Community food pantries rely upon the generosity and goodwill of community members. Food pantries are invaluable to those individuals and families who are either homeless or facing food scarcity.

As an education specialist for a large nonprofit, I (Seneka Arrington) oversaw the daily operations of our local food pantry. In the back, from ceiling to floor, nonperishable food items — organized by soups, vegetables, meats, snacks and beverages — lined the walls. On a shelf sat prepared food bags, created by hand and ready to be distributed to those in need.

One afternoon, a man walked through our front doors and requested a bag, stating, “I haven’t eaten in days.”

With delight, I grabbed a food bag and handed it to our guest. Famished, he decided to open the bag in front of me just to “have a few bites.” But to his dismay, he was unable to access any of the food because every can in the bag required a utensil to open.

Discouraged, he mumbled, “It’s so hard to get here. Now it’s hard to get the food out. This always happens.”

I quickly apologized for the inconvenience and asked if I could make the situation right. I took his bag and returned to the fully stocked pantry, scanning for a meal to provide to my guest. On the middle rack, three items in pop-top cans caught my eye. I grabbed all three and created a dinner bag that my patron could enjoy. Upon receiving this new food bag, the man smiled and hugged my shoulders.

This experience highlighted for me contradictions in the ways our society tries to support, care for and aid those who are homeless. Although goodwill is typically present in these initiatives, a lack of intentionality often plagues efforts to reduce suffering in this community. I came to recognize how education could increase the effectiveness of the support offered by society. From that point on, my mantra became that all food bags “need to make sense and include only pop-top cans.”

Homelessness is an ever-present concern in communities. The problem is anything but invisible. More than half a million people in the United States experience homelessness on any given night. The National Coalition for the Homeless highlights three types of homelessness: chronic, transitional and episodic.

Chronic homelessness is used to describe the people who are most vulnerable due to experiencing homelessness for at least a year while also struggling with a substance use disorder, physical disability or serious mental illness.

Individuals experiencing transitional homelessness rely on the shelter system for a short period. These individuals are likely to be younger and to have become homeless because of a calamitous event.

Episodic homelessness includes people who experience mental health, medical or substance abuse issues. These individuals are chronically unemployed, resulting in a frequent shuffle in and out of homelessness.

Homelessness and helping those in need has been a passion of mine since I was in the third grade. In working with this population, I have witnessed a frequent lack of intentionality by those who donate or serve and a subsequent lack of self-worth on the part of those who receive these donations or services. What are we saying to a person when we hand them food that they cannot access? As helpers, what is our attitude around giving to those in need? Do our services reflect our support?

It is important to first look at our biases toward those who are homeless and the difficulties that surround asking for help.

Stereotypes about homelessness

Throughout my career, I have heard words such as annoying, needy and lazy applied to those who are experiencing homelessness, often as justification for someone’s lack of desire to serve this population. Such words are often used when describing panhandlers. “If that person can ask for money, they can get a job” is one prevalent line of thinking that negatively influences people’s willingness to help those they deem to be undeserving. There is also the idea that given all of the community and government efforts to assist those who are homeless, individuals who are still asking for help are not taking advantage of these resources.

Homelessness is repeatedly associated with choice. Those burdened by homelessness are often viewed as being individuals whose predicament resulted from their own poor choices and who have full autonomy to get themselves out. Many of these individuals desire stability, but the added stresses of humiliation, worries of where to sleep at night and food insecurity are their reality.

Their losses of employment, housing and family are commonly viewed as resulting from poor decision-making and mismanagement. These negative impressions are so ingrained in our society that even well-meaning citizens have difficulty giving to those in need. Understanding the complexity of homelessness, addressing our personal biases and updating these beliefs are the first steps on the path toward advocating for this population.

Understanding homelessness through the lens of a counselor

Community mental health agencies are supportive of accepting individuals who are experiencing homelessness. These agencies typically accept Medicaid/Medicare or offer sliding feel scales to help these individuals obtain services.

Other organizations in which counselors may work with individuals who are homeless include nonprofit agencies, Department of Veterans Affairs facilities, and child and family services agencies. In addition, school counselors may assist students whose families are transitory or homeless.

As counselors, we are tasked with being influencers of hope and developers of self-worth. We create spaces for growth and facilitate transformations. Even as we help individuals work through the hardships associated with homelessness, coupled with the psychological processes, we must recognize basic needs. Often, it is a lack of basic necessities that serves as a significant barrier or hindrance to an individual’s progress. Counselors are therefore encouraged to affirm the existence of said barriers, as well as the barriers of discrimination, poverty, injustice and hardship.

