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May is Mental Health Awareness Month | Staff Profile: Caring Outreach

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Across the country, serious mental health challenges can disrupt people’s ability to carry out essential aspects of daily life, such as self care and household management. Mental illnesses may also prevent people from forming and maintaining stable relationships or cause people to misinterpret others’ guidance and react irrationally. This often results in pushing away caregivers, family, and friends who may be the force keeping that person from becoming homeless. As a result of these factors and the stresses of living with a mental disorder, people with mental illnesses are much more likely to become homeless than the general population (Library Index, 2009).

A study of people with serious mental illnesses seen by California’s public mental health system found that 15% were homeless at least once in a one-year period, and patients with schizophrenia or bipolar disorder are particularly vulnerable. According to the Substance Abuse and Mental Health Services Administration, 20 to 25% of the homeless population in the United States suffers from some form of severe mental illness. In comparison, only 6% of Americans are severely mentally ill.

However, in Marin County, the 2019 Point In Time Count brought some good news: homelessness among people with serious mental illness was down 40 percent and down 10 percent among people with substance-use disorders. This is in large part due to the county’s housing-first approach and coordinated system of outreach, rapid rehousing, and help provided by government and non-profit agencies working together in a Continuum of Care.

Community Action Marin has three mobile homeless outreach teams as part of the county’s network. Called, Community Alternative Response and Engagement (CARE) Teams, these mobile units are dedicated to offering peer support to those experiencing mental health challenges and homelessness. They provide trusted connections in community, help with immediate needs, transport as necessary to the agency’s drop-in services, and coordinate with other providers across the county. Here is a vignette sharing the story of one of our team’s newest members.

Staff Profile: Debra Walker

It’s a cool and foggy morning when Debra Walker from CARE Team III pulls her van into a nearly deserted parking lot in Novato. Due to the COVID-19 Shelter in Place there is no early morning traffic. The van is new and has not yet been branded with Community Action Marin logos, but when Debra opens the back hatch and the sliding door, people begin to emerge from the mist, clearly expecting that she would be there. Debra has a supply of socks for those in need, and she greets everyone by name as they walk up.

Debra is the newest member of Community Action Marin’s CARE Teams (Community Alternative Response and Engagement). She is a bundle of energy, pulling clothes baskets from the van as she explains that with sobriety came weight gain, so she is sharing clothes that no longer fit with those who can use them. As one gentleman approaches the van Debra admonishes him, “You need to have a mask, Honey,” and digs in to her stores to find the right size. His age and health don’t qualify him for a motel voucher, so Debra has promised him a tent, which she hands off with the mask and gloves. Another woman has arrived and Debra directs her to the clothes, telling her to take whatever she wants, explaining that the woman is looking for a job and needs interview outfits.

In another moment, Debra shares that she’s meeting later with an outreach worker from the Spahr Center for a woman they are hoping to get into a detox center. As she buzzes around the van, handing out supplies and social distancing advice, Debra shares that she is moving into her own apartment this week. As she describes her new home she turns to the woman looking through clothes and says “Hey, I did it! Never give up, if I can do this so can you.”

How did you become involved with Community Action Marin?

I got involved with the agency while getting my education taking the course through a program that trains people to become peer providers. When Laurel Hill, the agency’s VP of Mental Health Services, came to do a presentation for our class and talked about all the different resources that Community Action Marin offers and the job opportunities available, I knew that that would be for me.

How has working at the agency impacted you personally?

Through my life experience, going from addiction to incarceration then graduating from an intensive outpatient program and finding myself having to be housed in a shelter and then transitional housing, I knew that I could be a great benefit to the agency and the clients that we work with. I was able to secure CalFresh and Medi-Cal working with coaches, and I was able to improve my opportunities to secure employment.  I almost feel like I became an expert in our county by learning and going through all the channels to find out whatever resources that would work for me and even for others to better one’s life.

