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Personal finances, housing uncertainty during pandemic bring increase in mental health concerns

COURTESY PHOTO: UNSPLASH/MICHAL MATION - In 2019, the Clackamas Countys point-in-time count showed 110 unsheltered individuals were experiencing mental or emotional health issues.

For years, there has been a stigma around mental health issues, which has influenced how some view those who are unhoused. While mental health issues can factor into an unhoused person's chronic homelessness, more often mental health issues are caused by homelessness rather than causing homelessness.

That is the assertion of Vahid Brown with Clackamas County Health, Housing and Human Services.

"The most commonly assumed things that people associate with the experience of homelessness are not the leading causes," Brown explained. "Mental illness and substance use, those things do occur and sometimes it's a chicken-and-egg issue; somebody who has an economic crisis that's associated with the death of a spouse or the loss of a job, or the onset of a terrible illness, can lead to the deteriorations of one's emotional and mental well-being. And poverty and a lack of access to adequate health care can lead (people to turn) to the street pharmacopeia of the available means to treat chronic distress and suffering, which is often why people turn to drugs and alcohol when experiencing homelessness. Homelessness is a traumatic and horribly sickening experience; it makes people sick."

In Clackamas County's 2019 point-in-time count of unsheltered individuals, mental or emotional health issues were among the top five causes of homelessness, with 110 respondents saying that it applied to them.

Over the past year, Brown said, he'd actually speculate that chronic homelessness in the county may have decreased because of a new influx of federal funding, but that there's been a rise overall in behavioral and mental health needs.

Stacy England with Clackamas County Mental Health Services noted that while chronic homelessness may seem to have declined, she feels her department has fielded more calls from people on the brink of homelessness who are feeling an emotional and mental toll during the pandemic.

"It's definitely been feeling like we've had more calls from people (on the verge of being unhoused) or afraid they're on the verge," England explained. "These people are carrying the weight of 'Maybe I have a job today, but I don't know if I'm going to have a job tomorrow,' and they've been carrying that weight for over a year now. There definitely is a feeling amongst people of just kind of getting by, and I worry about that and what people are carrying with them (mentally and emotionally). At this point, for a year, we've been seeing a lot of chronic stress. It is affecting people's mental health."

Putting housing first

Michele Veenker, executive director of the Clackamas branch of the National Alliance on Mental Illness, said housing is one of the biggest concerns they encounter.

"Either they can't afford it or there's barriers in place because of their symptoms," she said. "We get a lot of elderly parents who are looking at senior living for themselves and don't know what will happen to the person they're caring for."

"I have a thesis that 100% of people living on the street are dealing with some kind of mental health issue," Veenker said. "If that's not what put them there, then they might have situational anxiety or depression from the trauma of the experience."

People with mental health concerns "often don't fit the norm of what's expected" in housing, Veenker said.

"Some people can't maintain housing, maybe because they're noisy or say things that bother people," she added, noting that many places require people to be clean, sober and able to control their symptoms.

When people with mental illness end up unsheltered, tasks that may seem easy become more complex.

"There are so many more layers of difficulty, like trying to keep hold of your medication, managing when to take it and having food if you need to take it with food," Veenker said.

She thinks a housing-first model, which prioritizes providing permanent housing to people who are unsheltered, would be particularly beneficial.

"If people are safely housed, and you provide them with services, they'll be successful. If their basic needs are met, they're more likely to follow through on other things," she said.

Seeking aid and mental wellness

Through the county's Behavioral Health Division, England and other experts provide numerous mental health services, including a crisis hotline, access to counseling online and in-person and more. The individual experiencing mental health issues does not always have to be the one to call in for help.

Especially in cases regarding unhoused persons, the county professionals have a broad network of resources to pull from to aid not only with counseling and immediate mental health assistance, but more long-term aid (help with housing, connections to job programs, etc.) that may also alleviate some stressors making mental illnesses worse.

The Department of Human Services, which has an office in Estacada at 320 S.W. Zobrist St., offers a variety of services for those in need of financial assistance, people with disabilities and the elderly, such as food and cash assistance, domestic violence services and medical referrals.

DHS offers a "no wrong door policy," meaning that anyone can visit the office and apply for any program the organization offers. Additionally, the group has created a new online application for services with the goal of streamlining the application process.

Madelyn Gaines, a family coach for DHS, said that the Estacada office works with around 900 clients. Gaines, who was stationed at Estacada High School prior to the COVID-19 pandemic, works with a caseload of around 45 families.

Gaines and her coworkers see many community members who are without shelter.

"A lot of people who come to the office say that they're camping," Gaines said.

Many DHS clients are living with some sort of mental illness.

"I see it a lot, and at different levels," Gaines said. "Some people can work and want to work and can get help at the same time. Some people have to solely focus on getting help."

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