Meeting Patients’ Needs with Supportive Housing and Mental Health Care
St. Joseph Hospital’s Emergency Care Center (ECC) in Orange County is a resource for people with severe mental health challenges and unstable housing. Historically, caregivers at the ECC were able to treat the immediate medical needs of people experiencing homelessness who sought care at the facility, but they were not equipped to provide the kind of ongoing support these patients needed to address their challenging circumstances Caregivers were heartbroken when patients left the ECC to go back out to the community. “It was just a Band-Aid,” says Jeannine Loucks, a psychiatric nurse and manager of the emergency clinical decision unit at Providence St. Joseph Hospital in Orange. “We would get them stable, discharge them and they would have nowhere to go.”
When the ECC saw an uptick in homeless patients who were experiencing mental health crises, Loucks and her colleagues knew they had to do more. A small team created a dedicated psychiatric program in 2017 specifically for ECC visitors who lacked stable housing.
Loucks went a step further and reached out to her senior leadership and community colleagues who served on nonprofit boards or worked in supportive housing. Together, they developed a plan to connect ECC patients directly to safe, stable housing. With a $400,000 seed grant from St. Joseph Community Health and a partnership with a local housing provider, Jamboree, the team renovated an old board and care home. The new collaborative project opened its doors to residents in June 2017.
Since its opening, the collaboratively managed SJO-Jamboree home has housed 38 residents for varying lengths of stay. Jamboree uses the supportive housing model which provides residents with wraparound services such as medication support, appointment scheduling, crisis counseling, clothing and referrals to other social services. Residents have weekly check-ins with Providence St. Joseph behavioral health nursing staff who help residents build a pattern of consistent health care.
Most residents stay at the house until they find more permanent housing, for an average stay of about four months, and then “graduate” from the program. Of the 30 residents who have graduated since 2017, five have committed to being alumni mentors for current and new residents. Being a mentor means serving as a stable figure in the residents’ lives, helping coordinate social services and lending an ear when they need a friend.
The COVID-19 pandemic in 2020 presented new challenges for the hospital, Jamboree staff and residents. It took additional time to find and secure permanent housing, so residents stayed longer than usual. Fewer people visited the emergency room – even if they needed care – out of fear of contracting the virus. This created barriers for reaching potential residents who would qualify for Jamboree’s services. Despite these outreach challenges, eight new residents came through the house in 2020.
Services and social gatherings had to be altered to keep everyone safe during the pandemic, but staff and partners found creative solutions to ensure residents felt connected during a time of isolation. A St. Joseph nurse partnered with local church leaders to organize a donation drive for toiletry items and clothing. The psychiatric nurse who visits the house weekly reached out to a local sock company that, in turn, made a large donation of socks for residents to stay warm. During the holiday season a team of four Providence caregivers organized a physically distanced Christmas tree lighting event complete with beautifully wrapped gifts, decorations and holiday merriment.
In addition to these successful adjustments, Loucks says one of the most impressive outcomes of 2020 is the opening of Jamboree’s brand-new facility in Santa Ana, dedicated to housing military. The project, named Heroes Landing, includes 75 fully furnished and ADA-accessible units, a communal garden and kitchen, and an on-site service center for veterans. “To see this facility finished and open to residents was truly special. These veterans deserve a beautiful, safe and supportive place to live,” says Loucks.