A footnote to the client profile in Audio Hallucinations in Homeless Outreach.
In the housing assessment, you need 12 points to qualify for permanent supportive housing, but despite John's history of incest, suicidal ideation, and audio hallucinations, he only scored a 10. A good case manager will tease details from a client's memory to raise their score ("You said your roommate threatened you with a knife?"), or flat out plead their case to higher-ups to gain prioritization, but often clients are left with a low score that precludes them from accessing services.
Let's go through it together. In the housing assessment, you earn a point if you:
-sleep outside (John points to his shack by the creek, +1)
-have been consistently homeless for a year or four or more episodes of homelessness adding up to 12 months over the last three years (John's memory is not great, but he says he's been outside for at least two years, +1)
-used emergency services four or more times in the last six months (John feels healthy and is crafty enough to know when the police are planning sweeps, and so manages to avoid hospitals and jail. No points.)
-have been attacked since becoming homeless, or threaten to harm themselves or others (John is an extreme recluse, which precludes any opportunity for fighting, and though the voices in his head are constantly telling him to jump off a bridge, he never tries. No points.)
-have any outstanding legal issues (No points)
-have been exploited by others since becoming homeless or engage in risky behavior with sex or drugs (John is sober and celibate. No points.)
-claim to owe money and/or receive zero income (John is penniless, +1)
-have no planned activities other than surviving (+1)
-are unable to take care of basic needs such as bathing, using a toilet, and finding clean water (+1)
-if their homelessness was caused by a relationship breaking down (this one's tricky, though he ran away from home as a kid due to incest, he still loves his brother and claims he would reconcile with the family if he had the chance. +1)
-if they have a history of physical disability (diabetes, +1)
-if they have a history of drugs or alcohol (No points)
-if they have a history of mental illness, a traumatic head injury, or learning disability (John has severe schizophrenia plus a developmental disability, +1)
-if they have tri-morbidity, which means they scored for physical health, substance abuse, and mental health (No points)
-if they don't take their meds or abuse/sell pain pills (he doesn't take the meds he ought to, +1)
-if their homelessness was caused by trauma (incest since age 9, +1)
The main issue with this test is that clients can be extremely vulnerable in one area (been incarcerated twenty times, smokes $100 of crack a day, has attempted suicide four times in the last year) but have it only count as one point. It's like the Joker's hygiene products, if they are not a little bit vulnerable in all the right areas, if they didn't combine the shampoo with the shaving cream with the underarm deodorant, they're not sick enough.