A community mental health needs and resources assessment was conducted for the purpose of becoming familiar with the overall mental health needs in the Miami-Dade County community. The most pressing local mental health needs were assessed along with a focus on the major identified issues involving the homeless population. An evaluation of services offered by public and private organizations is also presented.
Introduction of Miami-Dade Community
Miami-Dade is a large county located in South Florida with a population of 2,761,581 (Miami-Dade County, 2021). There are 2,154,913 registered vehicles, indicating a heavy dependence on cars throughout the County. Average annual temperature is 76 degrees with a 70% chance of annual sunshine. Its population has a majority 53.7% of foreign-born residents, indicating that the majority of the population is actually normally considered minority in the rest of the country (United States Census Bureau, n.d.). The median age is 39.9, with 5.9% under 5 years old, 79.5% 18 years and older, and 16.0% 65 years and older. 68.5% of the population identifies as Hispanic or Latino, while according to race, 75.1% identify as white alone and 17.4% as Black or African American alone. The median housing value in Miami-Dade County is $289,600 while median gross rent is $1,328. Median household income is $51,347. It is determined that 23.0% of children under 18 are in poverty in this county, however the overall poverty rate is 17.1%. The disabled population is 10.1% with the majority having ambulatory, independent living, and cognitive difficulties.
Local Needs Assessment
In order to make connections between the County, faith-based organizations, and other community groups, Engage305 was developed (Engage305, 2014). Through this platform the county offers several services, including counseling to several populations. Counseling services are offered to people with disabilities, homeless or at-risk of homelessness, substance abuse addiction, co-occurring psychiatric disorders, refugees, veterans, and victims of domestic, elder, and child abuse, and women.
A health assessment completed by the Florida Department of Health in 2019 identified six vulnerable populations. These include civilian non-institutionalized with a disability, persons 18-64 with independent living difficulty, persons with hearing or visions difficulty, seriously emotionally disturbed children, and seriously mentally ill adults (Florida Department of Health, 2019). Additionally, it was determined the area in Miami-Dade County with the most socioeconomic need was the Downtown/East Little Havana/Liberty City/Little Haiti/Overtown community with a 98.27 index on a scale of 1-100. Socioeconomic need was determined based on many social and economic factors, including poverty and education, and it was found to have a correlation with lack of access to health care and preventable hospitalizations. This same community was also found to have the lowest median household income at $25,774.73, which is almost half of the median household income for Miami-Dade County. In conclusion, it was found that mental and behavioral health, along with the opioid epidemic were the main areas in need of attention in the community. Adding to the problem is the lack of coordination to collaborate among healthcare providers (Florida Department of Health, 2019).
Identification of a Specific Population or Issue
In considering the difference between the median income and cost of housing in Miami-Dade, it is imperative to determine what additional factors could be leading to a loss of secure housing. The leading cause of homelessness is living in poverty (Florida Department of Health, 2019). This could be due to loss of employment or income too low to provide for housing. Almost one million households in Florida pay more that 50% of their wages in housing payments. Simply, many occupations in Florida do not provide enough income to buy a home or rent an apartment. According to Davis from Miami Homeless (2019), other risk factors for homelessness include unemployment, a personal or familial crisis, and being an LGBT+ youth.
The third highest state in the nation with people living either in shelters or in the street is Florida (Florida Department of Health, 2019). This population is at a higher risk of dying early, experience violence, and being sexually assaulted (TheMNetwork, 2018). The Homeless trust, a government organization responsible for the homeless population in Miami-Dade County, found that more than half of the population is comprised of black persons (Florida Department of Health, 2019). This is large overrepresentation when compared to Miami-Dade County’s general population (Florida Department of Health, 2019).
The homeless population in downtown Miami endures living on the streets with a lack of public restrooms available (Robertson, 2019). The Homeless Trust has repeatedly refused to spend the money it receives to build public restrooms due to its philosophy of how to end homelessness. They essentially discourage anything that could be perceived to aid any homeless person on the street due to the belief that it would encourage them to stay on the street rather than going to a shelter. Due to this philosophy, many in the homeless population must use the restroom at the base of trees and on the sidewalks of downtown Miami.
Additionally, among the single homeless population, around 22% have a serious mental disorder (Camillus House, n.d.). Mental illness makes it substantially more difficult to complete the necessary steps to enter into a housing program since housing requires registration. For those that may have an addiction problem the situation is perpetuated, as it would become increasingly difficult to obtain and maintain housing. Camillus House (n.d.) states that the majority of people, 83%, experience transitional homelessness. While about 17% experience perpetual homelessness.
