HOPE Cooperative's Personalized Plans Work to Improve Mental Health and Reduce Homelessness.

What if we could see homelessness not just as a social issue but as a deeply personal journey? In this episode, I sit down with Dr. Christina Bilyeu, Chief of Mental Health Services, The Permanente Medical Group, and President of the board at HOPE Cooperative, to explore the layers of homelessness in Sacramento. Dr. Bilyeu shares moving insights from her own family’s struggles with housing insecurity, revealing how these experiences have shaped her commitment to addressing this critical issue. We dissect the intertwined factors of mental health, substance use disorders, and economic instability that perpetuate chronic homelessness, especially in the post-pandemic landscape.

Dr. Bilyeu takes us through the essential stages of helping those experiencing homelessness transition to stability and independence. We uncover the significance of building trust and rapport, which form the bedrock of effective outreach and support. From there, we delve into the impact of family support and the complexities of mending strained relationships. For those grappling with severe mental illness or long-term substance abuse, persistent outreach and respect for their choices emerge as key themes. Dr. Bilyeu’s approach humanizes the often-misunderstood struggles of the homeless, bringing compassion and hope to the forefront of the conversation.

Our discussion culminates in the vital role of community support and collaboration in tackling homelessness. Dr. Bilyeu highlights how a unified effort involving healthcare providers, local businesses, law enforcement, and community leaders can create a robust support system. We also delve into the importance of education and relationship-building in promoting medication adherence among the homeless with mental health issues. This episode underscores that addressing homelessness goes beyond housing solutions; it requires behavioral and mental health improvements, with organizations like HOPE Cooperative leading the charge. Don't miss this profound exploration of one of society’s most pressing challenges.
You can learn more about HOPE Cooperative on their website by visiting: https://hopecoop.org/

To get details for the annual fundraising event and comedy show on October 18th, visit: https://www.eventbrite.com/e/stand-up-sacramento-tickets-836555699617?aff=oddtdtcreator

(00:00) Mental Health and Homelessness Support
Dr. Bilyeu discusses chronic homelessness, its causes, and the importance of treating individuals holistically.

(15:05) Building Trust and Empowering Change
Building trust, family support, and persistent outreach are crucial in helping individuals transition out of homelessness.

(23:26) Building Community Support and Collaboration
Homelessness, choice, medication, trust, education, relationship-building, collaboration, support, and solutions are discussed.

(37:01) Community Efforts to Address Homelessness
Homelessness, mental health, and community involvement are crucial in addressing the ongoing crisis. HOPE Cooperative and upcoming event on Oct 18th are making strides.

Thank you so much for listening! We appreciate you. Please visit the website to sign up for our email updates. https://www.nonprofpod.com/ And if you like, leave me a voicemail to comment on the program, leave a question for us to ask in the future or a message for me, Jeff Holden. I may even use your voice mail message in a future episode. https://www.nonprofpod.com/voicemail. Thanks again for your support in listening, commenting and sharing the great work our local nonprofits are accomplishing.

Transcript

Dr. Bilyeu: [00:00:00] This is not a one size fits all solution. And while there are a lot of things that will be true for a lot of our unhoused population, we still have to make sure that just like when I see patients in my office or I see patients in the emergency department, like I know that there's a medication. that has worked for hundreds of patients that I have treated, but I still have to treat that person as an individual because they might not react the same way to that medication.

And so if I just take this approach that, well, everybody with, you know, depression is going to get this medication and this medication only, and this type of therapy and this type of therapy only. I'm doing them a disservice.

Jeff Holden: I'm Jeff Holden. Welcome to the Nonprofit Podcast [00:01:00] Network. Our purpose and passion is to highlight a nonprofit organization in each weekly episode, giving that organization an opportunity to tell their story in their words, to better inform and educate the respective communities they serve, as well as provide one more tool for them to share their message to constituents and donors.

Our goal is to help build stronger communities through shared voices and to both encourage and support the growth of local non profit organizations through podcasting. Thanks to our founding partners for their foresight in helping us transform the way conversations start. CAPTRUST fiduciary advice for endowments and foundations.

