Outside In of Portland, Oregon, was awarded a SAMHSA treatment for the homeless grant on September 30, 2008. The StreetRISE Program of Outside In provides treatment in permanent supportive housing for homeless transition age youth. StreetRISE uses Assertive Community Treatment to provide outreach, substance use and mental health treatment, case management, education and employment supports, life skills training, integrated primary medical care, and access to permanent supportive housing. StreetRISE also screens all youth for co-occurring disorders, providing integrated mental health and medications management services. All youth involved in housing and treatment have a primary care provider at Outside In and receive primary medical care, integrated with mental health and substance use treatment, through Outside In’s Clinic, a Federally Qualified Health Center. Treatment groups and activities are offered by the StreetRISE team seven days a week and are structured to allow for youth in any stage of change to engage in a meaningful way. The StreetRISE team provides flexibility in offering supportive services in the community or wherever the youth feels most comfortable.
Outside In, Portland, Oregon
CHAB asked Heather Brown, M.A. Youth Services Director for StreetRISE to describe her program’s greatest successes. Brown explained it this way, “Our greatest successes are helping youth who are actively using drugs and sleeping outside through the recovery process and into housing. Our successes are best illustrated through youth stories.”
Lisa: For three years Lisa lived in [a park]. She would come in with her pet ferret and her partner to Road Warrior, the late night stationary outreach program that offered dinner, a movie, and health care. She had a family history of substance abuse and a 12-year history of problem drinking, marijuana use, and mental health concerns. She was slow to engage in any of the available resources. Just before she turned 24, she shared with us that she was tired and she wanted to make some changes. She began to work with the peer support staff on the StreetRISE team. Lisa did everything that the StreetRISE team asked. She engaged in healthy daily activities through a community-based performance arts program; she completed a renter’s rights and responsibilities curriculum; she met with the alcohol and drug counselor weekly; and she began working with a case manager on establishing some long-term goals for herself. Lisa moved into her own permanent supportive housing unit four months after identifying she was ready for a change. She continues to participate actively in the community performance arts program and StreetRISE recovery activities while residing in permanent supportive housing.
Youth feedback is gathered by the program’s evaluators, and, according to Brown, summarized one of the things youth liked about the StreetRISE treatment program - it is fun! This is an interesting perspective from young people receiving substance abuse supports and illustrates that StreetRISE has been able to provide innovative, developmentally appropriate treatment to a population that has been historically seen as difficult to engage in treatment.
The StreetRISE project recognizes that while chronologically its participants are considered adults, developmentally they are adolescents and benefit from an approach that recognizes their strengths and needs. The program incorporate principles of Positive Youth Development by focusing on building three core developmental assets: caring relationships, high expectations, and meaningful opportunities to participate. Activities often reflect youth interests and incorporate creative elements. One example was the program’s participation in a Recovery Panes Project that was a collaboration with a local artist who was working with youth to provide, “A project to help those whose lives have been impacted by addiction through the cathartic medium of encaustic (wax &fire) painting.” In addition, StreetRISE is involved in a street soccer program and recently played in a youth vs. staff indoor soccer match. Attending community events such as NBA basketball games and ballet performances are also opportunities for staff to model fun, clean, and sober recreation.
Artwork by StreetRISE participant
StreetRISE also leverages other youth activities and programs offered within Outside In. For example, youth participate in a CHAT pdx project, funded by HHS Office of Minority Health, which involves youth in HIV prevention learning opportunities that engaged youth as Peer Educators. One specific project involved youth as media interns to write, film, and edit HIV prevention shorts films. These films showcased not only safe sex practices but also drug use behaviors.
The StreetRISE team is an impressive team of six. Juliana Scholl LCSW, CADC III has more than six years of experience working with homeless youth and provides supervision, program coordination, and case management. Ian Bruce MS, CADC I is one of the case managers and brings understanding and expertise in working with traumatized youth and mental illness. Katie Kirkman MSW is the second case manager on the team and she has been working with homeless youth for more than 5 years and brings to the team a deep understanding of the issues leading to homelessness and a dedication to serving this population. Brandon Schwanz CADC I is the Alcohol and Other Drug Specialist. He has strong skills in group facilitation and providing treatment to youth from a harm reduction perspective. Erin Swenson BA is the Employment and Education Specialist for the team providing supports to youth in all of their school and employment goals. Jasmine Pettet, Recovery and Transition Guide, has been working with youth to provide outreach, building a recovery culture, and providing substance abuse supports to homeless youth for the past five years. Her ability to build relationships with the most vulnerable youth and assist them in accessing support services is impressive.
Staff and Youth at Outside In
The StreetRISE program continues to advance in the use of technology in providing youth with substance abuse treatment. Every staff on the StreetRISE team was provided a Blackberry. The use of this technology was intended to support the staff to increase communication and effective coordination among their team. Over time, the team found that the technology also significantly increased the quality and quantity of coordination and communication with the youth participants. Text messaging is extremely popular among youth and the StreetRISE staff use text messages to remind youth of appointments, gather information, schedule meetings, and coordinate community resources. There are currently youth that cannot be reached by phone or who are not home when StreetRISE stops by their apartment, but a simple text message will open lines of communication. The program has also begun to use Facebook as source of connection with youth. A private page allows them another way to increase long-term retention, contact for follow-ups, and communication about upcoming program activities. The page also has a private group that allows staff to post the program’s clean and sober activities that are offered, while not allowing those posts to be visible to the youth’s other friends.
There are four key partnerships that have contributed to the success of StreetRISE. De Paul Treatment Centers provides residential treatment for the program’s youth. Janus Youth Program’s outreach team provides on the street outreach and referrals to the program. Central City Concern partnered with StreetRISE to make housing units available to its population in one of their newly renovated buildings and has provided the program an on-site office to assist its residents there. The Regional Research Institute at Portland State University provides the evaluation to implement ACT, measure the program’s fidelity, and accomplish its project goals.