After worsening mental health confined her to a county mental hospital and cost Jodi Monahan her job at KTVU Channel 2 News in Oakland, she spent nine months staying in various hotels, living in her car in state parks, and sleeping on peoples' couches as she battled drug addiction. But then Monahan called the nonprofit mental health agency Bonita House in Oakland, and found the Homeless Outreach Stabilization Team (HOST). "I knew I needed to make a change," she recalled in a recent interview. "Desperation kind of breeds sanity: When you wake up in your car in a park, you realize you need help."
Thanks to seven years as a "partner" in the HOST program, Monahan has turned her life around. HOST helped her find an apartment; provided her with a position at its employment center; and helped her receive the right rehab treatment and medication for her drug use and mental illness. HOST also helped her regain custody of her now sixteen-year-old daughter
"HOST is an amazing program," said Monahan. "There's really nothing else like it."
To date, HOST has served about 140 people in its seven years of operation, and a recent report shows that it cut their rates of hospitalization and incarceration, and their time spent on the street.
HOST is funded by the California Mental Health Services Act, which became effective in 2007 as part of an effort by the state to create so-called Full Service Partnerships (FSPs), which are designed to provide mental health treatment to populations previously unable to access it.
During an evaluation of funding for these partnerships in September, HOST reported that among 138 people in their first year of enrollment at Bonita House from 2007 to 2014, there was a 92.1 percent decrease in nights spent homeless, a 79.6 percent decrease in psychiatric hospital admissions, and a 74.5 percent decrease in the number of new incarcerations.
HOST's unique approach begins with its involvement with clients, whom it refers to as "partners." Staffers go out to the streets to find people whose needs qualify them for the program. "We were designed to do classic street outreach," explained director Mark Shotwell. "When we began, a lot of it was under freeways and out in parks and in the woods where people were camped up."
When HOST staffers find a person who agrees to be in the program, they set him or her up with housing that night, using housing subsidies to pay for a room in a hotel until the staffers can find the person a semi-permanent apartment. After securing housing, the staffers then ask the partner about his or her personal goals, whether he or she will be getting a job, going back to school, or focusing on health problems. "We work on a recovery plan," said Monahan. "They put your feet to the fire in terms of being part of the process."
HOST also acts as a hub for all of a partner's care, thereby making resources feel more accessible for a population that isn't used to doctor visits and making appointments. "The programs are designed to have all the services and practitioners that need to be in somebody's life wrapped into the program," said Shotwell. This differs from other case management programs that refer clients to a variety of outside services.
HOST staffers can also monitor the partner in between appointments, which improves efficacy, Shotwell said. "You know, 'Do you do what the doctor said?' Oftentimes we can report more accurately on what's happening. Did this person eat right? Did they take their medications?"
Before serious progress can be made toward rebuilding a person's life, however, HOST staffers use social outings to develop a relationship with partners and gain their trust. "We've done everything under the sun," said Shotwell, recalling taking clients to the beach, to the park, to the movies, and out for meals.
"There may be more important things in our eyes that we could be doing with the partners [in the beginning], but what we do has to be important to them, too," Shotwell explained. "Sometimes, food is the beginning. It's amazing how many people, if you take them out for a burger, are willing to sit down and talk with us." Shotwell described partners opening up over a meal in what he considers therapeutic conversation. "In the partner's eyes, he's getting a burger. And that's fine with me," Shotwell said. "It's a great place to start a conversation."
Shotwell believes HOST's multifocused approach is the key to its success. He said that while affordable housing through housing subsidies is a crucial component in helping partners work toward independence, "if somebody can pursue education, can pursue employment, can get into work — if they're capable of doing that, even if it's working ten to fifteen hours a week and increasing their available funds — it really increases lots of choices."
"Homeless people are not much different than anyone else in the world," said Monahan. "They just have their own particular set of struggles.
"People come in here very raw," she continued. "They look like people you might see on the street. Then you see them a year later and you wouldn't be able to distinguish them from any other worker or resident in Oakland."
Monahan said HOST is "sort of like a university for people who are formally homeless. It's like a university of life." She related how Host staffers helped her regain custody of her daughter. She said she was previously married to a destructive partner and was able to get herself out of that situation but didn't have the means to bring her daughter with her. HOST provided someone to monitor Monahan's visitations with her daughter — a type of service provider that she couldn't find on her own — and helped her in court to achieve custody.
Now Monahan's daughter lives with Monahan's sister in upstate New York. "She wrote this beautiful thing called 'A Tribute to My Mother,'" said Monahan. "She's appreciative that I sent her to live with my sister."
Monahan said she now has a new boyfriend. "I have a lot of friends. I talk to my daughter every day: I'm doing very well. I've been drug-free for more than a year. My mental health is good, I found a 'magic recipe' with my medication."
Monahan is still a partner in HOST and is looking for work outside of the program with her employment coach. She wants to be a teacher and possibly go back to school to study social work so she can work with homeless people and give back what was given to her.
It's a measure of success when partners graduate from the program, Shotwell said. "When someone moves on and they go get that job and get that [private] insurance, and they're removed from the public system, then we know we really finished the job."