So you want to create a movement? by Wayne Centrone

I have been working in international health for almost twenty years. Our work, my own and the various groups I have had the fortune of working with, has changed a great deal in that time. The initial focus was on directly providing services. Whether it was working with street children in Lima, bringing teams down and partnering with in-country NGOs in outreach, or building water filtration systems in impoverished clinics – the services were delivered to a community in need . . . and the idea of a long term impact was often secondary to the service delivery.

The shift toward sustainability has steadily grown over the past 10 years. The need to build programs and services for the long term is front and center in everyone’s minds. There is, however, something different happening. This “something different” is a shifting of focus – a shift from focusing on the service to focusing on scaling, impact, and alternative perspectives. The new paradigm is about creating movements – social, political and economic – that shift thinking and re-order expectations.

One brave example of this movement mentality is Occupy Wall Street. Over the past couple of months Occupy movements in cities around the world have captured our attention and draw criticisms and praise from a variety of fronts. Regardless of the feelings people have toward the protesters and their methods for drawing media and public attention, one thing is clear: they have initiated an important public conversation.

Over the past few weeks, I have had the pleasure of working on a grass roots movement of my own. The Bridging the Divide campaign is the brainchild of the small non-governmental organization Health Bridges International (HBI). HBI has been working in Peru since 1994. In that time we have seen a tremendous shift in the economy of Peru.

The Peru of 2011 is a very different Peru than the one we first started working in 1994. The Peru of today is a society with a growing middle class and a broad range of economic opportunities. Yet, over 54% of the Peruvian population continues to live in abject poverty – unable to meet their basic needs of food, shelter, education and healthcare.

The goal of the Bridging the Divide event was to draw attention to the opportunities that exist in Peru to build “bridges” of support and collaboration to change the experience of extreme poverty. Through two 50-kilometer runs, one in the city of Lima and the other in Arequipa, we demonstrated the economic, social, and physical distances that exist between wealthy and impoverished communities. Our runs started in peri-urban poor communities, areas know as Pueblos Jovenes (or young towns), and ended in wealthy communities. We circuitously worked our way through neighborhoods and finished on the steps of municipal buildings in the historic districts of the cities.

Throughout the runs we drew attention from on-lookers, support from the various district politicians, and collaboration from many partner organizations. On multiple occasions we were presented with commemorative t-shirts to mark our entry into a new section of the city. It was a festive experience that really helped to draw together the various communities we traversed.

However, the runs were secondary to our goal of drawing more attention to the needs of the poor and the opportunities that we all have to “build bridges” to help close the gap that exists between the ‘haves’ and ‘have nots’ of the world. Our runs were about creating a movement.

Toward the end of our trip in Peru, the Executive Director of one of the organizations we work with came up to me and offered some very sage words of advice.

He told me “So you want to create a movement . . . Well, you have to recognize the great responsibility that comes with that. You can’t just get people excited by running through the streets and creating a ‘circus’ like atmosphere. You have to give people something tangible that they can hold onto. Something concrete that they can do to really source change.”

We know that the Bridging the Divide event is only the beginning. The real challenge will be to take the interest and enthusiasm generated from the events and turn it into actions. Over the coming weeks we will be working with our partners in Peru to build effective programs and projects that allow more Peruvians to volunteer their time, energies, and talents. Over the coming weeks we will be dedicating ourselves to the real work of creating a movement.

Take Shelter: Reflections on Film and Mental Illness by Wendy Grace Evans

This week I went to see the movie Take Shelter, written and directed by Jeff Nichols, starring Michael Shannon and Jessica Chastain. I wanted to see how mental illness was portrayed, as it is usually my experience that it is not portrayed with grace or dignity – which leaves me feeling rage, and a deep sorrowful ache of loneliness.

Take Shelter opens with the main character, Curtis, looking to the skies and hearing thunder. This image recurs throughout the film, along with a billowing cloud with an unworldly human face. Rain the color of oil falls onto his hands. Flocks of birds crisscross the sky in swooping migrations, at times hitting Curtis. Only Curtis experiences this. For some time, he is not aware that he is the only person having these experiences. People around him question his behavior.

