PREVENTING HOMELESSNESS

Through Collaboration

Clinicians Include Families and Reform the Mental Health System (Part 2 of 2)

Mothers, do you remember when your son or daughter seemed suddenly unfamiliar?

For me, it began in the lighting aisle at Home Depot when my son’s friend called, frantic. “He was driving 90 miles an hour. He tried to push me out of the car. I’m sorry. I’m sorry.” Minutes later, my son called. “They left me and took my car.”

That was just the beginning. I didn’t understand why he would stand in front of the TV and laugh for twenty minutes or stay up all night.

Reluctant but still trusting me, my son agreed to go with me to a doctor because, he said, “You have a mental illness.” The psychiatrist evaluated him and prescribed medication. My son said, “No!”

This is where prevention could have begun.

Since my son was unable to recognize his illness, we would have needed leverage, perhaps withholding money or his car keys.

But the most powerful tool to get him to take care of himself would have been something he had some control over: a team that included him and someone he could choose to include.

The team approach exists. Open Dialogue successful in Finland for twenty years[i], now in the U.S., includes a clinician, family, the person in crises and loved ones. The goal is to build connection and trust by being honest with each other. No one is singled out and no one is left out. The team of people work on their lives and share successes. Together.

Prevention isn't just about housing, medication or therapy. Like any other illness, families should be there, to help their loved ones heal and to prevent further illness.

As Michael J Fox says, “Family is not just an important thing, it is everything.”

The value of being together, the stability of family, is recognized and made stronger. In our case, we would have included my sister, with a special connection with my son. She could have been helped because no one is without stress; all benefit from support in making our lives better.

Some clinicians already embrace this. Others may feel it is disruptive and cite families that cannot be mended. That is tragic. But they are the exception, not the majority.

Mental illness lags behind other major diseases in research and solutions. The way families are treated and blamed, is outdated too. We do not jail people with heart disease. Hospital staff do not tell families of someone with cancer, “HIPAA says we can’t confirm or deny they are here.” Yet we do that with mental illness.

Disheartened, and feeling blamed by families, clinicians are leaving the profession. Only 42% said they would stay in their practice for the next five years.[vi]

Homelessness rose in 2024 by 18%. 50 percent of the homeless are there due to mental illness.

It doesn’t have to be this way. There are organizations that are proving what is possible:

· Miracle Messages[ii] has reunited over 1000 people living without housing, with family.

· NAMI’s Family-to-Family program reduces caregiver stress.[iii] This helps with better treatment outcomes.

· Dr. Xavier Amador’s LEAP model helps families rebuild trust even when their loved one lacks insight into their illness (anosognosia).[iv]

What about our loved ones who have been ill a long time, estranged or homeless?

We start where we are. Right now.

What is possible and what does it take?

Collaboration between families and clinicians. It may not be easy, but easier than the hell and heartache of discouraged families, clinicians and our loved ones’ estrangement, relapses and homelessness.

Families offer history and insight to clinicians. Families notice mood changes and medication compliance.

Families advocate for clinicians to have more time, smaller caseloads, and training in the value of family. “When families take an active part in treatment decisions, consumer outcomes are better[v]

Clinicians realize successes and families heal. Mental illness affects everyone. Who can deny that the health of the family depends on the health of its members?

Communication is a skill we can learn. We see signs in medical offices: “Are you safe at home?” What if they offered assistance when people say yes to, “Do you need help connecting with your family?”

Clinicians can reunite families telling clients, “Your family is here for you.” One psychiatrist told me, “I always say, ‘I need to speak with your family to give you the best care. I won’t share anything you don’t want me to.’ They always say yes.”

If we had started with a team, my son wouldn’t have had to find one in the streets.

Our story has a happy ending. A clinician did reach out to us. My son returned after ten years on the street. We did form a team. He is not just doing well, my son is thriving.

One less person lost to homelessness, one more whole family in recovery. Lifelong appreciation for the clinician.

When families and clinicians bring their unique skills, shared compassion and have the courage to work as one, recovery happens for families' loved ones, clinicians' clients, and our communities’ mental health care.

Thank you for reading.

Training is being created for clinicians and family to work together. Information is available.

You are strong, you are amazing

Together we can recover

One out of five people live with mental illness

The other four are family

The five of us are the team

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[i] https://pmc.ncbi.nlm.nih.gov/articles/PMC8844585/

[ii] https://www.miraclemessages.org/

[iii] https://www.nami.org/wp-content/uploads/2023/11/Dixon-Lucksted_F2F_2011.pdf?utm_

[iv] https://leapinstitute.org/leap-training-course-information/?utm_

[v] Family Involvement in Treatment. (n.d.). NAMI California. https://namica.org/family-involvement-intreatment/

[vi]https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-025-12698-6?utm