Sunburst navigates budget cuts to fill gaps in mental health care
The Daily Inter Lake - 6/3/2018
June 03--Print Article
Rose Day is frank about her situation. "I'm homeless, and it's not easy," she said over breakfast at the Village, the free drop-in center at the Sunburst Community Service Foundation in Kalispell. The atmosphere is light -- sun streams in through a wall of windows, and the rooms smells of fresh bagels -- but the conversation between a group of Village regulars is heavy. "If you've never been in [that] situation, then you don't understand it," said Day of the stress caused by the instability of homelessness.
Sally "Stony" Wise and Kevin Pearson nod in agreement. The scene at the Village is unassuming and quiet -- a few people gathered around a dinette table, a rerun of "NCIS" humming in the background. But it offers a snapshot of a community adapting to harsh realities, as a scarcity of affordable housing and bruising budget cuts to mental health care continue to upend many in the Flathead.
The Sunburst Community Service Foundation is one of several community organizations that provide assistance to adults coping with addiction, mental illness, homelessness or other destabilizing conditions, offering an umbrella of services including mental health therapy, arts and education, and family concept services. The foundation's Village drop-in center -- a free, open-door room for anyone needing advice, guidance to resources or just a place to hang out -- functions both as the building's literal entrance and as a welcome mat to a network of community services. "We help people find housing," said Cami Imperato, the coordinator of the Village. "We help them fill out applications for SNAP or Medicaid, housing applications, job applications -- just really anything that they need, we'll either help them or point them in the right direction of where to get it."
The Village's relaxed environment contrasts sharply with the stark trends of homelessness and mental health funding in Montana. Rates of homelessness in the Flathead continue to rise, while state budget cuts enacted this spring have strained or closed many local mental health services. The two aren't necessarily concurrent issues, but they are often woven together -- homelessness makes it harder to maintain adequate treatment for mental illness, and a loss of treatment makes it harder to maintain stable housing. But as the on-the-ground conditions change, community health and assistance providers adapt. And in the wake of devastating budget cuts to mental health care, the Village at Sunburst has emerged as one important piece in the larger puzzle of community mental health care in the Flathead.
As an "open door" drop-in center, the Village often catches some people in the midst of dealing with dual challenges.
One of those is homelessness. The lack of affordable housing in the Flathead is "the worst it's ever been," said Imperato. Homelessness increased statewide by 7.8 percent last year, according to a report released in December by the U.S. Department of Housing and Urban Development. The increase in Kalispell was over twice that, at 16.2 percent, according to statistics from the Montana Continuum of Care Coalition. When several area agencies, under the coalition called Flathead Homelessness Interagency Resource and Education, released a five-year plan to combat homelessness in 2015, the working number from a "point in time" survey was 763 people -- far more than the amount of beds in shelters. The disparity has only increased, said the Village coordinators, as affordable housing projects stall, rents rise and wait lists for subsidized housing stretch months or even years.
It took Shyanne Clark, a former client of Sunburst who now works as the Village's peer specialist, eight months to find a new place after hikes to her low-income rent in Whitefish forced her to move. "And that was with support," she said, noting that the confusion of rental applications, waitlists and the specter of lost health services can be "daunting" for those in unstable situations.
People like Sally Wise, who returned to Kalispell last fall after a life on the road as a truck driver. Suddenly using her pickup as a mobile home, she relied on the drop-in center for guidance on rental applications and resources, and to relax as the stress of finding a place took its toll. "I wouldn't have made it without this place," she said.
For Day, who first arrived at Sunburst for mental health services about a year ago, the Village's consistency -- safety and community, 8 a.m. to 5:30 p.m., five days a week -- provided comfort amid the tumult of unexpected homelessness. "This is my home. I come here and can hang out all day here if [I] want."
That consistency can come under assault if mental health needs aren't met.
Mental illness does not necessarily cause homelessness, nor vice versa. But the two often exacerbate each other. Without stable housing, treatment can be difficult or impossible. "If you're basic needs aren't met, you can't do much else," said Imperato. Conversely, if consistent treatment is suddenly upended -- as was the case for some who lost case workers to state budget cuts this year -- clients can fall out of stable housing situations and into jail or the hospital.