Curtis has violent dreams in which his dog, a gentle dog, bites his arm. The next day his arm is sore all day. In his dreams his wife, threatens him with a knife and his business partner attacks him. With each dream, Curtis becomes more paranoid of the people who threaten him, but insists that nothing is wrong.

His solution is to build a storm shelter. No one understands what Curtis is doing, including his deaf daughter. There is a storm going on in his mind and he is seeking shelter either from himself or from the storm. Perhaps he is the storm?

Curtis visits his mother, who was diagnosed with paranoid schizophrenia when he was a child. He asks her when her symptoms appeared and if she had dreams. When she says she did not have dreams, Curtis recedes into denial about his state of mind and continues to build the shelter.

Deep down he knows that all is not well. He sees the family doctor, who refers him to a psychiatrist, but the psychiatrist is located far away – a reality for many who live in rural areas. Instead, he sees a counselor. He explains how his mother just disappeared one day. It reinforces his need to avoid abandoning his own family.

A hulk of a man, his grip on his mind is fragile. Hiding his experiences from his wife in order to protect her only causes more conflict. He is fired from his job, and at a Lions Club meeting, things unravel. He is challenged by his best friend, asked to leave, and loses control of his emotions after being taunted and told he is crazy.

At this point in the film, I felt myself deflate. Here is the scene where the masses assault the misunderstood, a man who is trying to work things out, and do the right thing but is trapped by an illness he cannot escape. How sad, and how trite for the crowd to bully him. But then his wife gently guides him out. As they leave, a storm of immense proportions blows in. The storm could be seen as the metaphor for his life, the real storm that has been building, unmanageable chaos.

He takes his family to the storm shelter and they are safe. It is dark, quiet, and dry. But in the morning Curtis must face the moment of truth. The storm is over. His wife and daughter want to leave, but he insists it is not over. He reluctantly he gives the key to his wife. She refuses to open the door, telling him that he must open the door. Slowly, fearfully, he climbs the stair to open the door.

Outside, the day is clear, offering him passage to something new, with the knowledge that now that this storm is over, they still will face many more challenges with his illness.

The film closes with Curtis and his wife in the psychiatrist’s office. He is given the option of going to a psychiatric hospital. He is dismayed, responding, “You mean away from my family?” This moment is indicative of how important family and social support are for recovery. Yet like in life, the movie shows that treatment requires Curtis leave his primary source of support just as his mother was forced to.

The film ends before we learn what he decides, but the final scene offers insight into the many frustrations that people who live with mental illness face when presented with limited options, or no options at all. There is often little consistent shelter from mental illness.

See? I am intelligent. by Claire Berman

He was sitting in a small enclave in the side of a brick building downtown, hands folded in front of him, with an overflowing plastic bag beside him that crinkled and rustled in the autumn breeze. It was chilly, but at the same time, unseasonably warm for November, and he wasn’t wearing a jacket. People brushed by him, talking on cell phones, talking to each other, texting – but always, their eyes were focused straight ahead. No sideways glances were afforded to him.

So he sat perched, observing a group of twenty-somethings not ten feet from him discussing how to get to a restaurant. His face was stoic, and at first it wasn’t clear that he was listening. But just as they appeared to give up hope of finding the right street, he called out to them.

“The street you’re looking for is perpendicular to the water,” he said, describing it in relation to several other landmarks. They stared. He repeated himself, this time with a hand gesture to demonstrate “perpendicular.”

“Oh, ok – thanks,” one of the men said to him, with a sidelong glance at his friends. And then they took off.

“See?” the man said to the newly vacant sidewalk before him, as if they were still ten feet away. “I am intelligent.”

I watched it all unfold as I was speed walking to get to class. The whole interaction took less than 30 seconds. But when I heard his words, my head snapped in his direction. I slowed and looked more closely. He had refolded his hands neatly in front of him and was looking off to his left with his chin held high – possibly with pride, but maybe not. Maybe it was what he needed to hold up in that moment of dismissal. The late afternoon sunlight slanted into his face and created a dark mirror shadow on the concrete wall behind him.

