(Editor's note: The week of October 5-11 is being recognized by the state of Kansas as Mental Illness Awareness Week. This release is part of a statewide effort to increase public awareness about mental illness and to examine efforts being made to provide assistance to people with this often-stigmatized disease.)

Often, they are the most difficult people to help, people who are homeless and mentally ill. According to the director of a project attempting to bring assistance, many people who fit these categories strongly resist any assistance offered.

But Access to Community Care and Effective Services and Supports -- ACCESS -- is succeeding. To date, over 700 homeless people with mental illness who live in Wichita or Topeka have found various kinds of support, including housing and medical care, during the first three and one-half years of the project.

Begun in 1994, ACCESS is a nine-state, five-year federal demonstration project funded by the Center for Mental Health Services (CMHS). Fran Randolph, national director of ACCESS, called Kansas "one of our stars."

"Wichita has been a model of strategic planning; we have used them to provide technical support at other sites," Randolph said. "And Topeka did a lot of case management on bicycles. Both sites have provided good, quality services."

The goal of the ACCESS project is to enhance services to persons with mental illness who are homeless and to show how collaboration among agencies helps this process. The project receives about $1.9 million a year and is administered by the Kansas Department of Social and Rehabilitation Services' Mental Health and Developmental Disabilities Commission.

With this funding, both Topeka -- through Shawnee Community Mental Health Center -- and Wichita -- through Comprehensive Community Care of Sedgwick County (COMCARE) -- provide outreach and case management to persons with mental illness who are homeless. In Wichita, funding is also being provided to integrate services with other agencies; a major goal of the national project is to demonstrate how integration with other agencies improves services to homeless persons with mental illness. COMCARE has developed on-going partnerships with substance abuse centers, housing agencies, health care agencies, and income support programs. They have also a safe haven, which provides homeless people with mental illness a secure place to stay.

Randolph said ACCESS caseworkers work with an "incredibly resistant population; folks who have traditionally opposed the mental health system."

But she said the success being shown with the project has shown "it is possible to engage them and develop a relationship with them. Both Topeka and Wichita have improved outcomes in a lot of ways. They are getting housing. They are getting substance abuse treatment and there is a reduction in substance abuse."

ACCESS outcomes compiled by the Psychology Department at Wichita State University show the successes being registered by the program. Begun in 1994, 712 persons have enrolled in ACCESS, each for one year. At the end of the one year enrollment, 75 percent of these people have moved from the streets into stable housing. Outcomes also show a lessening in the symptoms of mental illness for persons who go through the ACCESS program.

Wichita State also measured the level of illness among the people case managers are working with in ACCESS. Consumers who agree to enter the ACCESS program also agree to meet with evaluators both before entering the program and after they leave. The also are evaluated by a medical specialist to determine their mental status as they enter the program.

Almost half the people in the program were diagnosed with schizophrenia, while the rest had bi-polar disease or another severe disorder, Wichita State reported. On average, people entering the program have had eight instances of homelessness in their lives. They also averaged 18 months of psychiatric hospitalization prior to joining ACCESS.

So how do case managers work with people who face this degree of difficulty in their daily lives? According to a description by one ACCESS case manager in Topeka who now is a team leader in the project, it's a matter of building trust.

"You go by and say hi, trying to build up trust," said Doug Wallace. "We bring them a cup of coffee and we do give out blankets in the winter. I try to respect the person's space; when I go into a campsite, I ask if it's OK if I come in and talk with them. I treat that as their home and try to be respectful of their privacy."

With two years left on the federal grant, SRS is looking for alternative funding sources to continue the program. Dr. Hugh Sage, commissioner of Mental Health and Developmental Disabilities, said there is an obvious need, not only in Wichita and Topeka, but in other areas of the state, including Kansas City.

"The ACCESS project has demonstrated that there are hundreds of homeless people with severe mental illness who need and will accept the help that solid case management and agency integration bring," Sage said.

Page Last Updated: May 29, 2001