Also, I first learned of the agency’s programs when I was a resident at the New Beginnings Homeward Bound program, from January 2018 up until very recently. I got registered with the Economic Opportunity program so I could get help to clean up my credit. As I had thought this would be an impossible feat, I soon came to believe and realize that not only was it a possibility, but that I was able to go from a very low credit score to a credit score that has afforded me the ability to rent and secure an apartment and build on a new secure independent future.

My employment with Community Action Marin has truly changed my life. It has provided me a sense of purpose. It has improved my health and my happiness counteracting the effects of stress, anger, and anxiety. It has completely changed my life on a path of true success. I am able to learn every day different tools and opportunities to empower myself and others.  I feel absolutely blessed and honored to work with the professionals in Marin County from every agency all the resources that have become available to the vulnerable folks in our community it has been a blessing.  Before leaving on her rounds in the van again, she notes:

“Hey, you can’t tell with the mask, but I am totally smiling. I love this job, I feel like everything I have gone through prepared me to do this work. I love it! I’m so grateful I was given the chance to do this work!”

LEARN MORE ABOUT OUR CARE TEAMS NOW

Enterprise Recovery Center: Emotional Warmth

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Although the Enterprise Recovery Center (ERC) is closed at this time, our site manager, Darcy Woodall, and peer support staff, Jennifer Carter, are keeping office hours daily. This is in part because many homeless people in crisis are still showing up at the center since it’s a respite they know and trust. The two team members are able to provide appropriate referrals and crisis intervention, working to ensure that people who come are not a threat to themselves or others.

During the course of the pandemic, they have helped to transport individuals to the hospital for non-COVID health emergencies. Some may not have made it there on their own. Recently, they coordinated with the county’s Adult Case Management, our agency’s own CARE Team doing homeless outreach and coordination, and the local police to have a client who was experiencing a mental health crisis transported to the hospital’s crisis stabilization unit. This was someone they had been dealing with for years, a woman who has been traditionally resistant to services and usually manages to mask her symptoms.  The work is hard and can take a lot out of staff. We are grateful for the difference they are making!

The WarM Line: Emotional Support

As soon as the ERC team understood that it would be necessary to close, they began to think about how best to continue offering mental and emotional support to community. With some focused effort, the agency launched extended hours for the Warm Line the day the statewide shelter-in-place order was released.  Peer staff were redeployed, offering 9am to midnight service. Even though this was not publicized in advance, people wanting to connect immediately began to call. Many expressed acute anxiety around how they would manage the disruptions to daily routines and needed recovery tools and assets, including mental health doctors.  Some have asked for information about available resources such as food banks.

In the past week alone, the incredible Warm Line peer support staff have fielded over 150 calls. There are a lot of callers still concerned about the pandemic. Many people check in daily and some several times a day to just feel companionship. Callers express relief and gratitude that they are able to reach out for support; to hear a human voice. As one staff member shared:

People are having a hard time staying indoors. One group home has very strict rules about people going out which was distressing for the clients that live there. Some people are worried that they will contract the virus. While these difficulties exist people in general are trying not to panic and stay positive. Also, callers are looking for more information about the Coronavirus. One lady is concerned because she is still going to work and feels vulnerable.

Additionally, many people do not have (due to limited financial resources) either cable or Internet service and have a hard time accessing reliable information. People who struggle with psychosis (particularly auditory hallucinations) are finding it more difficult to cope with the intense isolation.  It is clear to ERC staff and to callers that the impacts of the isolation would be much worse without access to the Warm Line.

The agency has also installed a second phone line in order to create a Spanish Language Warm Line. We are working on staffing this right now, looking into extended partnerships with other nonprofit organizations in the county.

While the expansion of the Warm Line was the right solution, its impact and success is only because of the dedication, empathy, and wisdom of the staff and volunteers who have been unfailingly heroic, patient, and compassionate. To all, we are grateful and proud of your commitment in community!

