Housing and healthcare go hand in hand. Our Assertive Community Treatment (ACT) team 
supports adults with severe and persistent mental illness, often after experiencing homelessness for years. Below is a glimpse into the work of one of our ACT team staff members, as told by Associate Director of Clinical Operations, Deana Perez.
It is 5:30 in the morning on a cold Chicago Friday morning. Nevertheless, our intrepid staff member bundles up and rides the blue line from the western suburbs and transfers to the redline, ending in Uptown. His riding buddies are the people he serves. These are people that have been forgotten and marginalized on the best of days, and blamed for their behavior on the worst.
Due to COVID and a general lack of space in shelters, the trains have become mobile havens for those without homes or a place to go. Even before his shift starts, staff listens to the needs and obstacles this participant has regarding nearly every aspect of engaging in community life.
It is 8:30am and the day begins, though effectively it started hours earlier. We review the team needs for the day in our half hour long daily scheduling meeting. It has been identified that a participant needs to be hospitalized. She is not eating, and not cashing her checks. She has been un-medicated for some time now and is in danger of losing her housing.
It is the team’s hope that we could elevate her to a higher level of care, but she refuses. The self-determination that we all enjoy means she, like all our participants, has a choice in her care. The steep decline and inability to care for self, means our staff must stand firm on the decision.
We take the time as a team to reflect on the gravity of that decision and agree it is time and it is in her best interest.
Staff and a partner go to the participant’s home. Her apartment door is open, she is nude with no obvious understanding of how vulnerable that makes her, and there is no food in the fridge. We call CPD and prepare for a coordinated response.
The staff waits until the officers arrive. The relationship we built with this CPD district pays off as the officers understand and wait while staff deescalates the participant. CPD transport the participant to the hospital, where staff will meet them.
The participant is accepted for hospitalization and the team will follow up at least 3 times a week, advocating for her physical and mental health needs.
It is 12pm.
Instead of lunch, staff starts a marathon of participant visits. One participant needs housing. A second needs help understanding why they have an oversized gas bill. A third is actively hallucinating, lying in the street.
And so goes the hurricane of support that is required from an ACT worker. There is no way to vet the needs, they just keep coming. Through the struggle of the day, the staff tries to be intentional, genuine and true to the people we serve.
And then, it is done. It is 4:30pm and the team comes together again for daily debrief. Catharsis, team, understanding is what they can find there. We review the day but more than that we come together in a shared understanding of how hard we work and that we are not alone.
And onward, to the next day.