When, in an attempt to recoup a budget shortfall, the Montana Legislature slashed $49 million from the Department of Health and Human Services in an emergency session last November, mental health professionals braced for a crisis triggered by a wave of instability.
"The [state budget] cuts are all over -- dental, schools, in-home health care -- so there probably will be a mental health fall-out from all that from fear and anxiety," said Winegardner, "so we're bracing for the possible storm it could create."
Mental health providers faced a blanket cut to Medicaid reimbursement rates, forcing many that treat low-income patients into untenable situations. Western Montana Mental Health Center's clinic in Libby and the AWARE Center in Kalispell closed entirely, while Western Montana transitioned the Sinopah House, the Flathead Valley's only remaining therapeutic group home for adolescent girls, into a more cost-effective group home for adults.
Most devastating to many mental health clients, however, was the $18 million cut from targeted case management services -- a loss of nearly half its funding. Case managers provide the consistency and coaching often necessary when maintaining a mental illness -- helping clients keep appointments, take their medications and keep up with jobs and living arrangements. Navigating life without them can be dangerously overwhelming, potentially leading to crisis situations, said Sunburst staff. "For clients, it's impossible and they get frustrated and they give up. They're losing important things in their life," said Winegardner.
The cuts are "intense," she said, and Sunburst has experienced a reduction in staff due the funding constraints. But the Village, funded by a state grant through at least June 2019, is not at risk of imminent closure.
"With the drop-in center, that's where we're able to create groups and a community where people can rely on each other," said Winegardner.
Though not as comprehensive as consistent case management or therapy, the Village offers makeshift "drop-in" case management for anyone in the community who walks through the doors, said Imperato, the Village's service coordinator. She and staff at Sunburst, are there to listen and advise "if anyone needs to talk."
"The whole point is to empower people and teach them how to use the system, because a lot of the case management is ... helping to schedule doctor's appointments, helping them make appointments and following up, 'how are you doing today?'"
Kevin Pearson, who first came to Sunburst for services over three years ago and now works there as a janitor, knows the value of this in-person consistency first-hand. In and out of psychiatric services since he was a teenager, Pearson has long struggled with alcoholism and chronic homelessness. And while Sunburst can't offer a bed or home outside of working hours, he said the stability and direction provided in the Village has helped him build stronger relationships and a better grasp on the available resources.
"It's really hard when you were institutionalized through the psychiatric system to adjust to regular life because you don't learn a lot of the skills," he said.
"When you're homeless, you lose a part of your humanity. So when you get all the budget cuts and stuff... you get to a point where you don't know where to turn. Sunburst gives you a place to turn."
Budget cuts may have put a strain on mental health resources in the Flathead Valley, but local mental health services are not set to disappear in full. Rather, the community network of mental health professionals and clients, such as the Village, are adapting to a volatile funding system by providing guidance where they can.
This can't offset all of the cuts' impact; Imperato pointed out that the Village can't fill the void of case management for more severe cases of mental illness, a loss that leaves the most vulnerable clients at risk of harm, jail time or hospitalization for a mental health crisis. But the hope, according to the Village coordinators, is that the center's services, connections and space will keep some of those dealing with mental illness or the stress of homelessness from falling through the cracks of a strained system.
"[The cuts] are very dark and depressing, but we're really trying to stay positive in how we are going to help our people here," said Winegardner. "Because we're not just going to shut our doors, we're not just going to say, 'Figure it out yourself.' We have a very creative staff and we're going to work hard."
For Day, that effort comes in the form of a welcome, nonjudgmental space where she can take on the challenges of finding a home and achieving stability "just a day at a time."
"They don't judge you," she said. "because everybody has problems. Everybody. Doesn't matter what it is...you just need a place where you feel comfortable and fit in, and this is where I feel comfortable and fit in. This is my home."
Reporter Adrian Horton can be reached at firstname.lastname@example.org or at 758-4439.
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