Local Resources Assessment
Many organizations in Miami-Dade are developed to assist the homeless population. These organizations address the specific needs the homeless population has in the community in similar ways.
Miami-Dade County Homeless Trust
Leading the charge in the care of the homeless community, the Homeless Trust is Miami-Dade County’s main organization (Homeless Trust, 2021). A 1% Food and Beverage Tax is allotted to the Homeless Trust for the purposes of assisting those in danger of becoming homeless or are already homeless. This tax is unique in the United States, with it being the first time tax funding was allotted to helping the homeless.
The main emphasis of the organization is ending homelessness by acting in accordance to the Homeless Emergency Assistance and Rapid Transition to Housing (“HEARTH”) Act and is considered to be the enforcer for Continuum of Care (“CoC”) for Miami-Dade County (Miami Dade County Homeless Trust, n.d.). It distributes funding to selected non-profit and government organizations, develops policies, advises the County Commissioners on homelessness issues, and implements the framework for ending homelessness in Miami-Dade County (Homeless Trust, 2021).
Camillus House
Camillus House is a faith-based organization that works closely with the county to provide many services and housing to the homeless population (Camillus House, n.d.b). Main services include direct care ministry, general assistance, mail and telephone services, ID cards, shower and clothing exchange, and food services.
Direct care ministry provides basic needs, such as beds and showers, in the hopes that they will be interested in other programs offered. Access is provided for public restrooms and water fountains. The mail service allows the homeless to use the address at Camillus house as a mailing address. Telephone services are available for local calls. ID cards provide identification, and in collaboration with the city, special ID cards are offered to those with mental illnesses. With this card, if anything ever happens, the police know that they are registered with Camillus House and have access to their services, as well as give them the knowledge to take the person to a mental health facility instead of jail. Assistance for those who need access to other basic forms of ID to ensure employment and housing is also provided.
A meal is provided every day during the week for those registered and bagged lunches are provided for those who demonstrate an immediate need and cannot attend the afternoon feeding. Camillus house also works with other non-profit organizations that may be able to receive some of the surplus food. Through the Career Help Program, they offer an educational program partnering with Miami Dade Public Schools which leads to a GED. Vocational training with needed certifications, mentoring, and experience in warehouse operations, housekeeping and general maintenance, and food services is also provided. Job development teaches skills necessary to obtain and keep a job.
Miami Rescue Mission
The Miami Rescue Mission is a faith-based organization that provides many services dedicated to ending homelessness (Miami Rescue Mission, 2021). With an emphasis on compassion, hope, restoration, and transformation, the Miami Rescue Mission developed The Caring Place. At The Caring Place, homeless can receive shelter, training, education, healthcare, housing, employment, and programs for youth. Many programs cater to the needs of women, men, and children separately with an emphasis on strengths of the individuals.
The Salvation Army
The Salvation Army is a faith-based organization that also provides shelter, food, and support to adults and children (The Salvation Army, 2018). The Red Shield Lodge offers emergency housing with the intent to find a more permanent living situation within three months with the help offered by staff. Meetings to educate about HIV, Narcotics and Alcoholics Anonymous are also available.
The Pathway of Hope programs comes alongside families with children to help the family overcome obstacles related to poverty, such as unemployment and missed education opportunities. Its focus is on helping families regain hope and thereby enhance the spiritual outcome while helping them become self-sufficient. Ideally, the program organizes all the community resources to best help the individual families.
Medical resources are provided through a collaboration with Camillus Health Concern and Health Foundation of South Florida. It provides prevention services that have shown to cause savings by lowering the amount of emergency calls made.
Operation Sacred Trust
Operation Sacred Trust was developed to help low-income and homeless veterans with housing solutions, care management, employment and entrepreneur services, peer mentorship, educational programs, legal services, benefit assistance, and healthcare support (Operation Sacred Trust, 2020). They provide fast rehousing through a partnership with Purpose Built Families Foundation. Transportation and counseling service are also offered. Financial assistance is available on a limited basis.
The program Rent23Veterans identifies the gap between vacant homes and homeless veterans. It encourages those who are able to rent a home to a veteran to contact them and serve the community is this way.
Lotus House
Lotus House is a women and children’s shelter in the heart of downtown of Miami-Dade County (Lotus House, 2021). They employ a trauma-informed, strengths-based design (A culture of care, n.d.). This creates an emphasis on developing a culture in the shelter of community and worth. While in this transitionary process, the women who enter this shelter are also provided with parenting education and mental health care. Adding to the culture of the shelter is the emphasis on activities such as art, acupuncture, and meditation. They provide holistic services in the shelter with the goal of “graduating” women and children to their own stable housing.
