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Come inside: Homeless outreach workers gently encourage mentally ill clients to get help

Kristen Felegy and Dave Katzenmeyer
MinnPost photo by Andy Steiner
Kristen Felegy and Dave Katzenmeyer following a path toward an encampment.

Dave Katzenmeyer, People Incorporated's homeless outreach program supervisor, wanted to talk to Nick, one of his clients. So he parked his car on Phalen Boulevard, walked a couple of blocks and then followed a worn path into the woods. Lately, Nick had been living in a tent he’d pitched under a bridge, so Katzenmeyer, an amicable, bearded man wearing shorts, hiking boots and a ripped flannel shirt, headed that way.

It’s part of Katzenmeyer’s job to make inroads with folks like Nick, people with significant mental illness who don’t have permanent homes and choose to avoid the shelter system, spending their nights on the streets, on Metro Transit, or in improvised camps hidden away in plain sight, just steps away from everyday life. He spends about 10 hours each week meeting potential clients at camps like Nick’s, and still more time in other places homeless people tend to congregate, including the Maplewood, Rosedale and downtown St. Paul libraries.

To get to Nick’s tent, Katzenmeyer followed a narrow, wooded pathway down a hill. It was a cool June morning, a little before 10 a.m., and the sun was shining through the trees, casting dappled shadows. Nick’s camp had three tents set up near a long-dead cooking fire. Outside the tents stood lines of shoes, folding chairs and a baby stroller.

Katzenmeyer walked directly to Nick’s tent, and called out, gently, “Hey, Nick. It’s Dave from People Incorporated. How are you doing?”

Nick appeared to be just waking up, but he recognized Katzenmeyer’s voice, and greeted him in a friendly manner. He smiled, but stayed zipped up in his tent, shirtless, speaking through the mesh opening. His friend Jean had spent the night, and she was also just waking up, still bundled in her sleeping bag.

Katzenmeyer approached the tent’s opening, leaned down and began speaking. “I brought you some blankets,” he said, pulling two out of a bag. He also handed over two bottles of water, some nonperishable food, and something people like Nick and Jean find invaluable: two pairs of clean, dry socks — a lifesaver for anyone who lives out in the elements.

Building bridges

Handing out essential supplies is one way Katzenmeyer tries to connect with people like Nick. It’s his goal to slowly introduce them to services designed to help them make the transition from sleeping outside to eventually finding mental health care, addiction treatment and supportive housing.

Outreach workers must tread carefully in these interactions, said Jill Wiedemann-West, People Incorporated’s chief executive officer. 

“With some of these people it can take years to build a basic level of trust,” she explained. “After many interactions with outreach workers, some are finally able to come in to our drop-in center to wash their clothes or get a cup of coffee. That’s a first step, and that helps. But to get them to sign up for case management, to allow us to help them get the services they need, a lot of trust has to be developed — and that can take a long time.”

Dave Katzenmeyer talking to Nick through his tent flap.
MinnPost photo by Andy Steiner
Dave Katzenmeyer talking to Nick through his tent flap.

Matt Horn, People Incorporated's homeless outreach program manager, said that outreach workers like Katzenmeyer work patiently and persistently to build a relationship with the people they meet on their walks.

“It varies person by person,” Horn said. “One thing we do is provide basic supplies for engagement purposes, things like socks, water bottles, hygiene supplies, to help meet a basic need. Doing that helps because you can provide something tangible. My experience is if people are by themselves they might be hesitant if a person just comes into their space. But if you keep offering something with persistence and you are nonjudgmental and open, people are generally interested in signing up for services. It takes an average of three to six months of engagement to get just get most people to enroll in case management.”

All this effort is worth it, Wiedemann-West said. People Incorporated’s homeless outreach program not only helps people like Nick live safer, healthier lives, it also helps local governments save nearly $725,000 a year by reducing shelter use, arrests, incarcerations and hospitalizations.

“Case management is a benefit to everyone,” she said. “We just have to get people to feel good about signing up.” 

Co-occurring conditions

Living without a home is rough — and especially hard on people with mental illness, Wiedemann-West said. A majority of the homeless adults in the state — as many as 60 percent, according to “Homeless in Minnesota,” a 2015 study conducted by Wilder Research, report struggling with a significant mental illness.

While some people like Nick feel distrustful of institutions and resist the urge to sign up for any kind of help, their off-the-grid lives can be extraordinary difficult. 

