“About 50% of adults with severe mental illness have a co-occurring substance abuse disorder,” said Wellspring CEO and Kent alumna Katharine Dobbins.

The goal is to help people become free of homelessness, engage in recovery and improve their quality of life through a community-based approach.

The nearly $2 million project is funded by the U.S. Department of Health and Human Services through its Substance Abuse and Mental Health Services Administration. It is designed to boost specialized training to serve 180 Louisville adults via Wellspring, a behavioral health agency with a 38-year history of providing mental health services.

“Obviously the issue of people having both mental health and physical problems is a major concern in Louisville,” said Bibhuti Sar, UofL social work professor and the grant’s lead investigator, who pointed to the efforts of Wellspring and other local groups working together to address homelessness. “The Kent School of Social Work and the University of Louisville strongly support the well-being of the community. We welcome the partnership of Wellspring to enhance their efforts and experience to do that work.”

Working with other community partners such as the Coalition for the Homeless and Louisville Metro Housing Authority, the project will identify some of Louisville’s most vulnerable adults living on the streets with both disorders and will seek to provide them with housing and services designed to stabilize their lives.

“This will be a life-changing program,” Dobbins said. “It helps move a person along the path of recovery toward the goals they want to achieve. We will take a harm-reduction approach, but critical life experiences serve as opportunities to help individuals make positive changes.”

Participants will have a support team that includes a therapist, case manager, nurse practitioner and a peer support professional. This team, in conjunction with the Kent School, will develop skills in using evidence-based methods that help integrate “trauma-informed” care for participants. UofL will bring in national experts for training in evidence-based interventions. Sar said he hoped the training will occur this summer with services to begin in early fall.

“This grant will help our staff hone and improve their skills in evidence-based practices,” Dobbins said.

Those practices include integrated dual disorder treatment, which addresses both problems (mental health and substance use) simultaneously with the same team; motivational interviewing, which guides people toward change; and a “housing first” model, which uses supportive services to help chronically homeless people with serious mental illness and substance use disorders.

The Kent School team includes Martin Hall, an associate professor with experience in researching substance use issues, who will lead the evaluation part of the grant to ascertain the program’s effectiveness. Jim Guinn will be the project’s daily coordinator, and Sar said the team will hire a research assistant.

“We also want to understand the impact of services on consumers in the sense of improving their functioning and well-being,” Sar said.

Partnering organizations also will measure outcomes including how many homeless people get housed and how quickly and whether they maintain housing for a year or more. Other measurements will assess improvement to their quality of life and whether their psychiatric conditions changed.

“Our goal is to get people into independent housing, their own apartments with their own amenities,” Dobbins said. “We provide supportive services. We hope to get people into treatment as well, using these evidence-based practices.”

Continuing the UofL connections, Dobbins has a Kent social work degree and Wellspring program manager Paul Bliss has been a Kent adjunct faculty member; Sar hopes later to involve Kent students in the work as well.

“It’s rewarding to see our graduates making a difference in the community, and the chance to partner with them as alumni is fantastic,” Sar said.

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The University of Louisville’s and conducted the study, thanks to $50,000 from Louisville Metro. With a transdisciplinary research model that spans beyond traditional academia, CIK and CCTSJR provide infrastructure for researchers to find solutions  to complex social problems, recognizing that problem solving requires expertise from multiple disciplines in partnership with the community.�� 

As a community, Louisville attempts to address homelessness in a coordinated and comprehensive manner, using data to identify gaps in services and streamlining the use of valuable community resources. In the past year, new property developments and attempts to enforce community safety have displaced homeless camps, leaving unsheltered individuals to collect on downtown streets and under overpasses.

In response, Mayor Fischer’s Homeless Encampment Task Force engaged researchers from CIK and CCTSJR to support their work with the following specific aims:

1. To determine national best practices to address street homelessness.
2. To provide an assessment of the existing service system for individuals experiencing homelessness in Louisville.
3. To perform a gap analysis between Louisville’s existing services and best practices, with recommendations on policies, practices and funding, to aid Louisville in progressing toward reducing the number of individuals who remain unsheltered.

The study recommendations are outlined below:

1. Expand and evolve homeless services. Ensure individuals experiencing a housing crisis have access to the single point of entry system at all times. Reinforce the Housing First model and trauma-informed care within the Continuum of Care, such that a centralized case management team provides the accompaniment needed to navigate a complex system, resolve barriers and move into and maintain a home.
2. Revise encampment policies. Expand policies to shift focus from clearing to providing needed services, including hygiene facilities and housing assistance. When clearances are required, ensure that campers not only receive notice of a clearing, but that they are required to be offered and assisted with storage and shelter options.
3. Offer multiple low-barrier shelters in locations throughout Jefferson County. To ensure everyone has access to shelter and feels safe, emergency shelters should be smaller, designed for specific subpopulations, meet Americans with Disabilites Act standards and offer a staff to guest ratio that supports trauma-informed care. Emergency shelters should be used as a touch-point to link guests with wraparound services.
4. Improve collaboration. Resolving homelessness requires the participation of everyone. Communication and collaboration among service providers and across sectors is imperative.
5. Housing and community development. Prioritize affordable housing in Louisville, especially to meet the needs of households with income below 30 percent Area Median Income ($25,100 for a family of four). As needed, revise zoning ordinances to achieve this.
6. Address root causes of homelessness beyond housing. Create policies to raise the minimum wage and revise policies that create barriers to employment and housing for individuals who have been in the criminal justice system.
7. Promote community education and engagement. Develop a comprehensive public awareness campaign that sets achievable goals, involves multi-sector participation and is aimed at multiple audiences (individuals experiencing or at risk of homelessness, advocates and service providers, and the general public).
8. Evaluate the outcomes of new policies and programs.

“It’s critical to recognize that homelessness is a result of a system that perpetuates discrimination and creates poverty. This study reveals that we must strengthen the connectivity between services and providers, as well as across sectors, and employ an approach of accompaniment, whereby our community meets individuals where they are and walks with them on the journey to stability,” said Susan Buchino, PhD, OTR/L, assistant professor, , and research study lead from UofL’s CIK and CCTSJR.

Other UofL researchers include Catherine (Cate) Fosl, M.S.W., Ph.D., co-director of CCTSJR, director, Anne Braden Institute for Social Justice Research, and professor, Women’s, Gender, and Sexuality Studies; Lora Haynes, Ph.D., associate professor, Department of Psychological and Brain Sciences; Kelly Kinahan, Ph.D., A.I.C.P., assistant professor, Department of Urban and Public Affairs; Diane Zero, M.Ed., CIK graduate research assistant and doctoral student; and Jamie Beard, administrative assistant, Anne Braden Institute.

“We are all aware that we have a homeless crisis in Louisville,” said Natalie Harris, executive director of the Coalition for the Homeless. “This problem will only get worse through the proposed cuts to preventative services that are currently funded by Louisville Metro Government. We need the community to step up and demand that vital resources provided by the Office of Resilience and Community Services, the External Agency Funds and Neighborhood Development Funds are preserved and expanded using the guidance outlined for us in the University of Louisville report released this week.”

“We appreciate the hard work and collaboration among all of our partners, and especially the Coalition for the Homeless and University of Louisville,” said Mayor Greg Fischer.�� “It will take a united community to address the complex issue of homelessness.”

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