Runyan Saltzman Incorporated, RSE, marketing, advertising and Public Relations, creating integrated communications committed to improving lives and Western Health Advantage, a full service healthcare plan for individuals, employer groups, and families. Before the episode begins, I wanna take a minute [00:02:00] to share that.

We now have a website where you can sign up to get our weekly email updates on the latest episodes, transcripts to prior episodes. And see what else we have going on. Please be sure to register so you never miss an episode or any other important information we may have to share in the nonprofit space.

You can find us now at nonprofpod. com. That's nonprofpod. com. You'll also notice on the website, a microphone in the lower right hand corner. By clicking on it, you'll be able to leave me voicemail messages, maybe a question you'd like me to ask our guests. Or just a comment on the program. I may even play your message in an upcoming episode.

I look forward to more engagement with you as we continue to grow and better serve our nonprofit community. Thanks. We're going to do something a bit differently today as a discussion on homelessness presented an opportunity. You may have heard our episode on the non profit organization, Hope Cooperative.

They serve our unhoused population with a variety of programs, and [00:03:00] we've seen the interest in this topic played out in the activity on that episode. We're going to take a tangent to explore the complex intersection of mental health, and housing insecurity by talking about the psychiatric struggles faced by the chronically homeless.

That's a part of the organization's DNA. Living without stable housing doesn't just present physical challenges. It also exacerbates and sometimes causes significant mental health issues. Are there psychiatric conditions that disproportionately affect the homeless population, like severe depression, schizophrenia, and substance use disorders?

We'll talk about the underlying causes How the lack of consistent care worsens these conditions and the systemic barriers that make treatment so difficult for this vulnerable group. My guest is the president of the board of Hope Cooperative, who just happens to also be a psychiatrist. Dr. Christina Ballou is chief of mental health services for the Permanente Medical Group.

She earned her undergrad from Duke University and she completed her medical [00:04:00] school and residency at the University of Florida College of Medicine. Her accomplishments and accolades in the field of psychiatry are many, and she has been with Kaiser Permanente since 2015. She enjoys all things Disney. is an animal lover with dogs, cats, and a gecko, as well as a devoted sports fan.

Welcome Dr. Christina Balu to the Nonprofit Podcast Network. 

Dr. Bilyeu: Thank you so much for having me. 

Jeff Holden: Dr. Balu. This is a little different approach with our program and it comes as a result of what I see in the interest in various. Uh, topics and episodes, our original Hope Cooperative episode gets a lot of attention.

And it's no surprise, the discussion is all about the efforts of the organization to support those experiencing homelessness, which, obviously, is a huge topic of conversation, not only in Sacramento but around the country. You're the president of the board as well as a respected psychiatrist and chief of mental health services at Kaiser Permanente in Sacramento.

When the opportunity presented itself to speak with you for an episode, I couldn't deny [00:05:00] the privilege just because of the essence of the topic and the nature to speak with a psychiatrist who's going to be able to answer some questions, and I think we all have. So before we go deep on the topic, would you please share with us what led you to take your skill set and apply it to the homeless in our region?

Dr. Bilyeu: So it was a very personal reason. Both I have had members of my family experience homelessness and housing insecurity, and so it was a very, when I had the opportunity, when I was, when I first met Erin Johansen, the previous CEO of Hope Cooperative, she said, Hey, I think I, I think you might like to get involved with this organization.

And I jumped at the chance and just the work that Hope Cooperative does in the community is. It's amazing in terms of, you know, serving over 10, 000 clients a year. It's absolutely amazing what they're able to do in our community here in Sacramento. 

Jeff Holden: There was a recent point in time report for the homeless population.

It reported around [00:06:00] 6, 500 people experiencing homelessness in the region. Not all are permanent and many are situational. But we still have the largest percentage in those data points at 45 percent as chronically homeless. And that's where I want to spend the bulk of this conversation because those are the people who need the most attention, the most help.

Would you share your observation both on that number and what it is you've seen over time? 

Dr. Bilyeu: Yeah, well, we've seen that number grow over time. I moved to California about nine years ago, and I've definitely seen that change over, over the past almost decade. And I think As we look at why is this number growing, what does that look like?