“Think about how anxious you might feel if you were forced out of your normal routine,” Wiedeman-West said. “Then imagine an individual who has been living outside in all kinds of conditions, enduring the hostility that comes from other folks trying to take their things or maybe being aggressive or dysregulated. It’s an incredibly stressful life.”

As Katzenmeyer passed out his supplies, Nick started to talk. He said he’d been having a hard time sleeping, having bad dreams and struggling with people who want to “ransack” his tent. He listed the medications he takes for depression, stress and anxiety, and told Katzenmeyer he’d lost his state ID card.

An ID card is key to getting even the most basic of services. As Katzenmeyer explained the process of obtaining a new one, Nick, who’d been thankful and kind for everything he’d done, had one more request: “I need candles,” he said, abruptly changing the subject. “It gets dark down here. Could you bring me some the next time you come?” 

On a nearby track, a train moved by, slowly and noisily.

Kazenmeyer kept following the path in the woods until he met Cleveland, a slight, nervous man who’d been sleeping in a structure made of wood scraps, sleeping bags, and corrugated metal. When Katzenmeyer walked up to the tent and explained who he was, Cleveland stepped out into the sunshine. He was barefoot and wearing only underwear. He told Katzenmeyer that his phone had run out of charge and he asked if he knew where he could find a spare outlet.

While this would have been the perfect opportunity for Katzenmeyer to tell Cleveland that he could charge his phone at People Incorporated’s walk-in center, to lure him to a place where he could sign up for services, instead he tried to gently explain what he does and the services he can offer. Cleveland didn’t seem interested. Not yet anyhow.

“Folks who are sleeping outside meet the definition of long-term homelessness,” Katzenmeyer said. “That’s who we can work with on case management. Our goal is to normalize that interaction and slowly bridge them into People Incorporated’s services.”

It works best to take a subtle approach, Katzenmeyer added. “I don’t always want to dump this on them all at once. It can feel overwhelming.”

Come inside

The rest of the morning continued in a similar fashion, with Katzenmeyer walking worn paths to different camps. In two hours, he talked with 10 or 15 people who were living outside, in hidden communities near doctors’ offices, union halls, the state Capitol. Some of the people he spoke with that morning had been living outside for days or weeks or months; others were new to the camps, forced to live here because they’ve been evicted or because their drug addiction made it hard for them to find a safe and stable place to live.

As he had with Nick, Katzenmeyer had already begun to build a relationship with some of the other people he met, and he felt hopeful that his regular, reliable presence would encourage them to take the next step, to come inside, if not for regular shelter, at least to People Incorporated’s drop-in center on York Avenue, where they can do a load of laundry, pick up some free clothes, play a game of pool, try out tai chi or massage, or attend a recovery or smoking cessation group. Somewhere along the line, they may also meet a caseworker and get signed up for services.

Dave Katzenmeyer approaching Cleveland's tent.
MinnPost photo by Andy Steiner
Dave Katzenmeyer approaching Cleveland's tent.

The long process of building bridges with people like Nick and Cleveland can feel frustrating, but Katzenmeyer said he’s seen plenty of people successfully transition from life on the street to a safe, permanent homes.

“My experience with the individuals we engage is once they enroll in our program we are able to help them access basic things like identification and medical insurance,” he said. Once that bridge is crossed, life starts to take a positive turn: “The majority of people we work with eventually start getting medical help and eventually move into housing.”

‘Training wheels’

Later that morning, at People Incorporated’s clean, bustling drop-in center, a group of people played pool. Others gathered around a conference room table, drinking coffee and chatting. A cell phone charged in an outlet. 

One or two people appeared to be speaking with case managers.

Horn led a brief tour of the facility, pausing at a calendar that lists a full schedule of activities and classes available for clients. There was at least one activity every day.

“We support people who are really vulnerable,” Horn said. “I like to call outreach ‘case management training wheels.’ ” Like training wheels on a bicycle, he explained, building a relationship with an outreach worker can help a shaky person begin see the stabilizing benefits of accepting help: “Case management eventually helps people start getting used to having appointments regularly, showing up routinely, checking their email, helping them get insurance for the first time. These are important steps. Once they sign up for case management, about 80 percent of the people that we work with have made progress and achieved one of their goals within six months.”

Maybe because he’s seen how his outreach has helped many people move from desperate situations to more settled, healthy lives, Katzenmeyer said he does not often experience compassion fatigue in his work.  

“Over time, I see how I am helping people make progress,” he said. “When people enter case management with us, we can be successful in helping them meet their needs.” Sounds simple, but getting there is a long, delicate process.  