Chapman Partnership
Chapman Partnership is a private organization directly tied to the Homeless Trust (Chapman Partnership, n.d.). It has two centers, one being located in Miami-Dade. Case managers are assigned to the residents and a personal plan is put in place to guide their next steps. In the shelters there are clinics, dorms for families, classrooms, day-care, basketball courts, and dog kennels.
The Family Resource Center provides children services, ensuring they are transported to and from school and are provided with the necessary supplies. It includes a Young Adult Career Academy and a Parent Institute. The programs are designed to attend to the family’s physical, educational, and social-emotional needs.
Housing is available for over 800 men, women, and children. Within the average length of stay, residents are able to discover many government programs they may not have been aware of. A youth dorm houses 20 males and there are plans for expansion due to the increasing number of young adults experiencing homelessness.
Workforce development includes two programs designed for all ages, the Social Enterprise Academy and Workforce Trades Program. Starting at the age of 5, the Social Enterprise Academy teaches the children about finances and spending habits. School-aged children learn about new technology and young adults learn job skills. The Workforce Training Program offers a certificate in construction/carpentry and is looking towards entrepreneurship training in the future.
The Agape Network
The Agape Network is a faith-based organization that provides service to homeless and low-income families through a Community Health Center, Residential Inpatient Treatment, Mommy & Me programs, Outpatient programs, Children of Inmates’ programs, Criminal Justice and Inmate programs, Housing programs, and Chaplaincy programs (The Agape Network, 2021). The community health center focuses on a whole person care model, including physical and mental health. The residential inpatient treatment program serves single women over 18, pregnant women, and women with children who are experiencing substance use disorders or mental illnesses. Their Sunflower Housing program provides transitional and permanent housing to help women move from homelessness to managing their own living well.
Fellowship House
Fellowship house follows a model for psychosocial rehabilitation for those afflicted with severe and persisting psychiatric disabilities, co-occurring substance use disorders (Fellowship House, 2021). Preference towards pregnant women is required due to funding it receives. Programs and services include Psycho-social Rehabilitation to integrate them back into the community, Club Fellowship recovery model, Community Employment Services to achieve goals related to preferred vocation, Case Management according to an individualized plan, outpatient services for mental health and therapeutic services, FACT services which assists those with severe mental illnesses without having to enter the program, and FMT services.
Miami Homeless
Miami Homeless assigns a case manager to every homeless person that enters the center, a clinic to assist with health issues, a dental office, and mental health services (Miami Homeless, 2021). Programs include job development and placement and housing placement. The center can house about 1000 people, with a primary emphasis on families, even those with pets.
Conclusion
There are many public, private, and faith-based organizations that provide access to services to the homeless population. Case managers are assigned, and individualized plans are made. Many offer shelter, as well as services needed to increase physical and mental health. In conclusion, Miami-Dade County has the funding and capabilities of assisting the homeless population.
Personal Reflection
This assignment has opened my eyes to some of the issues going on in my community. As I was completing it, I became aware that community issues are not addressed throughout local schooling as they need to be. It seems the emphasis on using the school environment to promote a desire to improve the community is absent from many classrooms in this county. I was appalled by the classroom resources available for teachers. I felt a stigma and stereotype of the homeless community was the undercurrent of the resources provided by the Homeless Trust. With Florida being of the most dangerous places for the homeless population, I wonder how much of that is attributed to this negative stereotype taught by the Homeless Trust. In essence, the homeless population has a culture and in order for us to be the best available to help them we need to become competent in understanding that culture without the persistent focus on the negative aspects (Lee, 2015).
I was more pleased by the emphasis on strengths-based programs offered by the faith-based organizations. It seemed to fit better with my belief that everyone deserves to be loved and cared for because that is the only way the true love of Jesus Christ will be displayed. Although the faith-based organizations seemed to have a greater emphasis on strengths, there are still many hurdles to overcome in the way that the organizations function. Jesus Christ needs to be first and foremost in the treatment of spiritual problems for re-creation and recovery (Young, 2002).
