A Fort Smith homeless shelter, among a few in the nation with a fully staffed on-site mental health clinic, is seeking a state license and has received a grant to expand its treatment program.
The Riverview Hope Campus was awarded a donation from BancorpSouth earlier this month that will allow the clinic to expand mental health services to include therapeutic art group therapy.
The clinic is applying for a state license to allow Medicaid and Medicare billing for mental health services, said Jennifer Oliver, program director at the Hope Campus.
"At the end of the day, independent living is their goal," Oliver said of the program's patients. "We meet them where they're at when they walk in our doors, and we teach them skills to manage their mental health and function in society."
The mental health program -- called Hope Cares -- began offering services last year but is in the "final leg" of getting all certifications. The national Joint Commission on Accreditation of Healthcare Organizations has already given its stamp of approval, Oliver said.
The clinic's staff of five treats an average of 29 patients per day. The clinic is funded through donations and grants, Oliver added.
Nationwide, shelters use a variety of methods to provide mental health resources to people experiencing homelessness. These can include staff training in recognizing symptoms of mental illness and establishing a dedicated mental health clinic on-site, said Cindy Manginelli, community engagement manager at the Nashville, Tenn.-based National Health Care for the Homeless Council.
An on-site clinic such as the one at the Hope Campus is rare, Manginelli said. It's more common for shelters to partner with local clinics and either transport patients there or allow clinicians to visit the shelter at designated times.
The Fort Smith campus aims to be a "one-stop shop" for people experiencing homelessness, Oliver said. It offers meals, showers, laundry, case management and skills classes. The campus also has offices for community partners that provide housing, food assistance and other services.
Riverview opened in 2017 with grants from the federal government, the city of Fort Smith and the Mabee Foundation. It can house up to 150 people per night.
"I think for a lot of communities, that's the ideal," Manginelli said of the one-stop shop model. "When you think about working with populations where transportation is a significant issue, that is really ideal."
Up to a quarter of people experiencing homelessness may have severe mental illness, studies from groups such as Harvard University and the National Institute of Mental Health have suggested. Homelessness also has been known to exacerbate mental illness symptoms.
Homelessness itself can be a trauma that needs treatment, said Amanda Siddons, a social worker at Hope Cares.
She added that she works closely with case managers, with a goal of helping clients get housed and learn to cope and improve their mental health.
"We work really hard to get to the root cause of what is causing their homelessness," Siddons said.
Dr. Donala Jordan, the program's clinical director, said he's still working on programming that fits the needs of the population experiencing homelessness.
Particular challenges arise when clinicians aren't sure whether a patient will return for the next session. Therapists work on communication skills and crisis situations, among other coping skills. Some people are good candidates for therapeutic approaches that require up to 12 sessions, Jordan said.
"The context of it being an emergency shelter is ever-present, and that brings some unique challenges," he added.
Whether clients will return to continue therapy has long been an issue when providing mental health services to the homeless, Manginelli said.
"It's one thing to say, 'What are you struggling with right now?' as opposed to 'Let's really delve into things in your past,' if you don't know if they're coming back," she said.
The campus's mental health treatment program focuses on five components of wellness: emotional, social, physical, intellectual and spiritual, Jordan said.
In the future, administrators hope to add a substance abuse treatment program, he added.
If patients find housing while they are undergoing treatment at Hope Cares, they'll be able to continue treatment, Jordan added.
He thinks treating patients who are in transitional housing, a program meant to help people move from homelessness into permanent housing, could be one of the most helpful offerings in the future.
The Hope Campus plans to expand its operation to include transitional housing. The move can be stressful for people who have experienced homelessness, especially for long periods of time.
"When they're placed in housing and it's just them and they're alone, it can be very isolating," Jordan said.
Jordan plans to evaluate outcomes for clients over the next few months and continue to shape the program around their needs.