Learn more and contact us

 

CARE Teams During COVID-19

Posted on Category Stories, UpdatesTagged , , ,

UPDATED April 26, 2020

Our homeless outreach teams are called CARE Teams. CARE stands for Community Alternative Response & Engagement. The three teams share a mission to work with and support the homeless, or those at risk of becoming homeless, in Marin County.

CARE Team One, funded through the county’s Behavioral Health & Recovery Services, is working exclusively in West Marin. There are limited services available to the homeless population in Pt. Reyes, Tomales, Inverness, Stinson Beach, and Bolinas, which is the route this team covers. Michael Payne and Peter Planteen, both veterans of this work, are our staff for this team. They check in regularly on people who are living in cars, campers, or who are otherwise on the street. They work closely with Health & Human Services, West Marin Community Services, and the Coastal Health Alliance at Pt. Reyes Station. Michael and Peter have been told by multiple members of the community that this CARE Team is, in Michael’s words, “the only game in town.”

In normal circumstances, the team will traverse West Marin on Mondays and Tuesdays. However, due to requests from partners and members of the West Marin community, for the last month and a half due to the pandemic, Michael and Peter have been in West Marin much more. On an average day, if there is such a thing in this work, the two men will seek out and engage eight or nine clients. Michael shares:

What do we do? Everything from A to Z and more. It is important to understand that unlike the homeless, as well as the homeless mentally ill and the homeless dually diagnosed (with mental illness and substance abuse) in other parts of the county, the homeless in West Marin have very little support services.

Food? Sometimes the only food for some of the homeless comes from the food pantries in Pt. Reyes Station and Bolinas. When these food pantries are closed situations can become dire; some folks will either beg or go without food at all. We know one woman who, having no income or support, uses any means available to her to acquire money for food.

Michael continues,

Where do the homeless live? Some live in the woods, some live in their cars, and some spend the night on porches. There are three people Peter and I know who have endured nights huddled together for warmth on the floor of the Post Office in Pt Reyes Station, when it has been cold or raining.

It’s tough. Peter relates that he recently found a homeless young man sleeping in mud, under a wet blanket, who hadn’t eaten for a day and a half. And Michael says it can all hit one pretty hard. “Yesterday, Peter and I drove out to North Beach to eat our sandwiches we had bought for lunch. For a while we just sat in the van in silence, staring out at the ocean.”  The team keeps its eyes on people, looking for anything that indicates something is different today for this person. Michael relates,

Every time Peter and I engage with a person we look for signs that something is different from that last time we saw the person. We have ‘eyes on.’ We monitor the entire engagement looking for anything that has changed either for the better or worse. We then review our findings and based on our assessment we determine a course of action. Interventions range from counseling to soliciting help from service providers such as West Marin Community Health and Human Services, the Coast Health Alliance Medical Clinic, the West Marin Community Services Agency, and/or the West Marin County Sheriff’s Department.

Who are some of the people and what are some of the services that CARE Team One provides?

  • M (male) – found riding a bicycle in circles; services provided; eyes on.
  • S (female) – missing three days; found living in her car near the ocean with little food and no water; services provided; purchased water and sundry items.
  • V (male) – found sleeping on the ground under a tree in the woods; services provided; transported to Novato for medical support and later to a motel room in San Rafael.
  • K (female) – missing two days; found huddled in a corner of the public rest rooms at Point Reyes Station; services provided; medical support from Coastal Health Alliance for scabies and lice.
  • N (adolescent male) – missing four days; found sitting on a bench outside the Pt Reyes Food Pantry. N now has boots on his feet but no laces to hold them on (used to walk around barefoot); services provided; eyes on and counseling.
  • H (male) – found in his car outside food bank in Point Reyes Station (has blood clots in legs, uses crutches to walk around); services provided; eyes on and counseling; monitoring medical condition.
  • J (female) – missing two days; found sitting in her car outside of town (has trouble walking due to edema); services provided; eyes on and counseling; monitoring medical condition.
  • K (male) – found sitting on a porch on top of blanket (left foot broken approximately six months ago; no medical treatment); services provided; eyes on and counseling; monitoring medical condition.
  • C (male) – sleeps in his van, missing two days (moderate to sever memory problems due to medical condition; C smiles every time he sees us, but often can not remember our names); services provided; eyes on and counseling; working with Coastal Health Alliance to monitor symptoms.
  • P (male) – missing.
  • R (male)– often missing but sometimes contacts us via phone, meeting us outside the Point Reyes Food Pantry; services provided; eyes on and counseling.