I felt a strong urge to acknowledge what he said – to let him know that someone had heard him and believed him, even if I didn’t know anything else about him or the situation. I wanted to show him that his words hadn’t disappeared into the abyss of busy downtown commuters. But he never looked back at me. I twisted my head forward again and finished walking the three remaining blocks to campus.

I thought about him all night in class. I thought about how strange I might have seemed for approaching him, how maybe he just wanted to be left alone, and how I could very well have been intruding on his space by approaching him and inserting myself into the situation. He might have asked me to leave him alone.

But then – maybe not. Maybe he just wanted to be acknowledged and seen. And isn’t recognition at the core of what we all want and need, when it really comes down to it? It seems like the most basic of all human rights. No one wants to feel invisible.

And this is what I see as being at the core of what we do at C4. We reject invisibility. So many see only the indistinct shadow against the brick wall, but we see the person casting the shadow. And whether it’s through training providers, writing literature reviews, or producing online learning modules, we see (and help others see) people experiencing homelessness in full color, recognizing the rich experiences that have led them here, and equally importantly, the resilience that can lead them into recovery.

What I Believe by Wayne Centrone

For many years, some believed that homelessness would end on its own. The idea was that the economic and social disruptions that created the crisis of homelessness would eventually equalize. I have heard people say that the economic pressures that led to the experience of homelessness would eventually recalibrate.

Well, it seems like that recalibration that is so desperately needed is not happening anytime soon.

For now, record numbers of people are experiencing homelessness. The economy is sluggishly moving along at a pace that seems almost at a standstill. The roll out of the Affordable Care Act seems at times too amorphous to fully understand or ever truly affect the lives of the uninsured.

So how will we end homelessness?

I believe that ending homelessness requires a skillful and competent workforce. At C4, we believe that by “up skilling” providers working in homelessness services, we can better meet the constantly changing needs of people experiencing homelessness.

Our goal is not just training providers – our goal is preventing and ending homelessness – and we believe that the training and mentoring of a highly skilled homelessness service provider workforce is a means to ending homelessness.

The other day I was at a homeless services program and I overheard two staff talking. “I feel overwhelmed at times,” remarked a young staff member, “I don’t always know what to do or how to help.”

Her co-worker gently reminded her that the work they are doing is all about the relationships they have with the clients they serve. She went on to tell her that the most important thing she can bring to her work is a listening ear and a compassionate smile.

She’s right. In my years of experience providing direct services, I witnessed the power of empathic listening and sincere compassion. I believe that a highly skilled homelessness provider workforce combined with empathy and compassion can be powerful tools in the fight to end homelessness.

Warts Shouldn't Matter When Communities Embrace By Steven Samra

Our company was recently awarded an important 5-year contract from the Substance Abuse and Mental Health Administration (SAMHSA) to launch the Bringing Recovery Supports to Scale Technical Assistance Center Strategy. I was invited to attend the kickoff meeting as a key staff member. On the flight to Washington DC, I had time to reflect on the significance of this opportunity for myself and C4.

Fifteen years ago I was living homeless and suffering from a severe drug addiction, fueled in large part by my uncontrolled bipolar disorder, ADHD, and situational depression resulting from my life on the street. My primary focus at the time was ensuring I had enough heroin to stave off the physical illness that accompanies abrupt withdrawal from the drug. Homelessness, unemployment, and the destruction and loss of relationships with family and friends were all consequences of my need to remain “well.” I spent the majority of my time engaging with members of the drug community. I lived the heroin lifestyle. It was where I could find what I needed and it was a community that accepted me, “warts and all.”

It wasn’t until years later, when I was able to abstain from the use of drugs, treat my mental health symptoms, and change my community that I realized what it actually meant to be in “recovery” and how important it is to be part of a community that embraces you.

The idea of community support as a component of recovery isn’t new, but I suspect that the critical importance of “community” in general may be lost on those who have not functioned outside of mainstream society. This facet of recovery goes hand in hand with peer support, both of which SAMHSA has been keenly aware of over the past several years as they have worked to transform behavioral health service delivery from illness-focused to recovery-centered.