I think we, we definitely saw an increase after COVID and during the pandemic with people losing work and not really not being able to stabilize after that. And like you said, there are some that are chronically homeless, that 45%. And I think there are a lot of factors that go into [00:07:00] that number, whether that's underlying mental health diagnoses, substance use.

Just not being able to get out of that poverty gap. I think that those are just a few of the factors that go into that number. 

Jeff Holden: As we talk about that substance use disorder and the, the mental health issues, it's six of one, half a dozen of the other, which started first, which caused the homelessness. What is it that you see?

Where, where do you start when you start to analyze the mental health and well being of somebody who is chronically homeless? 

Dr. Bilyeu: So the first thing you're doing is making sure that you're seeing that person as an individual, not necessarily as an unhoused person or a person with mental health or substance use issues, but really you're seeing them as a human being, just like you would want somebody to see you.

And so. We're trying to get at what is the root of the issue. If that's mental [00:08:00] health, undiagnosed mental health or untreated mental health, can we get them into treatment? If that's substance use, can we get them into treatment? And do they want to be in treatment? Those are also two of the things that we have to ensure.

And then what led them to become unhoused? Were they not able to find affordable housing? Were they not able to continue to work in an environment that would let them continue to live independently. So, again, looking at multiple factors of that whole person, and what may have led to their, to their homelessness.

Jeff Holden: Let's talk a little bit more about that mental health versus substance abuse disorder. And again, it's hard to say what triggers the homelessness part of it, but in layman's terms, and I'll say that just from my own perspective, you know, you see somebody on the side of the road, you know, that they've got an issue and you know, that it's both mental health, mental wellness and substance use disorder.

Uh, how do you see that in the [00:09:00] people that you treat? What do you see first as that individual comes in? Do you look at them as somebody who's got a substance use problem that's maybe insurmountable, has now caused them into homelessness? Or is it the mental health disorder that led them to the substance abuse disorder?

Dr. Bilyeu: Yeah, I think it's really what, with what I see, it's really what are they presenting with in that moment? So I do a lot of work in the emergency department. Are they presenting as psychotics. Are they having trouble with reality testing in terms of what's real and what's not real? Are they having difficulty with providing for their basic needs?

So food, clothing, obviously shelters if they're unhoused. And we do see that those go hand in hand. We often see people that come in psychotic after they've used a substance or after chronic use of substances. And so we really have to be able to treat the uh, sequelae or the, the result of that substance use in [00:10:00] terms of their mental health to be able to get to a point where they are able to fully engage in a conversation around how can we best help you.

They really often go hand in hand and sometimes it can be really difficult to parse out. Which is which and, and what came first, but at the end of the day, making sure that we're treating what we see in front of us to make sure that that person can get what they need to be successful. 

Jeff Holden: As you look at it over years of experience and having dealt with, I'm sure, some of the most severe both mental illness and substance abuse situations and individuals experiencing both, what are you finding is maybe a best solution or a best practices?

That at least moves that, you know, that person, those individuals forward from their homelessness situation. 

Dr. Bilyeu: So really it's, it's wraparound care, right? So it's not just [00:11:00] providing them with shelter or providing them with a home. It's not just taking care of their mental health. It's not just addressing the substance use issues.

It's possibly all three of those things, and it's also, it's bigger than the individual and looking at the institutional practices and things that systemically might be. contributing to them being, to them being unhoused. And so really it's a, it's a full spectrum approach when we're, we're thinking about how can we help someone that is unhoused, that might be suffering with untreated mental health and substance use issues.

You have to make sure that you're caring for that whole person. And also, you know, I, I can't express enough how important it is also to make sure we're taking care of their physical health. Because that is another reason that, that people become unhoused. You know, maybe they have an injury at work or something happens and they're not able to work.

Or they're not able to [00:12:00] continue to climb the stairs of their apartment. So there are a lot of factors to making sure that we're taking care of their physical health as well. Because that can also contribute to untreated or undertreated mental health symptoms. 

Jeff Holden: Well, and I'm sure hand in hand goes food insecurity.