The team was recently able to get an 81-year-old homeless, wheelchair-bound man in Mill Valley into a motel in San Rafael.  Working with partner agencies, Homeward Bound and St. Vincent’s, the team was able to secure him a room.   Michael notes, “I took a look at this man’s legs and feet; the feet were swollen and bluish in color.  He said he had diabetes but had not seen a doctor nor had any medication, so I informed county staff at the motel about his situation and they were going to call to get a medical evaluation.  Peter and I intend to follow-up.”

It takes a county-wide collaboration to ensure that the people our CARE Team encounters are given the treatment and support they need.  One of our agency’s Peer Support Specialists, Hasani Moore, usually working alongside county case managers, has shifted to the county’s response team helping to get the homeless into motels that have been converted to shelters. The temporary residents were offered rooms so they could shelter in place to help prevent the spread of COVID-19.  Hasani is providing overnight staffing support. “The coolest part,” he says, “is seeing people who have been out on the street now getting housed, at least temporarily, and hearing them be appreciative of that. They’ve been outside so long and they’re not used to being cooped up. Some of them have issues that are triggered by being quarantined, but I’m telling them this is a good thing and they can relax.”

Collaboration can mean the difference between life and death for someone. Michael sums up his report:

Suffice to say that the current pandemic, COVID-19, has made our job much more difficult. However, difficult does not mean impossible. Peter and I will continue to do our best to provides services to those who without our help would have no services at all. This afternoon had a referral from Homeward Bound about a homeless woman in San Anselmo who is living in her car and apparently quite symptomatic.  Peter and I intend to follow up on her Monday morning after we have a meeting about the homeless census count here in Marin. We’re staying busy!

Want to learn more or contact us?

Visit the care team page

Warmline Now in Spanish | Support During Difficult Times

Posted on Category UpdatesTagged , , ,

UPDATED MAY 17, 2020

In an effort to curb the spread of COVID 19, state and local officials have issued a shelter in place order. As a result, many of us are experiencing fear about the future, confusion, and loneliness due to restricted contact with our peers, friends, and loved ones. Even though the Enterprise Recovery Center is closed at this time, we are still available to help.

A new report from the Kaiser Family Foundation reveals that mental health issues are a concern for about 50% of Americans as the COVID-15 health crisis continues. This is particularly true for families and those who have lost income because of the pandemic. For over twenty years, Community Action Marin’s Mental Health program has operated the “Warm Line,” a call in service where trained Peer Support Specialists are available by phone for anyone who feels the need to talk.

The Warm Line is not a counseling service. Instead, people listen, and if callers want feedback, the Peer Support Specialists may make suggestions. All staff are familiar with the services available in Marin County (mental health and other services) so can direct people to places where they can get additional help, whether it is a mental health service, a food bank or affordable child care.

WARM LINE EXTENDED HOURS: ENGLISH SUPPORT

(415) 459-6330

During these stressful times, we recognize the importance of providing extra care, comfort, and support to those with mental health challenges. For this reason, we are extending our peer support Warmline to 9am until midnight, 7 days a week.

Community Action Marin Launches Spanish Language Mental Health Warm Line

(415) 457-4026

On May 4, Community Action Marin launched a Warm Line for Spanish Speakers.  Marin’s Latinx population have been disproportionately economically affected by the restrictions of Shelter in Place as many work in low wage, public-facing jobs that do not offer a “work from home” option. The Warm Line will begin with limited hours; 1PM – 6PM,  7 days a week provided by bilingual staff from Community Action Marin’s Family Partners program.

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