The Anthem Foundation awarded DOORWAYS a Healthier Generations grant to enable the agency to focus on delivering mental health services to those who are vulnerable and disenfranchised—people at the intersection of poverty, homelessness, and HIV. This population experiences high levels of mental health conditions, which have been found to be both the cause and the result of their circumstances.

People living with HIV are twice as likely to have depression. Mental illness can lead to risky behaviors that expose individuals to HIV. Mental health conditions may also lead to homelessness, and the added stress of homelessness may lead to mental health conditions. A study by the National Institute of Mental Health estimated at least 45% of the homeless population experiences mental health conditions with 20-25% suffering severe mental illness (https://www.hcs.harvard.edu/~hcht/blog/homelessness-and-mental-health-facts).

Combining HIV, mental illness, and homelessness leads to significant deterioration and limited progress in all three areas. “Due to this critically intertwined relationship, we estimate 70% of our clients would benefit from mental health services, with 25% severely affected by untreated mental health conditions and, in some cases, undiagnosed mental illness,” explained Pat Plumley, Chief Program Officer at DOORWAYS. “The path to stability is challenging for all of our clients, but significantly more difficult for those in need of mental health services.”

In fact, program progress reviews revealed mental health conditions were actually weakening client outcomes within the entire DOORWAYS matrix of services—managing and retaining housing, food security, maintaining a source of income, developing skills and experiences instrumental to daily living, plus participating in goal setting activities that can lead to viral suppression and improved health.

“Like housing, good mental health is an essential part of the foundation our clients need to build a self-directed life in which they may achieve improved health outcomes and a better quality of living,” noted Opal M. Jones, President & CEO of DOORWAYS. “Referrals to counselors have always been an important aspect of our coordinated care plan, but client ability to follow through was overwhelmed by navigational barriers such as mental illness, physical illness, lack of transportation, no childcare, and a sense of hopelessness. It was time for a new model of care with onsite access.”

Jay Moore, M.D., the Chief Clinical Officer, Emerging Business Group at Anthem and immediate past president of the DOORWAYS board of directors, added “Today, HIV is treatable. As our clients stabilize, they are better able to manage their HIV medication regimens, which leads to reductions in viral load counts. At this point, clients not only feel better but, when they achieve undetectable status, they also render the virus untransmittable, reducing new cases of HIV.”

With the pivotal role mental health plays in strengthening client progress toward gaining stability, funding from the Anthem Foundation contributed towards hiring two counselors to provide easily accessible mental health services. “We are extremely grateful for this grant from the Anthem Foundation to support the launch of our onsite Behavioral Health Program,” noted Jones. “We are now able to seamlessly deliver mental health and substance use counseling onsite, increasing quality of life and life spans for individuals plus reducing the HIV epidemic in the community. Decreasing disparities in mental health care within this vulnerable population can directly contribute to bringing an end to HIV.”

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Each year, DOORWAYS conducts a client satisfaction survey. Questions explore client perceptions of the agency’s environment and services. That includes the scope and value of our programs, accessibility and convenience, plus self-reported outcomes.

Our focus is to provide housing to create the foundation for a services home that enables clients who have endured a life of homelessness, poverty, and chronic illness to build health and life stability. Through DOORWAYS, they are able to step into a portal providing resources, knowledge, and a supportive environment encouraging behavior change. For example, in our 2020 survey, 86% of the respondents noted they are better able to manage their daily HIV medication regimen thanks to DOORWAYS supportive services. This is a critical milestone in contributing to better health and improved quality of life. Adherence to an antiretroviral therapy program can lead to HIV suppression. Achieving undetectable status renders the virus untransmittable, stopping the spread of new cases in the community.

The survey was sent to clients in 5 of our programs providing emergency, permanent, and transitional housing plus rent subsidies to prevent homelessness. A total of 317 clients returned the survey. Analysis of the responses calculated a 4.7 satisfaction rating on a scale of 1 to 5, with 92% and 95% of respondents, respectively, feeling their privacy and presence were being respected. Eighty-nine percent confirmed staff successfully conveyed available services with 90% reporting convenience in securing assistance.

Pat Plumley, MA, MSW, LNHA, serves as DOORWAYS’ Chief Program Officer. “In our 33 years of operation, DOORWAYS has adapted to client needs,” she stated. “This agility allows responsiveness to changing environments.” She discussed the first change in focus experienced by the agency that occurred with the introduction of new pharmaceuticals to treat HIV: “DOORWAYS shifted from hospice services helping people die with dignity to housing services helping people live with hope.”

