Recovery Integration in Homeless Services Urged

Recovery specialist Gloria Dickerson says integrating recovery services and supports in homeless services helps providers recognize multiple client issues.

“Recovery doesn’t have an endpoint,” says Gloria Dickerson, recovery specialist at the Center for Social Innovation. “It’s an ongoing journey. There’s never a time when you feel like you’ve finally arrived. You spend your life recovering. The good part is that this forces you to develop skills that allow you to keep moving forward in a spirit of hope. Because for me, no matter what, even though there are setbacks, hope is what recovery is all about.” As someone in recovery from trauma, mental illness, physical health problems, and homelessness, Dickerson has a lifetime of lived experience to support her belief in the healing power of hope.

Recovery-focused Principles and Practices

Dickerson has also written about concrete actions that can be taken to integrate recovery-focused principles and practices into the homeless assistance network. There is a need for a recovery orientation when serving people experiencing homelessness. Through a study on recovery and homeless services, Dickerson and her co-authors found that these people often face complex, multi-faceted challenges. The study noted, “Recovery from homelessness overlaps significantly with the process of recovery from mental illness, substance use, and/or traumatic stress… This overlap suggests a significant opportunity for the homeless assistance network to learn from the research, practices, and policies used to promote and implement recovery-oriented care in the areas of mental health, addiction, and trauma care.”

The first step to adapting recovery principles and practices to homeless services is to understand how this concept has been articulated by different systems and to find the commonalities. In 2012, SAMHSA's Working Definition of Recovery did just this, bringing together a variety of stakeholders from the mental health and addictions fields to craft a shared vision that defines recovery as, “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” The working definition is further elaborated through ten guiding principles, the first of which is hope, which is viewed as the “catalyst of the recovery process.”

Dickerson believes that homeless service providers can fan the flames of hope by recognizing that people using services “need to direct and be in charge of our own recovery. Providers need to let clients know what they are doing right, because success breeds success. When you see me succeeding, tell me, encourage me!” Providers also need to recognize the extent to which the people they serve have experienced trauma, both prior to and because of their homelessness, Dickerson believes. “Being trauma-informed is not an add-on,” she says. “Trauma is at the heart of most clients’ experience and its effects need to be recognized; the resilience that people have developed in the face of trauma needs to be honored.”

Housing First is Effective

Another way the homeless service network can promote recovery is to offer low-demand service models like Housing First, which view housing as a basic human right, not as a reward for being compliant with treatment. These models do not tie housing to other services, take a harm-reduction approach, and do not put conditions on retaining housing that go beyond what would be required of any tenant in the general housing market. This model has been found to be effective in promoting recovery. A 2011 study, comparing Housing First and Treatment First program outcomes, showed that people experiencing homelessness and co-occurring disorders who were served in Housing First programs had significantly lower rates of substance use than people who received traditional “treatment first” services, and were more likely to remain housed. Learn more about Housing First at the National Alliance to End Homelessness.

Consumer integration—the meaningful involvement of people who are current or former service users—in the development, implementation, and evaluation of policies and services is another vital part of creating a recovery culture, according to the report Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Service Design, Delivery and Evaluation. Providers must ensure that consumers are seen as equal and valued partners in the change process and that their input is taken seriously if organizations are to successfully incorporate recovery principles into every aspect of their operations. Through this process, everyone—staff and people receiving services alike—work through the complicated, messy, but ultimately rewarding and ongoing process of figuring out how to make recovery real on a daily basis. “I have a lot of hope for the future of recovery-oriented services,” says Dickerson. “It helps people take joy in their work when they can walk with people on their recovery journey. It’s a process, and sometimes it’s slow, but the relationship of hope and recovery is vital.”

This article was originally published as a Voices from the Field Blog post to highlight the theme of Recovery. Find the latest SAMHSA Blog posts about behavioral health and homelessness.

Learn about SAMSHA's recovery services and supports for people with mental and/or substance use disorders.

Access more behavioral health and homelessness resources.


Publication Year
2014

Author
Darby Penney
Last Updated: 04/19/2016