Because now they have no place to eat. and then the next thing you know, they have nothing to eat and that cascade of negative situations just keeps coming and coming and coming and then what the heck, why not, you know, just, just, continue the, the substance abuse and, and really have a bad situation. In that point in time report, if I read it correctly, it looks like there are about as many beds in shelters as there are homeless in the community, which you want to scratch your head and go, wait, there's a place for everybody.

Why are there so many people on the street? Again, back to your experience, why, why can't we get them into shelter when there seems to be enough shelter [00:13:00] overall in the community? 

Dr. Bilyeu: Multifactorial reasons, so they're, you know, the thing that I hear the most and the thing that I see the most is safety. Am I going to be safe?

Are the things that I have accumulated, are my belongings going to be safe if I leave the shelter to go look for work or to go to work? Will I be able to come back to the shelter if I leave, like if I have to work? The only work that I could find was overnight and the shelter closes its doors at 11. Am I going to get kicked out because I was out working?

Again, am I personally going to be safe? Am I going to be able to sleep through the night and And know that you know, I'm not going to get assaulted or anything that I can be safe And so I think safety is one of the biggest things and also There are communities in our unhoused population and they have established a safety net in, in that population and, and amongst friends or acquaintances [00:14:00] that they've met and so they trust those individuals more sometimes than they trust the system that they feel has placed them in the situation where they become unhoused.

Jeff Holden: It's interesting because that's where I was going to go with it, thinking, wait a minute, you're, you're explaining this backwards. The shelter is the safe place. This is the haven, the point of respite where they can get, yet they choose the neighborhood, let's say, that they're familiar with. And in fact, that is the case, which I would never, never have expected, but I understand that differently now.

Dr. Bilyeu: I've had patients both in the emergency department and in my outpatient practice tell me, I just felt safer living in my car or I felt safer living with three or four other people on the street because I knew that they would have my back and I knew that they would protect me. And there's also something to just be said about that community and having.

that, that sense of support that could [00:15:00] sometimes be taken away if you're moving into a shelter type situation. And so that's another thing that we have to look at is how are we supporting people when we're moving them from an unhoused situation to a housed situation. 

Jeff Holden: That leads in to the next question is they have the ability to get into possibly a housed depending on I would imagine their mental health status and their sobriety based on most of the institutions and or residences that I've seen.

That's, that's a significant part of it. Again, in your experience of that 45 percent that we know are chronically homeless, what do you think in terms of a percentage might be capable of getting to the point of shelter and independent living again? 

Dr. Bilyeu: Oh, that's a hard question. I think if we look at, if we look at some of the factors that have caused them to be chronically unhoused, I think I would [00:16:00] probably say maybe 25 to 30 percent of those.

So a big chunk of folks that could benefit from supported housing, that would include mental health treatment, substance use treatment, and, and really just. life skills. That's some, some of that is part of that. I had, I had a young man tell me once that he was homeless and he had gotten, had the opportunity to get a housing voucher and he got put into a brand new apartment and he was like, that was great.

But I didn't know how to take care of myself and so three months down the line he wound up being Unhoused again because he had no support and hadn't learned how to care for himself and so he added to that, you know that 45 percent of the of the chronically homeless because we didn't serve him as well as we could have.

Jeff Holden: I know the hospital systems and certainly Kaiser Permanente in our region are wonderful in [00:17:00] terms of addressing to the best of their capabilities those in need with mental health issues and substance abuse disorders and Hope Cooperative is an incredible organization to the point of that story you just shared on the website.

There are some really good stories of people who have been in this situation who are now integrated back into society with sobriety with housing and, and with an income and I think a sense of pride and accomplishment and confidence that they can do what they need to do to stay sober and, and stay in a good situation.

What does that transition look like for somebody Who's moving through the process. They come into an organization not unlike HOPE and you are monitoring and working with them all the way through. And I'm saying this again from a clinical perspective as a psychiatrist. How do you see those shifts in stages in [00:18:00] their mind?

How does that work? How does it look to you? 