The agency’s next transformation is currently underway. “As the depth and breadth of client need expands, it’s clear that we must refocus our service-enriched housing model,” noted Opal M. Jones, President & CEO of DOORWAYS. “Giving people a place to live can no longer be the first step in a linear progression of recovery. The heightened severity and combination of challenges experienced by our clients needs to be addressed together. Housing must become the base for a services home connecting clients with a comprehensive mix of resources to rebuild physical, mental, emotional, and spiritual health simultaneously.” DOORWAYS 2.0 creates this network of support.

The idea was sparked through feedback from annual satisfaction surveys back in 2017 and 2018. Already operating beyond capacity, the agency initiated feasibility studies and focus groups that included clients. In 2019, the first capital campaign in DOORWAYS’ history was launched. Scheduled to open Summer 2022, the new campus will provide additional housing, programming space, and offices for client services provided by DOORWAYS staff and partnering agencies bringing their operations to the campus to remove access and navigational barriers. “This effort was guided by clients and for clients,” said Jones. “We are grateful to every client who trusts us enough to communicate the areas in their life that they can’t conquer alone. Their feedback has been heard and is becoming a reality.”

If you would like more information on the DOORWAYS Beyond Tonight Capital Campaign, please contact Jim Timmerberg, Director of Development (jtimmerberg@doorwayshousing.org or 314-328-2705).

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CLICK HERE to Make a Donation to DOORWAYS

Many clients have endured years of deprivation, abandonment, shame, and hopelessness. They too need help finding their value, resilience, and personal agency to change the trajectory of their lives. In response, DOORWAYS has launched an onsite behavioral health program. In this first phase, services are provided by two DOORWAYS counselors. As we expand into our new facilities, we will welcome several expert partners in delivering therapy and crisis intervention services through our two programs: SHINE and Constellation–names inspired by our new logo.

SHINE (which stands for Strengthening Health, Illuminating Newly-Found Empowerment) provides individual counseling services. Counselors meet one-on-one with clients as well as through online video platforms and over the phone.

Constellation is our group counseling program, which has been launched currently at Cooper House and will be offered at other sites soon.

Since launching the Behavioral Health program with two counselors at the end of November 2020, 50 people have been enrolled and are actively participating. We expect to exceed our goal of serving 90 people annually by the end of 2021.

This program expansion would not have been possible without the generous contributions of a number of foundations: Anthem Foundation, Elizabeth Taylor AIDS Foundation, and the Missouri Foundation for Health. If you would like to contribute to DOORWAYS, please contact Jim Timmerberg, Director of Development (jtimmerberg@doorwayshousing.org or 314-328-2705).

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CLICK HERE to Make a Donation to DOORWAYS

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For more information, please contact: Jim Timmerberg, 314-328-2705 or jtimmerberg@doorwayshousing.org.

A Housing Model of Care
To Stop the Spread of HIV

DOORWAYS is beyond capacity, with no space to expand housing, staffing, or programs. We conducted feasibility studies regarding the need for expansion and our capacity for growth. With board approval, we began planning the first capital campaign in the agency’s history. “Beyond Tonight: A Capital Capital Campaign for DOORWAYS” will enable us to pioneer a new model of care offering flexible housing and onsite services that address 360-degrees of need through DOORWAYS programs and many partnering AIDS-serving organizations seeing clients on our campus. We are removing access and navigational barriers that create delays in achieving undetectable status, which renders the virus untransmittable–and thus reduces the spread of HIV in the community. The project is receiving broad support, as many recognize the basic right of individuals to regain health and improve their quality of life plus the importance of stopping forward transmission.

The Capital Campaign Cabinet formed in 2018 has been making many strides this year in our journey to a new campus. Similarly, our community development consultants and architects (Rise and Trivers respectively) have made substantial progress with advancing the project. In fact, you may have seen the media coverage highlighting the artist’s renderings of the new facility that is scheduled to open early 2022.

Clearly, the next few years will bring much excitement, but none of it would be possible without your steadfast support over the years that paved the path to this pinnacle of expansion. Your partnership has given the agency stability and positioned us for growth. We are grateful for all you have done and look forward to our next era together.

-Opal M. Jones
President & CEO

RESOURCES:

Beyond Tonight Campaign Brochure
Case for Support
Rendering
Pledge Form

Your gift saves lives — Beyond Tonight.
Make a donation in support of the campaign.
Make a pledge of support over a period of five years.

Questions: Call Jim Timmerberg at 314-328-2705 or email jtimmerberg@doorwayshousing.org