The essential need for community inclusion and strong peer involvement for those of us who have become isolated, ostracized, and/or rejected from our parent communities has evolved to become a strong focus for SAMHSA. SAMHSA has been committed to the idea of recovery as a holistic endeavor for years now and has been aggressively pursuing avenues to make this a reality for those of us who continue to battle with addiction, homelessness, and severe and persistent mental illness.

The reality that I – a formerly homeless individual, in recovery from mental illness and a co-occurring substance use condition—was a key member at the table with SAMHSA’s highest leadership is a solid testament to the desire and commitment of SAMHSA to “walk the walk” when it comes to peer involvement and inclusion. Our shared ambitions to transform behavioral health service delivery as we currently know it is not just short of miraculous: it is visionary in scope, breadth, and depth.

This opportunity wouldn’t be possible for me without the influence and support of another community: my colleagues at C4. The C4 community is important because it nurtures, mentors, guides, and encourages us to take the risks of participation in community. For those of us who’ve struggled for so long with seeing ourselves as outsiders whose contributions meant so little that we stopped trying to provide them – this is nothing short of miraculous.

We face a challenging task ahead, but I believe we will succeed beyond the wildest dreams any one of us could individually imagine. While each one of us is committed to the idea that people can, nay, they are expected to recover, as a community we are more than the sum of our parts. It is the strength and support generated through community that provides the courage and fortitude to those in recovery to trust, speak, and do again. With this support in place, all of us are able to take our rightful places as a valuable member of our society with something important to contribute.

When this lived experience compliments the work of other professionals within the recovery community, the results, rewards, and benefits are life changing—for all of us.

A Gentleman and His Home by Sam Catherine Johnston

I’m an avid runner and I run the same route two to three times a week. There’s a subway station on the way, where I’ve seen the same gentleman living. His name is Hank* and he is the only person I’ve seen there. He’s usually on the computer or reading. Once I had a brief conversation with him. I got a bottle of water for him, but he told me, “No, thank you,” and that he hoped it wouldn’t weigh me down.

I realized that I was running through his street home space and that it was important for me to remember that I was just passing through his space. We didn’t have the kind of relationship where I could stop to converse and offer him a bottle of water.

Last week I was shocked to find transit police signs that said “Do Not Cross” by Hank’s home. It had been burned. All I could see were pieces of his shopping cart and burned books. He was gone. I asked the officer if she knew where he was and where he had been sleeping. At night, Hank usually chains himself to his belongings for safety. That night he had not chained himself to his things. He woke from a deep sleep to everything in flames. Someone had lit his home on fire. The officer explained to me that Hank was very upset and had found a new shopping cart. He told her that he was going to a different place in the city, one that is very crowded, where police frequently confront people who are without homes.

I thought about how he had had this peaceful place, where he was part of something. Now, for safety, he has to go somewhere that is chaotic. His peace has been lost. I find it hard to re-tell this story when I don’t actually have all the facts, but I know how it affects me. He was someone who was part of my experience in a really positive way. Now all of his belongings are burned. It feels like it is too easy for this to happen to someone.

The choices he made were taken from him so quickly. In an ideal scenario, he would have housing on his terms, but he has chosen something that was the best alternative for him. Even with the best-laid plans at the federal level, a human being can fall through the cracks in a really profound way. There is nothing logical or rational about it. It makes me ask, how can we account for one individual’s life in the work at C4? How does this experience line up with the piece of the puzzle I am trying to put in place in my professional work? It feels both so connected and so disconnected at the same time.

The system is not approaching people with the level of care and concern that we should be. People like me can feel sad about it, but the way things are, the weight is ultimately on the shoulder of the person who has to start over.

******

Three days later I went for my evening run. It was raining and Hank was back in his street home space setting up some new things. I told him I was glad that he was back. He was as nice as ever with a smile on his face. I guess it shows that what matters most is that he knew it was his place and maybe that he also knew that enough of us really do see him as our neighbor and that spot as his home.

Sam Catherine Johnston, Ed.D is a Senior Associate at The Center for Social Innovation, specializing in curriculum design, distance education, adult learning, and developing communities of practice.