Dr. Bilyeu: Yeah. So the first stage is, can I trust you? Right. And can I trust that you're going to do what you say? And can I, can I just trust you at face value? And once you're able to establish that trust and that rapport and really back that up with the support that they need, what you start to see is a building of confidence.

Really, it's, it's one of the reasons I love that Hope is named Hope, because it's a building of that hope that they have, that they begin to see, like, what things are possible. And so, it starts to look like them taking their medications. 10 days of sobriety, 30 days of sobriety, them showing you their sobriety chips for the months.

It looks like them going to therapy, them showing up for community events within the organization, or coming to a wellness center. [00:19:00] And then it, it starts to look like them, if they're able bodied, able to work, then going to therapy. to look for work or using the resources that are available to them. Hope has, they have a center where folks can come, they can work on their resume and they need to send it out, you know, apply for jobs, they, they can do those things.

And so it starts to step wise look like them becoming more and more independent, but still having a lot of support to get to that place. And then obviously, eventually it's. It's them being fully independent, whether that's, you know, fully independent and working and maintaining their housing, but also knowing that there's still support and, and backup and that these things that they've learned through therapy and substance use counseling and, you know, medication management for their mental health, like all of those things, all of those pieces need to continue for you to be able to maintain.

this [00:20:00] stability and really helping them to understand that. And, and a lot of people do understand that it's just helping them to take that first step or few steps to, to get to that point. 

Jeff Holden: Do you find that there's a, a trigger point for those who are really seriously interested in getting off the street and doing what they can to end their homelessness.

Is there something that you see that's a common thread over the course of many cases that you've worked with? that is the cause, the catalyst that they say, I've got to change this lifestyle. 

Dr. Bilyeu: Yeah, I think the most common thread that I see is consistency in the outreach. So if I am unhoused and living on the street, and I have somebody that every week is coming, bringing water, fresh towels, whatever that may be, and I'm [00:21:00] seeing that same organization, and I'm seeing that, that same few people and they're telling me, we can help you.

And they're consistent in their outreach. That is the most common thread that I see when people actually respond because the individual reasons that people decide to seek out help, that could be a medical illness. It could be, they're just, they're tired of continuing to live that way. Maybe, Their family said, we will, we'll help support you if you do X, Y, and Z.

But that consistent outreach is the, has been the biggest thing that I've seen where people said, again, it's about building that trust and building that rapport. Like, I think I can trust these, I think I can trust these people and I'm going to give it a shot. 

Jeff Holden: You mentioned family. How many of the people do you think that you see actually have family that is either around or that they're aware of or that's caring, considerate, [00:22:00] concerned?

Dr. Bilyeu: I think there are quite a few that have families that are that are concerned, but also are feeling a bit burnt out in terms of chronic substance use, not getting treat treatment for their mental health. And so they've put up some boundaries for the for themselves. And so it's again, those, if you can demonstrate to me that you're serious about getting help and consistently staying sober or, and sticking with your mental health treatment, then I would be able to help you.

help and support you in these ways and help looks a little bit differently for everybody. And sometimes it's just that, yes, you can call me and let me know how you're doing versus I'm going to give you money for an apartment and then, but with still without that support. So really trying to help them in different ways, but we do see a lot of.

folks come in that have families, but they aren't necessarily getting the support that they could, and that some of that is because [00:23:00] some past behavior. 

Jeff Holden: And I can see some generational issues there as well over the course of time with families. And then on the flip side of it, I can see frustration and dismissal.

At some point, you've done so much and tried so hard. You just, as the family member, give up or member. Right. And so we can't. There's nothing we can do. And in some cases, that's true. With regard to those on the other percentage, the ones who really, we're not going to benefit them by care and process. They just aren't going to get there.

Either the mental illness is too severe. The substance abuse has been It's been too long and it's, it's permanently damaged them. What do you think at this point in time is a best case? What, what do we do to care for those people so that they're not on the street? 

Dr. Bilyeu: Yeah, I think it goes back to again, how are we building that relationship with that person?

Are they going to be looking for us when, um, every Tuesday because that they know that that's [00:24:00] when the organization comes. And I think some of it is just continuing to work with the population and not, not giving up. But there will be people that, like you said, because of their mental health or because of substance use or because for whatever reason they've chosen that they're going to stay unhoused.