Counselors can create spaces for individuals to work through feelings of guilt, shame, helplessness, hopelessness and fear associated with simply surviving from day to day. Counselors can also work with clients who are homeless on overall wellness. We recommend addressing the “Six Dimensions of Wellness” created by Bill Hettler, co-founder of the National Wellness Institute. The six dimensions are:

1) Emotional wellness: Reducing stress and improving sleep

2) Environmental wellness: The creation of happy, clean and safe spaces

3) Social wellness: Relating, interacting and communicating

4) Physical wellness: Regular exercise, proper nutrition and good sleeping habits

5) Intellectual wellness: Problem-solving, processing and creativity

6) Spiritual wellness: Meaning, purpose and guidance

In addition to addressing the emotional and psychological needs of individuals experiencing homelessness, counselors rely on community resources and relationships with community stakeholders to meet the needs of this population. Through interdisciplinary partnerships, counselors can create a broad network of support. These duties — e.g., securing food or shelter — are typically divided among helping professionals rooted in various disciplines other than counseling.

Factors counselors should consider

The stigma around asking for help: Even with a strong support system made up of co-workers, friends, family or helping professionals, it can be difficult to ask for help. People experiencing homelessness are often seen as burdensome, which can reduce the willingness of these individuals to request assistance.

In addition to the stigma of asking for assistance, few organizational and individual resources give without first asking or demanding that individuals meet certain criteria. The number of documents required to prove homelessness and obtain housing, food and security impedes the process at times. Advocacy from the counselor and education regarding how to navigate the complex system of aid can assist clients who are homeless in connecting with the necessary support.

Health: Individuals who are homeless can face severe barriers in accessing basic needs related to health and nutrition. The prerequisites to obtaining medical services, coupled with the financial means to sustain such services, hinder access and consistency. Health complications, poor hygiene, lack of adequate or varied nutrients, possible drug and alcohol abuse, and environmental stress directly affect the health and well-being of individuals experiencing homelessness.

Illnesses that most individuals recover from within a couple of days (e.g., the common cold) can become serious problems for those who are homeless due to living in unsanitary conditions. Chronic conditions are vitally important to consider because they require consistent medical treatment and healthy lifestyle habits to control. When not adequately treated, these physical conditions worsen over time and can contribute to mental health issues and a decrease in quality of life.

To assist these clients, counselors can aid in providing seamless transitions to medical offices. Partnering with local transportation networks, churches, food banks, medical professionals, local free medical clinics and shelter systems can create consistent care and build a supportive community to address homelessness collectively. Support is often evidenced by donations and collaborations.

Mental health and emotional well-being: Mental health conditions can be either the cause or the result of homelessness. A study by the National Institute of Mental Health reported that approximately 6% of Americans are severely mentally ill, compared with 20-25% of individuals experiencing homelessness. The predominant mental health disorders seen in those living in impoverished conditions include major depressive disorder, bipolar disorder and schizophrenia. Mild, yet prevalent, mental health issues show up in the form of generalized anxiety and adult attention-deficit disorder.

Counseling services require weekly sessions for effective treatment. Consistency is key to progression, follow-up and accountability. However, lack of adequate sleep and lack of access to immediate needs can continually disrupt the process of counseling for individuals who are homeless.

A recommended strategy that may be helpful to counselors is incorporating a weekly needs assessment to inquire about the client’s basic needs and whether they are being met. It can also be helpful to connect clients to resources that will allow them to attend counseling more consistently, such as free transportation and stable shelter. It is recommended that counselors put a multifaceted approach in place to address the needs of and provide appropriate mental health care to individuals experiencing homelessness.

Impact on helping professionals

Individuals experiencing homelessness are especially vulnerable due to a lack of access to stable shelter, reliable communication, financial means and medical resources. These barriers also restrict access to preventative health care and treatment that could aid in cultivating a more balanced and healthier lifestyle.

Gaps in professional partnerships often hinder consistent and effective care. Continuity of care should flow from the counselor to the medical professional, to the housing caseworker, to the food pantry volunteer. When this flow is inconsistent, so is the individual’s access to these services. Collaborative efforts, or a lack thereof, weigh heavily on the ability of those who are homeless to have their physiological and psychological needs met.