I chose the homeless population because my house church members and I all have a passion for helping this population. We have developed some relationships with some members of the population and hope to bring the Gospel of Christ to them in actions and words. Within the homeless population, there is a smaller population that do not want to live in a shelter. Going out to the streets and having conversations with them reveal the realities of shelters being a kind of jail. When faced with situations that make them feel dehumanized, many choose to stay on the street, because at least there, they are in charge of themselves. The question then becomes how are these reached? How can they receive substance abuse information? Some of the organizations I found require the homeless person to be on the pathway to be clean before they can have access to their programs.
I would like to see the Homeless Trust doing a better job in meeting these right where they are. Bringing resources to them that will help them move forward and encouraging them to have hope for a future. Rather I saw an organization that will not even use the millions of dollars it has to build public restrooms, leaving those out there to feel even more dehumanized. I saw an organization that shows education videos of a homeless man taking the scraps of money he receives to go buy alcohol and teaching students that not providing a meal or giving money is the right thing to do. Instead, the encouragement is to donate to the organization. Jesus Christ said, “For I was hungry and you gave me something to eat; I was thirsty and you gave me something to drink; I was a stranger and you took me in,” (Christian Standard Bible, 2017, Matthew 25:35). The followers of Jesus Christ have a greater calling than simply donating to an organization. We have been commissioned to go and make disciples of all nations, and therefore of all people groups. There are many unreached in our own communities, and the homeless population is one of the most vulnerable. This assignment revealed to me a need in my community to foster love and encouragement from all towards the homeless population.
References
A culture of care: How Lotus House Women’s Shelter heals program participants through
genuineness, dignity, belonging, individualized attention, high expectations, and space.
(n.d.) Journal of Community Psychology.
Camillus House. (n.d.a). Causes of homelessness.
https://www.camillus.org/aboutus/causes-ofhomelessness/
Camillus House. (n.d.b). We’re here to help.
Carrfour Supportive Housing. (2018, March 27). Karis village affordable housing community
opens in Miami’s Goulds neighborhood. http://carrfour.org/wp-content/uploads/2018/05/3.27.18-Press-Release.-Karis-Village-Affordable-Housing-Community-Opens-in-Miami.pdf
Chapman Partnership. (n.d.). Programs and services.
Christian Standard Bible. (2017). Christian Standard Bible.
Davis, D. (2019, March 13). Why people become homeless. Miami Homeless.
Engage305. (2014, October 14). Engage305: We serve better together! Retrieved February 2,
2021, from https://www.miamidade.gov/engage305/home.asp
Fellowship House. (2021). About. https://www.fellowshiphouse.org/about/
Florida Department of Health in Miami-Dade County. (2019, June 30). 2019 Community Health
Assessment: Miami-Dade County, Florida.
Homeless Trust. (2021). About us.
https://www.homelesstrust.org/homeless-trust/about-us/home.page
Lee, K.S. (2015). Effecting social change in diverse contexts: The role of cross-cultural
competency. In Scott, V.C., & Wolfe, S.M. (Eds.). Community Psychology: Foundations
for Practice (pp. 113-131). SAGE Publications, Inc.
Lotus House. (2021). About us. https://lotushouse.org
Miami-Dade County. (2021). About Miami-Dade County.
https://www.miamidade.gov/global/disclaimer/about-miami-dade-county.page
Miami Dade County Homeless Trust. (n.d.). Continuum of care governance charter.
Miami Homeless. (2021). Our services. http://www.miamihomeless.org/our-services/
Miami Rescue Mission (2021). About us: Vision, mission, services, history, impact.
http://www.miamirescuemission.com/about.php
Operation Sacred Trust. (2020). Ending homelessness for America’s Veteran families.
https://www.411veterans.com/about
Robertson, L. (2019, October 19). Human waste from homeless people makes downtown Miami
streets unpleasant, unsanitary. Miami Herald. https://www.miamiherald.com/news/local/community/miami-dade/downtown-miami/article236262158.html
TheMNetwork. (2018, November 20). The Miami-Dade County Homeless Trust PSA [Video].
YouTube. https://www.youtube.com/watch?v=DX7LZ8caRLE
The Agape Network. (2021). Programs and services. https://www.theagapenetwork.org/services
The Salvation Army. (2018). What we do.
https://salvationarmyflorida.org/miami-ac/#what-we-do
United States Census Bureau. (n.d.) Florida.
https://data.census.gov/cedsci/profile?g=0400000US12#
Young, A. (2002). Substance abuse: A pragmatic approach and its blessings. In June, L.N., Black,
S.D., & Richardson, W. (Eds.), Counseling for seemingly impossible problems: A Biblical
perspective.. Christian Research and Development.
Discerning Trauma 