And so. We have to be respectful of that and know that if we've done, we've truly have done all that we can, we can continue that consistent outreach. And maybe one day they'll change their minds and they'll, they'll say, yes, I I'm ready to get some help, but it's just important to continue to foster those relationships and build that community trust.

Jeff Holden: We'll be back with more from Dr. Christina Ballou right after this message from the people who make the program possible. I was in the media business for over 35 years and had the great privilege of working with Runyon Saltzman RSE, Marketing, Advertising, and Public Relations. We [00:25:00] collaborated on many different campaigns, but their commitment to the non profit sector hasn't changed since their founder Gene Runyon started the agency.

Over many years and many campaigns, Runyon Saltzman has been committed to improving lives by tackling California's most challenging issues. Guided by research informed strategies and insightful, creative solutions, RSE develops innovative communications campaigns that raise awareness, educate, and reduce stigma in diverse communities throughout our state and beyond.

To learn more about RSE, visit rs e. com. 

Scott Thomas: Hello, this is Scott Thomas with CAP Trust in our Sacramento office. I specialize in working with local nonprofits and associations. Annually, we survey private and public nonprofit organizations across the country to better understand challenges they see in today's environment.

In our more recent survey, we heard concerns about proper board governance, mission aligned investment, and how to implement alternative investments. [00:26:00] If you would like a copy of the survey or to discuss your organization, look me up, scottthomasatcaptrust. com. 

Jeff Holden: I'm thrilled to have Western Health Advantage partnering with us as they do so much to support so many non profit agencies in our community.

As a truly local health plan, you'll find individual and family options, employer options, plans for CalPERS and Medicare Advantage. From medical services to pharmacy, health and wellness support, as well as behavioral health care, Western Health Advantage has a plan that fits what you need. As an employer for profit or non profit business.

individual or family. You can find more at westernhealth. com. You have a wonderful perspective because I haven't heard you say give up on anybody yet. You say someday they may, they will, or might choose. And choice is the word I wanted to drill down a little bit more on. Do they see the [00:27:00] option of choice, that it is their choice, that there is something that they could choose to do for those that you speak with in those moments of sobriety or where they're, they're lucid enough.

Over time, I understand building that relationship. Do the majority of the homeless people you deal with recognize that this is a choice, that they do have a choice? 

Dr. Bilyeu: Yeah, they do. Their next question is, well, how can I get help and how can that be consistent? And so, they do recognize that some of the choices that they've made have led To the, the point that they're unhoused, but also there are also people that are unhoused that, you know, were previously living paycheck to paycheck and they lost their job and now they're unhoused.

And so it's, it's about, again, looking at the individual and saying, how can we help you in terms of. Not necessarily you and the person sitting next to you, but how can we help [00:28:00] you to, to make sure that you understand what your options are and what choices you do have to make. And I think that's where the conversation can start.

Jeff Holden: That's the most encouraging part of all of this from my perspective and certainly the circle of people that I talk with and we share the situation and the concepts and ideas. But to hear that those individuals do have an interest and when you build that trust, there's enough of a conversation to say that yes, there still is an opportunity for you to break this cycle of homelessness and move beyond.

And in terms of medication, as a psychiatrist, obviously you deal with. A variety of options for people to help themselves. And sometimes they choose not to take the medication. As you are working with them and they are using their medication properly, what is the process you use to keep them engaged in the medication?

Because we hear so many times, I just went [00:29:00] off my meds and the next thing you know there's a psychotic event. How does that work? 

Dr. Bilyeu: Oftentimes we'll hear, I was doing so well and so, you know, I didn't think I needed them anymore. So really doing up front a lot of education with the patients about this is why we want you to take your medications.

This is why it's important. And then if they do stop taking their medications, not coming from a punitive standpoint, well, if you had continued to take your medications, This wouldn't have happened, right? But really re engaging them around, okay, so this was a setback. Let's get you back on your medications.