*Not his real name

A Wake-Up Call for Social Media Slackers by Steven Samra

I turn 52 this year, and like so many other “mid-lifers,” I have been slow to enter the social networking scene. I frankly don’t care what most of my acquaintances and family are “gearing up for” on Facebook, and the terms “Twitter” and “tweeting” makes me sort of goofily embarrassed.

But I confess that I did enter the blogosphere some years ago to advocate for those experiencing homelessness. I found it a great way to raise awareness of the complexities of this scourge, so I’m not totally ignorant of the value of self-publishing and social networking. But I like to have a point to say, rather than simply swimming in the narcissistic pool. I’ve done a considerable amount of writing over at Stone Soup Station and my massive audience of five or six readers have in the past sent me a couple of comments about certain issues and/or situations that seemed to make it worthwhile to continue.

A couple of years ago, I received a comment on a blog post I’d written about women veterans experiencing homelessness. This comment set in motion a series of events that has forever changed my opinion of social networking and has made me committed to using social media for more than looking at the latest pictures of my children eating dinner or my friend’s sleeping dog.

The comment came from distinguished filmmaker and documentarian Patricia Foulkrod, who was interested in filming a documentary about the challenges facing women veterans upon returning to civilian life. After several conversations with Ms. Foulkrod, I referred her to Mary Ross, Deputy Executive Director of Operation Stand Down Nashville, Inc., a Nashville-based non-profit specializing in serving veterans experiencing homelessness.

The two connected and a year after the blog comment and introduction, a documentary on women veterans was born. Several days ago, Mary sent me an article about Homefront, the completed documentary (posted, of all places, on Aljazeera – the irony is almost breathtaking) –the result of the amazing power of social media to connect total strangers who, in the world before the internet, may never have had an opportunity to say hello, much less collaborate, with each other, and certainly not with individuals like Patricia Foulkrod.

Today I’m part of the t3 Tweet Team for the ThinkT3 Facebook account. I’ve found these sites to be an incredibly important resource for delivering the work of my C4 colleagues to the world and for learning about the tremendous work of others. I am arguably the most active “social media” employee in our company, posting updates and pictures of our training events and our travels as we bring information and training to agency personnel around the country related to ending homelessness.

Computers and the internet have forever changed the way we do business and see the world. If you’re not embracing the use of the social media delivered by these tools, you’re not only behind the times, you’re missing potentially the largest audience you’ve ever had to promote your products, toot your own horn, provide kudos and accolades to those you admire, and generally engage in being “social” with colleagues and friends. It’s amazing how much better this is than looking up the weather, reading Family Circus cartoons, or settling in for a nice power-nap.

It Could Have Been Me by Melissa Cogswell

There are times where I have gotten so caught up in the day-to-day work, the planning, the logistics, the scheduling, the data, the making-it-happen, that I forget precisely what it is that I am are doing here and who I am doing it for. Recently I helped implement “PATH to Housing” an 8 week, online course offered to PATH providers in Idaho and Montana. From day one, it caused me endless logistical headaches and frustrations.

The first assignment asked providers to interview consumers about how they lost housing, where they wanted to live, and how being housed would impact their lives. It was my job to compile these interviews and extract data. Most providers provided general summaries and simple one line direct quotes from the individuals they interviewed, but one provider submitted something different.

I received two direct transcripts that changed the way I view the work that I do, and in many ways, changed my view of myself. The first interview was with a 19-year-old woman who had recently been diagnosed with bi-polar disorder. Her family asked her to leave due to her illness and her substance use. About half way through the two-page transcript, I realized that I had stopped pulling data, stopping tabulating in my head. She could have been me.

At the age of 19, I was diagnosed with bi-polar disorder. I was asked to leave my parents’ house due to the behaviors my illness and my substance use cause me to exhibit. “I’m petrified. I’m scared,” the young woman in the transcript admitted. I was petrified. I was scared. I know what it feels like to be confused, alone, and ill. Shaking it off, I finished her interview; I pulled the data; I did my job.

