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About Street roots. (Portland, OR) 1998-current | View Entire Issue (May 27, 2011)
street roots 10 May 27, 20J1 r a / * ] I Am Not A Poet HEADS, from page 1 of time and need to address each client’s most pressing health issues. According to Solotaroff, by Sergio Holffmans clinicians end up using a “clinical reasoning more edgy when you’re homeless,” Hill'said. “And process” to determine what type of screening you’re closer to violence when you’re on the A lazy admirer of poetry is what I am. might be most important for a particular client streets.” A loving dreamer, TBI rarely makes it to the top of the list who always has a dream to dream and a failure to tell. But given the high correlation between homelessness and brain injury, some advocates I write verses and poems, but I am not a poet. think it deserves more attention. ne of TBI’s biggest dangers is that it often I have the disgrace of not getting advice from my Father, “We have to find a way to identify brain injury on goes unrecognized. People with TBI often don’t connect their symptoms with previous head the streets,” says Pat Murray, the Executive who says he is a poet Director of Portland’s Brain Injury Resource injuries, and many health care providers, mental Community (BISC). “When we understand that this health workers, and case managers don’t either. I do not write because he is a poet, is a physical injury, we start to look at people Some brain injury survivors have a hard time I write because I am a slave to love. differently. We might need to work with them a remembering appointments, following instructions little differently. And there may be ways to help.” or taking medications. They may have a hard time I am just a verse, According to Murray, identifying brain injury organizing their thoughts, finding the right words, and the pen, that writes the tears that wait to be cried, could lead to more appropriate treatment, as well or picking up on social cues. As a consequence, in the hands of the woman that I want, that I love. as better access to benefits and services. these clients might be labeled as disinterested, | rude, or non-compliant. They will say that I inherited my inspiration, but no! Or they may be misdiagnosed. Symptoms of TBI can also look a lot like major mental illness, ecause the effects of brain injury can be emotional trauma, or drug and alcohol abuse. And I created my inspiration with one look - disabling, some TBI survivors are eligible for these conditions often co-exist and exacerbate one my inspiration was created Social Security disability benefits. For Nick Patton, because I am a slave to love another. Distinguishing between them can be it was a turning point in his recovery. But getting difficult. and nothing else! there wasn’t easy. This was the case for Nick Patton. “Without help, I would’ve walked away. I had “They thought I had schizophrenia, even though given up on it three times already. It would be the symptoms didn’t start till after the injury. And hard for a normal person. But they make it so that was when I was 32.” (Much later than the hard that a person who really, really needs SSI typical onset of schizophrenia.) The Housing Authority of Portland (HAP) is can’t do it unless they have an advocate.” His doctors prescribed heavy antipsychotic preparing to open the Bud Clark Commons — Luckily, Nick found one: Central City Concern’s medications to control his hallucinations, but that Portland’s new access center that will also provide BEST program, a project that helps homeless men left him so sedated he couldn’t function. And it 130 units of permanent supportive housing. For and women through the long and complicated didn’t get to the root of the Nick’s problem: small file first time in Portland, these units won’t be disability claims process. The program provides seizures caused by the brain injury, left completely offered on a first-come, first-served basis. Instead, assistance with every step and pays for the undiagnosed. the Commons will offer housing to those they expensive testing that’s often required; According According to Dr. Wismer, Nick’s case is a prime consider the inost vulnerable. And that will to Kascadare Causeya, BEST’S program manager, example of why it’s important to identify TBI in an include individuals who experience memory more than half of BEST’S clients have had a TBI in individual who is homeless. Treatment for TBI is attention, organization, social skills and anger their lifetime. often different from traditional mental illness, management, all areas that can be directly affected “I couldn’t think well enough, so they helped me including differences in medications. Some by a brain injury. psychiatric medications have little positive effect on fill out the paperwork,” Nick explains. “They knew Although the model is controversial, it could what doctors to send me to and got my medical an individual with TBI, yet can produce very offer vital support for those recovering from brain records sent from Alaska. I couldn’t remember the harmful side effects. . injury. It also indicates a growing awareness of name of the hospital where I had my surgery, so George Dennison knows more about traumatic ■■Gog ai tiw fri'iwtion i ng and - t h e- important -role T5râîîTn^urÿTRâîrmosr^êôpîëTT<nav7~WTTên"rTêîr" plays in a person’s ability to care for him- or her They also stuck with Nick through two denials him I’m doing a story on TBI and homelessness, self — especially amid the chaotic, deficient, and and appeals. According to Mellani Calvin, Nick’s he says, “Oh good! Because it’s rampant out often dangerous circumstances of the streets. advocate at BEST, “the state’s disability reviewers there!” He goes on to tell me about his own brain were blaming