Michigan’s community mental health providers serve the unhoused

The people photographed for this story voluntarily agreed to have their photos taken and their words used.

“I'm a Chicago native. I live in the Battle Creek Shelter. I’m trying to be positive and encourage others,” Richard Evans, 62.
According to the Michigan Coalition Against Homelessness (MCAH), more than 40% of the Michigan homeless population have a long-term mental and physical health condition. Associating mental illness with homelessness can lead to victim-blaming and may distract from the real causes of housing insecurity — namely the lack of safe, decent, affordable housing. Until those root causes are better addressed, Michigan’s community mental health providers are stepping in with innovative programs that support Michiganders experiencing both homelessness and mental illness. 

Genesee Health System takes action for the unhoused

In addition to providing mental health care through its behavioral health urgent care center, Genesee Health System (GHS) helps connect clients experiencing homelessness to housing through its Community Housing Program. And their commitment to this community doesn’t stop there. GHS actively collaborates with the Flint-Genesee County Continuum of Care, the Genesee County Youth Corp., Communities First, and the Shelter of Flint. After the May 2021 approval of the county’s mental health millage, GHS held community events asking for suggestions for what to do with the money.

“As a result of these surveys, in April of this year, GHS also awarded $200,000 worth of grants to five local homeless shelters,” says Bill Doub, community housing supervisor for GHS, which is Genesee County’s Community Mental Health provider.

Being homeless creates stressors that can lead to or exacerbate mental illness. With affordable housing becoming less and less available and more individuals and families finding themselves on the street, in shelters, staying with family, or living in government subsidized motels, the need for mental health supports is also rising. According to the U.S. Department of Housing and Urban Development (HUD), in 2019, 7.77 million renter households across the U.S. were “worst case needs,” meaning they paid more than half of their income for rent. 

Homelessness and housing instability are associated with a range of stressors and even traumas: from exposure to the elements and stigma to an increased risk of violent victimization. All of these factors have the potential to negatively impact mental health. A study published in 2022 by researchers from the University of Michigan Institute for Healthcare Policy and Innovation found that 50.3 percent of hospitalizations among the unhoused were for mental, behavioral, and neurodevelopmental disorders — ten times higher than for the general population. Children are particularly vulnerable to the psychological effects of housing instability,

“For many of our clients who are paying just a standard room-and-board $700 a month, this is worst-case housing, where they’re paying over 65 percent or better for their housing,” Doub says. “Social security went up to $914 for a lot of our consumers. What’s 70% of that, roughly speaking? I can tell you right now that it ain’t enough.”
“I was born in upstate New York. I have lived in the Battle Creek area for 55 years. I fell on hard times and live on the street.” Kevin Robert O’Brien, 59.

Crisis Intervention keeps the unhoused out of jail

Many Michigan community mental health agencies are also offering help with crisis intervention. The combination of homelessness with substance use or untreated mental illnesses has been shown to be a recipe for crises. In some Michigan counties, CMHs train law enforcement officers how to better handle mental health crises.

“For a long time, police had the option of taking a person to the hospital, taking them to jail, or maybe releasing this person who's having trouble,” Doub says. “At the same time, they know at their gut level maybe ‘I'm gonna send you back home’ is not a good idea.”

Another way CMHs have partnered with law enforcement is through technology that links the officers with mental health professionals who can guide them in handling a mental health crisis. GHS helps train Genesee County’s Crisis Intervention Team, where mental health professionals accompany police officers on calls. 

 “We now have a listing of resources that we provide to police officers,” Doub says. “They're getting training in mental health services and all the resources that are available to the community. And they're also going to have a mental health professional who’s going to be going with them when they respond.” 

In 2020, the Center for Civil Justice introduced a homeless court in Genesee County. Homeless courts are a way for people experiencing homelessness to resolve misdemeanor offenses without having to go to court. Oftentimes these misdemeanors stem from homelessness or mental illness, and jail is not a solution. 

“It’s almost as though you’re penalized for being homeless. You’re taken to jail because you're acting out versus, ‘How can we get you help?’” Doub says.
“After moving from Texas, I was raised in Detroit by my grandmother. I moved to Battle Creek after meeting a girl on Facebook. I live in the Battle Creek Shelter even though it’s not safe.” Charlie McDonald, 32.
OnPoint meeting needs in Allegan County

The mental health professionals, social workers, and other support providers at OnPoint provide mental and behavioral healthcare for residents of Allegan County. They also assist clients with substance use disorders (SUDs), developmental disabilities, and emotional disturbances in children. OnPoint’s crisis program offers 24/7/365 crisis services to direct people in crisis to assessment, counseling, and hospitalization. 

OnPoint also manages the Homeless Assistance Program (HAP) for Allegan County, which serves people who are experiencing homelessness or at risk of experiencing homelessness. First, an initial housing screening helps the HAP staff to determine which programs and services are a good fit for the individual or family coming to them for services. Next, housing assessment helps to ascertain barriers to housing access the applicant may be facing. The last step is to connect the applicant to community resources and services that can help them keep or find a home — and stay in that home long-term.

For those who need a little extra help, HAP offers case management. The Housing Search Packet, a resource provided by OnPoint and the Allegan County HAP Team, provides information about subsidized and income-based housing options, homeless shelters in nearby areas, housing search tips, and links to those community resources. One section of the packet lists housings for seniors or persons with disabilities.

HAP offers an array of programs for short- and long-term housing assistance. The Emergency Shelter Program pays for a one-week stay in a hotel. The Emergency Solutions Grant provides financial assistance for a security deposit and up to six months’ rent. Permanent Supportive Housing and Rapid Rehousing programs specifically target those who have experienced homelessness for an extended period and who live with a diagnosed mental illness or SUD. Rapid Rehousing can provide a maximum of 24 months’ rent; and Permanent Supportive Housing has no limits.

“I am a Battle Creek native, kind of) homeless, but am staying with a friend. I rely on the services at the drop-in center.” Debra Martin, 66.According to MCAH’s most recent data, 30,805 people in Michigan experienced homelessness in 2020. People in families had better mental health outcomes than their single counterparts. Among Michigan’s hardest hit groups experiencing mental illness were homeless adults over the age of 65 (44%), single adults over 25 (45%), and veterans: 49%.

Doub believes these numbers may in truth be higher because people don’t always disclose that they live with a mental illness.  

“Some of them will talk about it — some of them have difficulty talking about it,” Doub says. “We know among the veteran population, PTSD is considered as a prime explanation for why folks have difficulty coping in the community.” 

Until Michigan’s communities find better policies and programs to address the root causes of homelessness — systemic racism, low wages, lack of affordable housing, and lack of residential opportunities for those with debilitating mental and physical illness — Michigan’s CMHs, like GHS, are doing their best to support the mental health of their neighbors who lack a home.

“We’re not just a mental health system that plays with Medicaid dollars,” Doub concludes. “We are an active partner out in the community.” 

Enjoy this story? Sign up for free solutions-based reporting in your inbox each week.