervention and management
• working with whoever is considered family
Barriers to Ending Family Homelessness
• Chronic homelessness, instability and poverty
• Lack of employment skills necessary to earn a living wage
inadequate affordable housing
• Substance abuse problems & history of inadequate drug tx
for homeless mothers
• History of trauma and victimization
• CPS involvement - child placement in foster care system
• Loss of public entitlements
• Lack of external supports
Gaps in Service - Service Needs
• culturally accountable and responsive services
• affordable housing with supportive services
• family preservation & child abuse prevention services
• rent subsidies for times of family crisis
• federal dollars funding homeless families
• mental health services specifically for caregivers
• mother-child residential substance abuse treatment
• systems collaboration
• services for youth transitioning out of foster care
References
Bassuk, E.L., Buckner, J.C., Perloff, J.N., & Bassuk, S.
(2003, November). Prevalence of mental health and substance
use disorders among homeless and low-income mothers.
Am J Psychiatry,
155: 11
Brissett-Chapman, S. (1998) Homeless african-american women and
their families: Coping with depression, drugs and trauma. In
book, Drug Addiction Research and the health of women. Eds.:
C.L. Wetherington & A.B. Roman. National Institute on Drug
Abuse.
Kushel, M.B., Evans, J.L., Perry, S., & others (2003, November).
Victimization among homeless and marginally housed
persons. Archives of Internal Medicine 163, pp. 2492-249
Zima, B.T., Wells, K.B., Benjamin, B. & Duan, N. (1996, April).
Mental health problems among homeless mother: relationship to
service use and child mental health problems. 53(4) pp. 332-338.
Zlotnick,C., Robertson, M.J., & Tam, T. Substance use and separation of homeless
mothers from their children. (2003). Addictive Behaviors. (28) pp1373-1383.