The signs of that progress could be subtle, Katzenmeyer added, but they are there, if you listen carefully enough. Take Nick, for example, who said, softly, as Katzenmeyer got ready to move on to the next tent: “Hopefully things will get better.”  

It’s not much, but it’s progress. And maybe it’s a good sign. 

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Comments (1)

Great Article -- with heart and realism, and humanistic

As one who served the Hennepin County Adult Mental Health Advisory Council from 2012 to 2015, I found this article very refreshing. People with mental health issues come in a variety of packages. Some of us are from well educated and wealthy families -- who at times declare their noticeable eccentricities - to those from any imaginable family who are living in extremely poor conditions of either homelessness, or poor care for their hygiene or household.

Both World War II era British Prime Minister Sir Winston Churchill, MBE, and U.S. President Abraham Lincoln were known to have the same depressive background that I experienced. Both are thought of as among the greatest political and social leaders in all of human history. And, while autism is niched in the field of developmental disability, people often comment that both Albert Einstein, and billionaire businessman, cultural, and philanthropic leader Bill Gates appear to have (had) a high functioning form of autism -- although a Google or Bing search will arrive at a link that quietly and purposefully states that Gates' medical records remain private, and that Gates has not publicly acknowledged experiencing or being diagnosed with autism spectrum.
condition.

Please know that films and "news" reports done by people like former WCCO broadcaster Randye Kay, last known to work at CNN, where she wrote and produced a gory story about people with mental illnesses, do great harm to the opportunities and reputations and futures of people with these minority-population outcomes. Conquering their impediments upon our psyches and productivity, and civility, is possible -- as shown especially by the young Churchill in 1917 when he lost a naval command and created a 'scandal' -- but by the 1930's and 40's, his capacity as a great leader emerged despite occasionally being bothered by his "black dogs," .as that slang had been in use regarding brain illnesses for many years.

If you, as an employer, learn of a prospective employee's bout with either of the conditions mentioned (or others listed and named in the APA's Diagnostic Statistical Manual - V (DSM-V), please consider that they may, in fact, have conquered their condition, and are ready to work. A franchisee of a former corporate employer of mine recently told me to never call the store again, and after talks with the corporation, no one from the franchise, which otherwise has a fun culture and makes delicious food, has contacted me. Their district manager has for over one week refused contact with me -- despite the former MN corporate HR official telling me that I am a great employee and to come back to work any time (after I left during the 2008 recession began, following weeks of low volume and no need for more than two or three employees who were excellent pizza makers). I have been a good customer of the store where I applied, for a third tour of duty, for 24 years. The new general manager was incredibly rude to me. His behavior was immature, unprofessional, not in keeping with generally high reputation of the Company, its brand name, and advertising.

I am an honors graduate of De La Salle College Preparatory High School, an alumnus of Macalester College, having served as a campus ambassador for our admissions department; and having put together much of our 10th and 15th year reunion. Former Macalester College President John B.Davis, Jr., and I were great friends for 31 years from the early days of my years at "Mac" until his death at age 89 years on July 5th, 2011.

Many of you may know of Dr. Davis from his time as Superintendent of Minneapolis Public Schools, and busing in the 1970's, and former chairman of the Minneapolis Federal Reserve Bank, President of Mankato State University, and Ordway Theater champion of development -- and interim director of the Minneapolis Children's Theater following sex abuse and guilty findings against the previous director. With men and women of his character and excellence also having come to my moral and ethical, and political and professional attention, overcoming my hardships was easier. John was a thoughtful and courageous man of conscience. That said, one of the top bankers in Minneapolis sat behind us at our last breakfast together and made a snide rhetorical question, "So John, are you still doing good for everyone?" John, who normally was a man of candor and and magnanimity, actually slumped into his chair, and later told me that those two men were two of the most prominent bankers in Minneapolis. I had an earlier naive approval of bankers, apart from one bank which Warren Buffett is now the top shareholder -- and may he bring ethical conduct and professionalism to that National Association's top leadership.

Getting back to the material that Andy Steiner worked with for her article: She did a grand job at presenting these often poorly regarded folks in a humanistic, objective, and professionally advanced format and style.

Barry N. Peterson
Current Community Healthcare Worker Student at Summit Academy OIC
University of Minnesota College of Liberal Arts B.A., History, 1996
Macalester College Friend and Alumnus, Class of 1984, without graduation
De La Salle College Preparatory High School, Class of 1980, with Honors
DFL Minnesota Senate Districts 59 and 60 Central Committee and Board Member (2010-2017)