And, and it's okay to use that period of time to say, remember what happened the last time you went off your meds? We don't want that to happen again. But really doing a lot of education at the beginning, making sure that they're tolerating their medications, okay? And addressing side effects and, an appropriate amount of time so that they will want to stay on their medications and then making sure [00:30:00] that they are able to continue to take their medications and afford their medications and have access to that follow up care.

I think those are the things that are essential to making sure that, that folks stay engaged in that, that medication management piece. 

Jeff Holden: Magic wand situation, you have all the resources you need to address the community, the homeless community. What would be the key steps you would take? 

Dr. Bilyeu: Give me the keys to the city.

Um, you know, right. , you know, I think the first step is making sure that we have the infrastructure. in place, right? So we have the resources that we need. And then how are we letting the community know? How are we letting our unhoused population know that these are the resources available? There's, there are housing, mental health, physical health, substance use.

Helping you with social, the social determinants of health, employment [00:31:00] help. It's going to be a little bit different approach for each individual, but really looking at what do you need first in terms of do you need housing first? Or do you need, do we need to address your mental health? Do we need, do you trust us to address your mental health?

And again, so I know I've said it a lot, but going back to that relationship building is really, really important. 

Jeff Holden: Yeah, you've stressed that a lot in the conversation and I understand that. Once you've built that trust, it's unlikely that trust would be violated. It's more likely they would shift somewhere along the line and realize, okay, you're still here.

It was me that went off the rails a little bit, but you're still here. And I would imagine those bonds only increase over time as you get to know more and more of the individual. You mentioned hope and it's such a key word for everybody because if a situation becomes hopeless. We know that that is a, a deteriorating both mentally, physically, and emotionally when people lose [00:32:00] hope completely.

And obviously it leads to, to so many other, so many other issues that are of no benefit to the community at all. But keeping that hope alive is something that you're doing on a regular basis through this trust process. Do you find that there are other organizations, or maybe better phrased, what other organizations do you work with in collaboration?

to keep things in a hopeful situation for the individuals. Because obviously you can't do it alone. The healthcare system can't do it alone. Hope Cooperative alone can't do it. Who do you see that works a lot with you in the, the support of the homeless process to get them engaged? 

Dr. Bilyeu: Yeah, so it's really about, it's a whole community approach, right?

So organizations like Hope Cooperative, obviously the, the medical system, and then, you know, your local community leaders that are seeing the unhoused population grow and want to do something to make a difference, want to do something to help their fellow [00:33:00] community member. So it's really a, an all hands on deck approach that like you said, not, there's not one entity that can, if I had a magic wand, we would be done.

We wouldn't be having this conversation, but it is, like I said, an all hands on deck approach where we can say as a community, as local leaders. Whether that's local leaders in our, you know, our legislators, law enforcement, local business owners, the medical system, all of those folks coming together to say, we recognize that this is a problem.

This is how we're going to work together to solve it. 

Jeff Holden: Yeah. And to the point of recognition, I think everybody's got that. They do understand it. They see it. It appears that we might be getting some traction. in the right places. But that's why it was so important for me to want to have a conversation with you from the mental health perspective of the individual.

For the many of us who might look and just say, that just needs to get swept off the street. And, and that's not [00:34:00] the case. These are individuals, these are human beings, these are people who have issues that if addressed appropriately, maybe can become productive members of society again. And we know there's some that are not, but we can address that about a lot easier when it's not an overwhelming number.

The element of housing that Hope Cooperative provides, I think, is beyond what most people recognize in a variety of different ways, from those who are in the greatest need all the way to those who are looking for low income housing as they start their re entry into the workforce. And while that's not the context of this conversation, I don't want to not address that.

We have a new Executive director and CEO, they're in April Ludwig who, we will reach out to and have on a future episode because Aaron Johanson was last and that was over a year ago. And the significance of people that are interested in that episode from beyond Sacramento is large. So we know that there's a lot of interest.

in what it is you're doing. And so [00:35:00] as, as a board and for the team at Hope Cooperative, we applaud what you're doing. What is the best way for somebody to reach out to Hope if they want to find out more information? 

