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DNP Program Brings Homeless Simulation to Campus
-By David Braz
Dr. Chris Harsell, a faculty member in the Department of Nursing, first learned of homeless simulations when she attended a conference last spring. One of the conference participants was Michael Carbone, the Director of the North Dakota Coalition for Homeless People (NDCHP). Michael has spent the last 6 years assisting persons in need to access services in the state of North Dakota. The NDCHP utilizes the Homeless Management Information System to track services provided and to conduct grant reporting, both of which are essential to getting resources where they can have the greatest impact. He has conducted roughly a dozen such simulations during this time. Participants have varied from high school students to Chamber of Commerce members.
Chris immediately saw the potential for the simulation to bring together interdisciplinary students and expose them to the difficulties persons may face as they try to access services and resources. She knew this was an experience that would enhance the Doctor of Nursing Practice (DNP) students' learning and brought the idea to the DNP program director Dr. Maridee Shogren. Chris and Maridee worked with faculty across campus to bring twenty seven students from Occupational Therapy, Social Work, Nutrition & Dietetics, Counseling Psychology and Nursing together to take part in the simulation.
For Michael, this extensive outreach is critical because no one profession or area of society can end homelessness and exploitation. "The only way we will make a difference is through collaboration. There are many different services in need. Housing supports, chemical dependency counseling, transportation, job training, and mental and physical health assistance are just a few. We can end homelessness. We just don't have the political or social willingness to do so. That's why this simulation exists, to educate people like you about the reality people experiencing homelessness face. You are key to ending homelessness."
The simulation involved setting up several tables, each staffed by a volunteer, which represent different tasks for the students to complete. Grocery stores, social service offices, and both public and private housing are a few of the stores and offices represented. Several of the volunteers were individuals who are currently receiving services. Their firsthand experience of the hardship they have faced enables them to accurately portray to the students what life is like for those seeking help.
When the Simulation began, Michael assigned identities to each of the students and asked them to answer some questions. Students were given only the floor and wall for a writing surface. "Remember, people without a home don't have a desk to fill out applications for jobs or housing. Neither do you."
Music blared out of portable stereo as students ran from station to station, trying to pay bills, find child care, and locate housing. Michael increased the volume every 15 minutes as another "month" passed, and informed the students that their situation had changed over the course of the moth. Some found extra income, while others experienced a hardship such as an unexpected medical expense or loss of employment. The volunteers often informed students that their life circumstances did not qualify them for assistance, that current programs had full enrollment, or that the office or store was "closed," all of which are common occurrences to those seeking assistance
Michael's voice bellowed above the din of music. "Why don't you get a job already...If you don't pay your bills, the state will take away your children...All I see are lazy people." The constant stream of negative thoughts and comments are a reminder that many individuals will be judged without any consideration to their circumstances or efforts to seek help.
"I kept wanting a break to allow time to catch up, balance my finances, and write out my checks. We didn't get a break during the simulation," observed Lauren Roemmich, a graduate student from the Department of Social Work. "After reflecting, I realized that people cannot just take a break when they are feeling overwhelmed with accessing resources or struggling to pay bills. The constant stress and pressure made me feel hopeless."
Scattered around the simulation room are various drop boxes where students made payments for transportation, insurance, utilities, and other expenses. Students were not told where they can find the boxes as this represents the difficulty of locating where such payments need to be made for people experiencing homelessness. They know that they need to pay a bill, but the location of the office is not readily apparent.
While students try to make ends meet, faculty members take on criminal roles such as drug dealers and sex traffickers, enticing students to engage in criminal activity for extra income. If the students are caught, they are "arrested" and detained for part of the simulation. Afterwards their felony record reduces assistance that is available to them in the simulation, and makes finding employment that much more difficult.
During the debriefing, Michael informed the students that many teens who are experiencing homelessness engaged in the practice of survival sex where they trade sexual favors in order to move from residence to residence simply to have a place to sleep each night. The Wilder Study, a MN state wide survey, estimates that as many as 36% of females are approached by the sex industry within 48 hours of losing shelter. Men are also targeted for sexual exploitation.
"No one chooses this life. People don't choose to sleep in cars, in culverts, in dumpsters. People don't grow up thinking I want to be an addict or mentally ill. It's the circumstances beyond their control that lead them to this situation. People sometimes don't ask for help, and when they do, they don't necessarily get the assistance they should on the first few attempts. This leads them to disengage from the system. Why try to find assistance when the system has already failed them?"
Allison Reuer, a senior in the Dietetics Program, learned a variety of the ways accessing services can be discouraging for those seeking assistance. "The simulation definitely offered a new perspective on the difficulties individuals go through when trying to access resources. This simulation has shown me that even though there are resources and programs available out there, there are many procedures that someone must go through to gain access to those resources. Long applications, waiting lists, and insufficient program funding are some of the hardships individuals face while trying to access resources in addition to taking care of themselves and possibly a family."
"They did a good job of recreating the experiences of people who are homeless," stated Amanda Nelson, a graduate student in the Department of Social Work. "I have prior experience with the homeless population, (but) the poverty simulation brought my understanding to an entirely different level. I truly felt as if I was in their place."
Recently, Michael has witnessed a paradigm shift in how local communities and state governments try to end homelessness. The focus used to be on following the housing ready model. You had to prove your readiness for housing by addressing education, job training, and mental health or chemical dependency needs first. Organizations and service providers now understand that the key to moving people out of a cycle of abuse, exploitation, and neglect is provide housing first. "We used to think if we can just get people cleaned up, educated, or trained for a job, then they will acquire the skills necessary to get a home. We now know that the home is paramount to everything else: accessing mental health, employment, etc. "
Michael encouraged the students to review information on the National Alliance to End Homelessness website, and offered some words of encouragement for the future professionals who will serve populations in need. "There is hope out there, if you know where to look."
For more information, please contact Maridee Shogren (Maridee.shogren@email.UND.edu), Chris Harsell (chris.harsell@email.UND.edu), or Michael Carbone (firstname.lastname@example.org).