his mental health disorder on his injury. prior drug use. They saw him as just a drug addict who didn’t really need those (psychiatric) meds.” ccording to Pat Murray, we still have a lot of After four-and-a-half years, Nick finally won the work to do, and it needs to start with claim. information. “Awareness has to happen first. And The medical benefits started first, which gave "We have to find a way to Identify brain that awareness needs to start with those who serve Nick access to new doctors. And when the In ju ry on the streets, When we understand homeless individuals.” She offers Brain Injury monthly cash benefits kicked in, he was able tp Support Community as a resource to these that this Is a physical Injury, we start to look afford the co-pay to see a new doctor - one who providers. “We want to work together with people at people differently. We m ight need to work got to the root of Nick’s hallucinations. serving the homeless community - to help those Measurements of electrical activity in his brain w ith them a little differently. And there may who have already fallen through the cracks.” confirmed that Nick was having small seizures - a be ways to help." And, she says, the time is right. “We have a real direct result of his brain injury. Now, finally, an — RAT M U R R A Y opportunity right now - brain injury is in the media anti-seizure medication is helping to control the E X E C U T IV E D IR E C T O R O F P O R T L A N D 'S and research is catching up with the reality. We’re , B R A IN IN J U R Y R E S O U R C E C O M M U N I T Y voices and hallucinations. The medication has just getting a lot smarter about brain injury.” been a critical piece of Nick’s recovery. Nick Patton is living proof that with the right diagnosis, the right support, and a committed advocate, life can get better, even if it never goes 1 “See this water cooler? This is like brain rain injury comes in all shapes and sizes and so back to normal. reserve. If you’re way up here at the top, you’ve Even 10 years on, Nick still feels the effects of does recovery. A lot depends on the location got a full tank. But I had the genetic predisposition and extent of the damage. Mild TBIs may take just his attack. Although the medications have helped for bipolar disorder, so that means I start off a little dramatically, he still hears voices. But now he a short time to heal completely, while a severe lower - about here. Then I go for years with it knows that they’re just voices and that they’re injury may heal very slowly or cause permanent undiagnosed, so that brings me down some more. caused by the injury - he doesn’t have to listen to damage. In most cases, the underlying idea is the Then I smash my head into a car windshield. That them. He can trust people again. same - to rest the brain as much as possible while one - that brings me down to here.” George’s - He also still struggles with some of the signature it takes time to heal. hand is about halfway down the tank. symptoms of brain injury - including memory and If you suffer a brain injury, you’ll probably be George wants to be clear. It’s not just the TBI. concentration. “It’s hard to keep my thoughts advised to get plenty of sleep, limit sensory It has all taken a toll. “But TBI, mental illness, together. I can’t really read anymore - and if I do, stimulation, and eliminate stressors. You’ll be substance abuse, PTSD - they all go together like I can’t remember it five minutes later.” encouraged to drink plenty of water, eat well, and peanut butter and jelly.” He says he’d like to go to school to be a case avoid anything that might cause another injury - all Because of its high prevalence, the National worker, to offer the same kind of support he’s relatively minor adjustments for most people. But Healthcare for the Homeless Coalition gotten from others. But he knows it’s not in the recommends that homeless individuals be routinely for people without a home, they are virtually cards. He says it would just be too much; to do the impossible. screened for TBI during health appointments and coursework needed to get the certificate. “If you’re homeless you’re always living in this in other service settings. For a comprehensive, But he’s learned to be happy again and to work ultra-aware state. There’s no way to relax,” standardized screen, the coalition recommends a around his symptoms. He sets his phone to remind explains Brad Taylor, an outreach worker with web-based tool called the Brain Injury Screening him of appointments and tries not to promise that Questionnaire. Although it only takes four minutes JOIN. In the world of homelessness there is no he’ll be somewhere on time. Social security covers place to rest or to get a full night’s sleep. And for the questionnaire to rule out brain injury, his basic expenses. “I actually like paying my bills waking time is taxing. confirming a TBI takes about 20 minutes. now. It makes me feel normal.” Which is why Dr. Wismer sees housing as the This isn’t a standard practice in Portland where But most importantly, Nick goes fishing. As first real step in recovery for many who are busy clinics are filled with patients at risk for a often as he can, he goes out with a group of guys homeless - specifically, permanent supportive whole host of health problems. from AA to hit the best fishing spots in the city housing with nurses, case managers, and social “The system isn’t set up to support a really It’s something he knows by heart - something the workers. For some brain injury survivors, a new thoughtful and complete history of complex brain injury can’t take away from him permanent supportive housing facility in Portland individuals,” explains Rachel Solotaroff, Director of may come close. Old Town Clinic. Physicians have a limited amount O B A B