Most housing and homeless assistance organizations are fragmented and enigmatic systems. The difficulty in navigating such systems often leads to a sense of hopelessness and helplessness among individual in need. People are forced to obtain information on available services and programs through peer-to-peer interactions. Crisis response centers are under-resourced. Helping professionals receive incomplete information related to available resources and to the eligibility criteria for existing programs. Unfortunately, this fosters individual disengagement and distrust for public systems.

Consistently having to address crises and concerns such as trauma, addiction and emotional disorders with clients can be an overwhelming task for counselors. This is characteristic of settings in which clinicians are vulnerable to workplace stress, burnout and compassion fatigue. The latter can result in a lack of intentionality and patience when working with individuals experiencing homelessness.

Due to the physiological demands, working with homelessness requires patience and persistence that are not typical of everyday counseling encounters. As a result, counselors can experience a parallel process of hopelessness and subsequent compassion fatigue and burnout. To combat burnout, organizations can provide space for processing groups in which counselors can provide support to one another. These groups can be extended to partners in the community.

Action steps

Appropriately and competently addressing the needs of the homeless population requires intentional exploration and understanding of the multifaceted tenets of homelessness. The figure below depicts the necessary steps for counselors’ work with homeless communities.

Specific training for counselors and counselor trainees is essential in addressing the privation of the homeless community. Training can be offered through community and private mental health agencies and integrated into counseling programs. Practitioners and stakeholders can play an active role in addressing and supporting the identified needs by providing corporate training in the form of panels, lectures and service learning. Helping professionals and organizations can utilize the literature that expounds on care and attention for homeless communities.

Engagement efforts and materialization of the next steps can be demonstrated through interdisciplinary partnerships and collaboration. Immersion, outreach and advocacy can also serve as action steps toward increasing awareness and practical experience.

Hopes for the future

Highlighting access and engagement is pivotal in effecting change and fostering spaces where homeless populations can receive care. Multiple health and human services agencies, including the Substance Abuse and Mental Health Services Administration (SAMHSA), prioritize connection to programs that help address and prevent homelessness. The core principles of SAMHSA, as noted in its strategic plan, include expanding access to the full continuum for mental and substance use disorders and engaging in outreach to clinicians, grantees, patients and the public.

Health and human services typically include discharge planning in addition to financial support through Housing First programs. The Housing First model was created in New York City by Sam Tsemberis in the 1990s. Tsemberis asserted that housing was the only solution to homelessness. The model highlighted the significance of permanent housing for the chronically homeless with no conditions attached.

Counselors can be at the forefront of advocating for the integration of this model, with modifications that include intentional interaction, purposeful food contributions, advocacy and activism, preparation, partnership and hope. A modified approach could focus on creating opportunities for people experiencing homelessness to adopt a healthy and stable lifestyle through holistic treatment. Specific methods for counselors include:

• Training on people-first language
• Pursuing partnerships with low-cost grocery stores to provide vouchers to clients
• Increasing access to medical and clinical services through remote client monitoring and telehealth mediums
• Providing continuity of care by granting computer access in clinical spaces
• Offering career counseling
• Instituting a commuter benefit program by teaming with an independent transportation network and providing transport vouchers

Neglecting the resources that can contribute to the success of people experiencing homelessness is akin to giving someone a can of food that is inaccessible to them. A pop-top-can-oriented organization or helping professional embodies compassion and wherewithal that fosters change and growth. Counselors can further close the gap by offering substantive interactions with built-in goals for meeting clients’ hierarchy of needs, encouraging comprehensive treatment, and promoting hope by helping homeless individuals discover exceptions.

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Seneka Arrington strives to bridge the gap between research and practice, emphasizing the importance of connection, collaboration, and translating research findings into clinically meaningful information. For the past decade, her practice and research have been in the nonprofit sector, highlighting homelessness, mental health, career counseling and service leadership. She is a licensed professional counselor, as well as a current doctoral student and graduate teaching assistant at Idaho State university. Contact her at arrisene@isu.edu.

Chad Yates is an associate professor of counseling at Idaho State University. His counseling experience includes working with individuals with substance abuse disorders, batterers and survivors of domestic violence, families, and as a generalist treating many diverse client issues. His research interests include evidence-based practice in counseling, client-focused outcome evaluation, and the treatment of individuals with substance abuse and co-occurring disorders. Contact him at yatechad@isu.edu.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.