Dr. Bilyeu: Yeah. So Hope Cooperative is active. Social media is such a big thing nowadays. Hope Cooperative is active on all social media platforms.

So you could send a direct message that way. You could also. Reach out by calling. We host an annual event every year and this, this year's event is coming up soon next month and October 18th. It's a comedy show. It's a good time, but really it's a wonderful opportunity for our community members to see the work and put.

Faces the faces of hope to what, what is happening in our community and the work that Hope Cooperative is doing in the community, it's our annual fundraising event, and it's really a time where our community members that want to help. That again, that recognize the problem and see that, that this is what's happening and [00:36:00] want to have a heart to help.

That is a wonderful way for them to one, be introduced to Hope Cooperative and to, for them to. Assist in the cause of making sure that we are able to continue the services and continue to provide services for those over 10, 000 clients and the 500 units that we have of housing, of supported housing, all of those things that The things that we are really, really important to making a dent and making a difference in this ongoing unhoused crisis.

Jeff Holden: And to your point, I will, uh, I will put in the show notes a link to not only the website for the organization, but also for the event because it is an annual event. It happens every year at this point in time. It's interesting that you take a perspective of humor to address the situation. And, and I think part of that in so many ways, if we look at things from a.

It really opens our eyes because it disarms us and it lets us see things for the reality of, of what they really [00:37:00] are. And there is no better way than, than humor, at least to break down the barrier to get started for the significant conversation that is about to take place. Dr. Blue, I can't thank you enough for giving us the layman, a more clinical look at what takes place in the minds of those challenged with homelessness.

I'm shocked at some of that. And I really did not know, and I think it's going to help. People understand a little bit differently. Sometimes the shelter isn't the answer. 

Dr. Bilyeu: Yeah, if you think about like, some of the reasons why people are, are unhoused. If you have someone that was running from a domestic violence situation, right?

And they go into a shelter and they get assaulted. Like, that's not something that they're ever going to want to go back to. And so it's really just so, so important to have that individual conversation with if this is not a one size fits all solution. And while there are a lot of things that will be true for a lot of our unhoused population, we [00:38:00] still have to make sure that just like when I see patients in my office or I see patients in the emergency department, I know that there's a medication that has worked for hundreds of patients that I have treated, but I still have to treat that person as an individual because they might not react the same way to that medication.

And so if I just take this approach that. Well, everybody with depression is going to get this medication and this medication only and this type of therapy and this type of therapy only. I'm doing them a disservice. And so I have to get to the root of the why and then go from there. 

Jeff Holden: That's why you're so good at what you do.

That was wonderfully worded. And I think that is so, so true because it's the individual and everybody's genetic makeup, their anatomical makeup, their chemical makeup is different. So that drug will work differently on one person than it does the other. And there is not a one size fits all, sadly. I mean, wouldn't that be an easy [00:39:00] solution, huh?

Yeah. 

Dr. Bilyeu: Right. Yeah. 

Jeff Holden: Well, thank you so much. I appreciate your time. And it's not only that you're giving us a better understanding of the steps that are being taken toward remedy to reducing the homeless population, but things that we as individuals can also do. And that behavioral and mental health improvement for those people is far more critical and necessary than just building facilities to house them.

I had no idea that the shelters might be a bigger concern for them. So, thank you for your commitment to aid. So many in this situation and for your efforts on the board of Hope Cooperative, you and your fellow board members and, and the team at Hope and everybody involved in the organization, you're making so much progress to help reduce homelessness.

And we're most grateful for that contribution to our community. So thank you. 

Dr. Bilyeu: Thank you so much for having me and giving me the opportunity to not only speak about Hope Cooperative, but just what we can do as a community to address the ongoing [00:40:00] homeless crisis. 

Jeff Holden: And let's not forget that October 18th event that's coming up.

So thank you again. 

Dr. Bilyeu: Thank you so much. 

Jeff Holden: Thank you for listening to the Nonprofit Podcast Network. I hope you enjoyed the episode. If what you heard moved you, please reach out to that organization and do what you can to help. If you like and appreciate what we're doing to support local nonprofits, please give us a positive review, subscribe, and share.

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