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­The Human Services team at the New England Center and Home for Veterans continues to lead the way in providing compassionate and effective care to the most vulnerable Veterans.

­The Human Services team at the New England Center and Home for Veterans continues to lead the way in providing compassionate and effective care to the most vulnerable Veterans. Staff recently attended international and national conferences to share the success they have had using progressive models of care and innovative partnerships after moving away from a less effective “abstinence-only” model that is still practiced by many service providers today.

The abstinence-only policies at the NECHV required Veterans to maintain abstinence from alcohol or drugs in order to receive services at the Center. While this model worked for Veterans who were able to maintain sobriety, Veterans who struggled to adhere to abstinence-only policies often slipped through the cracks. The newer model of care, which has been in practice since 2015, is characterized by trauma-informed care and harm reduction principles. Trauma-informed care recognizes the far-reaching impact of trauma and its signs and symptoms in order to facilitate healing. Harm reduction seeks to minimize the risks associated with substance use disorder, while not necessarily focusing on abstinence. While this approach allows all Veterans, including those who live with complex challenges, to receive needed services, there are still barriers that prevent Veterans from seeking care.

Together with the Boston Health Care for the Homeless Program (BHCHP), the NECHV aims to reduce barriers to accessing care and treatment. Lena Asmar, MSW, LICSW, Director of the Veteran 360 Behavioral Health Programs at the NECHV and Geren Stone, MD, of the BHCHP, presented their collaborative efforts at the 2018 National Coalition for Homeless Veterans (NCHV) Annual Conference. For example, to address a barrier like distrust of providers, something that is often based on previous bad experiences with providers or systems of care that are difficult to navigate, the NECHV/BHCHP partnership works to meet Veterans “where they are at.” BHCHP operates a clinic inside the NECHV that provides services from primary care to addiction treatment. Doctors even make weekly house calls to Veterans living in the single resident occupancy units at the Center.

These efforts to reduce care and treatment barriers include a program called Office-Based Addictions Treatment (OBAT). OBAT was started to address the impact of the current opioid epidemic in a realistic way. By using a harm reduction approach, providers are able to engage Veterans who are actively using substances in a welcoming environment, without judgement. By discussing with them ways they can minimize the risks that come with active substance use, case managers and clinicians can build a trusting relationship with Veterans to make sure they stay engaged in care. That relationship is key to giving Veterans a higher chance of success. In addition to addiction treatment, the clinic also offers hepatitis C treatment.

OBAT is just a piece of a larger program focused on working with Veterans who have been diagnosed with Opioid Use Disorder. Asmar and NECHV’s Vice President of Human Services Kristine DiNardo, M.Ed., LMHC, presented NECHV’s strategies for supporting Veterans with Opioid Use Disorder at the International Conference on Veterans Healthcare in Amsterdam, Netherlands, such as training staff in overdose prevention and naloxone administration. Asmar, Stone, and DiNardo hope the audience members at the conferences are inspired to launch similar collaborative programs of their own.

NECHV is also leading the way in housing Veterans. Veterans Welcome Home Housing Specialist Sia Vissering, MSW, LCSW, Veterans Welcome Home Case Manager Chelsea Maillett, BS, and NECHV Director of Housing Services Sean Terry also attended NCHV to present their work. In their presentation Street to Home: Progressive Engagement and Stages of Change, Vissering and Maillett discussed their strategies for helping chronically homeless Veterans use their strengths to find housing. By using progressive engagement techniques, motivational interviewing, and the stages of change model to determine a Veteran’s readiness to move forward, Vissering and Maillett are able to identify the areas in which Veterans are struggling in regards to housing, determine what they need to help them overcome those barriers, and help them find the motivation to achieve their housing goals. Sean Terry’s presentation Meeting the Housing and Employment Needs of Chronically Homeless Veterans provided an overview of strategies to overcome the multiple complex barriers chronically homeless Veterans face to help them achieve stable housing and employment.

The NECHV continues to be a leader in providing human services to Veterans in a way that recognizes their humanity and autonomy, offers a judgement-free setting in which to discuss treatment options, and keeps an avenue to recovery open, even if Veterans are not ready to take that step. By sharing their successes with other Veteran services organizations, the NECHV seeks to inspire a new way of care for Veterans nationwide.

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