The second interview began with a note: “Individual incarcerated since interview.” The interviewee was a 27-year-old man, diagnosed with bi-polar disorder. He had been asked to leave his family home due to his illness and substance use. He had been without a home for over four years. It was at this point that, sitting at my desk, in the middle of the day, in an open office, I began to cry. I read his words with tears sliding down my cheeks. It could have been me.

These interviews have served as one of the most important things I have encountered in my work at C4. These two individuals are why I am doing what I am doing. I sit here and compile data, schedule meetings, and book flights. I do this because I know that at the end of it all are a young woman and a young man who are standing where I might have been, but for grace or perhaps sheer stupid luck.

Why t3? Why Now? by Jeff Olivet

This post was originally published on the Give Us Your Poor Blog.

Recently, the Center for Social Innovation partnered with the National Center on Family Homelessness to announce the launch of t3, an exciting new training institute dedicated to transforming the homeless services workforce. t3 stands for Think, Teach, Transform, and it is the most ambitious project of its kind.

t3 is more than a training institute. It is a center of connection for people to learn about best practices for ending homelessness in our nation. t3 allows people to connect with national experts, share what they are doing in their own communities, and learn from peers around the country doing the same work. We combine great content, adult learning theory, and beautiful design into packages of online and face-to-face learning that help homeless service providers enhance their knowledge and skills. Our hope is that they will become better equipped to sustain themselves in this very challenging and difficult work.

Why t3? Why now?

We know the homeless services workforce is spread thin. Workers are too often overworked, undertrained, and underpaid. They need and ask for training on how to do their jobs better.

Over our years of training service providers across the nation, we have learned that while many good training efforts exist, training is often haphazard or fragmented. Quality varies, and access to training is often limited by time constraints and travel budgets. To overcome these obstacles, we’ve created a flexible model that enables people to access a variety of learning opportunities on their own time, at their own pace, and in ways that are tailored to the needs of their workplace and community.

We offer training on basic knowledge about homelessness, subgroups within the homeless population, and evidence-based practices to address housing and service needs. We provide basic skills training to support all homeless service providers to better engage and connect with the people they serve. Then we go deeper with the advanced skills series that offer advanced training in areas such as Motivational Interviewing, Trauma-Informed Care, Critical Time Intervention, and other practices that have been proven to work.

Throughout the learning process, we support individual providers and their agencies to think differently about the work they do, teach each other how they have overcome challenges, and transform their communities.

If you are interested in learning more, find us on YouTube or go to the t3 website.

Building Your Team by Kaela Gray

Prior to joining the Center for Social Innovation, I worked as a four-season backcountry guide – a role that taught me about team-building. When you’re on top of a mountain, the health and safety of the entire group depends on the relationships built within it. Developing trust, understanding, and compassion creates shared goals and team spirit. It teaches us to ask for help and how to listen for the need for help. One of the most important rules guiding teamwork is to never undervalue the time you invest in building a team. It is these relationships that will get you through challenging times. These relationships will help you manage the chaos that ensues when your environment throws you a curve.

Since my time in the backcountry, I have made it a personal goal to emphasize the importance of team-building and strong interpersonal relationships in my work. At C4 we work toward creating positive systematic change for vulnerable populations. It’s a huge goal and we work toward it through many small daily struggles and victories. Every day, in the thick of the work, I am reminded of how important it is to take part in team-building activities outside the office. It’s especially important when the challenges mount and stress levels start to rise.

Extra-office activities are opportunities to get to know your colleagues in a different context. They remove the stress of day-to-day goals and challenges from interactions. Changing the environment allows people to show other facets of their personalities, laugh more, talk more, share a personal story, or connect over outside interests. A new environment gives people a chance to find new roles within the group; a quiet person can step-up and lead, or a leader can step to the side and observe.

My experiences have taught me that strengthening and diversifying relationship webs opens up new pathways and resources. It also helps me feel a greater connection to my colleagues. While playing a game of Pictionary, or going snowshoeing together may sound like nothing more than a chance to get away from the computer and have a laugh, it is also an opportunity to get a fuller, more honest view of your organization. This is why I encourage companies to take the time to get to know the people you work with, to understand a bit more about their histories, humor and passions, and to be that much more prepared to draw on their unique strengths.