'I’D Be Dead Without It': Why Doctors Are Prescribing Housing As Health Care

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Alright, so here I am. Alright, here's my room. Come on in. This is my little slice of heaven. Every time I come home, I thank God for it. How does it feel being here? It feels good, it feels really good, you know I'm, it's so funny, I saw my sponsor, I was so excited to, um, uh, pay rent. [Laughter] Oh, I get all emotional, but um, yeah, because it's been so long since I've done that.

Dawnyell Gaddis says paying rent for her Portland apartment is a blessing. My dad always tells me how proud he is of me, and I know my mom would be proud if she is here, so, yeah.

A Journey from Darkness to Light

Just a few years ago, she was addicted to heroin and living under a tarp on the streets. She's here now because every step of her recovery came with a roof over her head. Well, this guy. Dr. Richard Bruno is a big reason why. He's seen me, my transformation, you know, he's been here through this journey with me, and it's a good feeling. It's a good feeling to have somebody who doesn't judge. "I'm always telling you I'm on your team," he does. You know this is the thing, we're in this together, we're working on this together. Gaddis' story is a bright light in a bleak landscape. And it's a long way from living in a tent, in a city full of them.

Along Portland's highways and streets, crushing poverty, addiction, illness, it's everywhere you look. It's obvious people living out here need care and they need homes. Getting people off the streets and providing housing as the most basic form of health care is happening here in Portland. It's not solving the problem, but it is saving lives. This is Blackburn Center, one of the 30 buildings run by Central City Concern, a non-profit agency determined to house the homeless. Absolutely, we think housing is health care and housing is life-saving. Bruno is the senior medical director of primary care for the agency. The center here offers wrap-around care and housing to the sick and the vulnerable who have nowhere to go.

A Healing Sanctuary

"I had a gentleman, who I saw the other day, who half of his foot was cut off after having frostbite, right, and um, he was discharged back to his tent, where he was on crutches and having to sort of walk through the snow...um, and his wound opened up and dehisced and unfortunately started to get infected, and so he came and saw us and we said, 'Where are you staying tonight?' and he said, 'I'm going to go back to my tent,' and I said no, no, no, let's get you indoors, my friend, and we were able to get him into the recuperative care program. The healing from illness or addiction begins here, and so does a health plan that always includes a place to live.

So this is a great example of a room here at our Blackburn Center. It can be sometimes a first stop for people on the road to recovery. And they're getting care? Like are there nurses attending to them? Yes, we get a plan for the day, whether that includes going to a specialist visit or going to see one of the doctors downstairs or any of our other services that exist across our agency, and we help them get a plan for transitional housing when they're ready and safe to discharge. How are you doing? "I'm doing well."

A Journey to Recovery

Bruno's team helped Gaddis get into transitional housing when she was ready; she walked in off the streets to a clinic in another of the agency's buildings and was immediately offered a spot in an in-house detox program. So where are we heading? "Okay. 619 that's my room. Yeah?" Apartment 619 became her safe place to keep recovering when she was drug-free. But in order to stay here, you have to participate in EAC, which is the Employment Access Center, the outpatient treatment, and usually, it's only a nine-month program but I was here for 17 months, yeah, because I really, I really didn't want to leave actually, to be honest with you. It's kind of scary because it's been a while since I've been on my own.

She was scared, but she had support every step of the way. "And this is it right here. This is mine. Yeah. I used to have my name right there, and my own little saying right there, yeah. You know, I had a really, really good childhood. I had a two-parent home. Parents were really involved in what we did. I was never abused, you know, none of that. I'm the only addict." Gaddis says her addiction only deepened when her mother died. "I never ever experienced homelessness, and it was, uh, it was really bad." What was it like? "Um, depressing, really lonely, you know, I ended up in a tent, like down the street from my childhood home like literally, and I understood honestly, what that's about, I don't know, if I felt like that will make me feel closer to my mom, maybe because I would walk by that house like every day. And so I want people to know that we're not bad people, we just made bad choices, and if you work hard enough, you can turn your life around and live a life that you deserve."

Housing as a Lifeline

And how important was housing for that? "Oh god, it was really important; it really helped save my life. I was in a housing program straight out of treatment." Emily Fox says she wouldn't be here either if she didn't get the same help. She lived on the streets for five years. "How hard was it for you to be healthy when you didn't have a place to call home?" "I couldn't have done it without the housing, like without the housing in place, like I it's impossible that I could have gone to treatment for four months and had that amount of time and then went back outside to a tent and like sustained my sobriety or my recovery, just, it just wouldn't, it just doesn't work."

Housing helped Fox rebuild her life. She works here now offering the same compassion that saved her. "Every day I'm just like in awe that I work with like such absolute angels because you know we see a lot of hardship, and a lot of struggle and like, everybody's always so kind." When you see people coming in, in need, does it remind you of you? "Yeah. 100 percent." And what do you see when you see those people? "Hope. I can be like I was actually like literally just like that, and um, you know, with the right support and the right care, like, you can come back from that."

Restoring Dignity, One Person at a Time

From Bruno, so much of his work is about restoring people's dignity in the face of so much inhumanity. "But I know they didn't get her into a wheelchair and see how she's going to get from her wheelchair down to her sleeping

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'I’d be dead without it': Why doctors are prescribing housing as health care
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