The Need for HER (Homeless Emergency Response) Teams

As the number of females counted as homeless surges in
California so must our (HER) homeless emergency response 

• HER Teams must be skilled at integrating a trauma-informed approach into their street outreach and engagement activities;
• HER Teams understand that the lasting effects of trauma and the fear of being re-traumatized may cause too many females to live in a constant state of survival on the streets rather than taking the steps necessary to get off the streets, as counter-intuitive as it may seem; and
• HER Teams ensure that females living in a constant state of survival on the streets know that each team member is committed to safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and cultural, historical, and gender issues while helping each female take the necessary steps to obtain and maintain permanent housing.

The number of females who were counted as homeless by California’s 44 Continuums of Care (CoCs) throughout the state during the last half of the past decade has significantly increased according to California Point-in-Time (PIT) homeless count data as noted in the table below:

The difference between 2015 and 2019 is 10,964 females, which represents an increase of more than half (52.8%).

Tables 2 through 4 show that the number of females counted in each of the three Continuum of Care regions increased when the total number of females counted in 2015 is compared to the total number of females counted in 2019.

Click here to see a map of California’s CoCs by region.

Table 2 shows that the number of females counted in the Northern California CoCs increased from 6,269 females in 2015 to 11,991 females in 2019 representing an increase of 5,722 females or 91%.

Table 3 shows that the number of females counted in the Central California CoCs increased from 1,630 females in 2015 to 2,829 females in 2019 representing an increase of 1,199 females or 74%.

Table 4 shows that the number of females counted in the Southern California CoCs increased from 12,867 females in 2015 to 16,910 females in 2019 representing an increase of 4,043 females or 31%.

We have yet to see if the current trend continues. Nearly all of California’s 44 CoCs received an exception from the U.S. Department of Housing and Urban Development (HUD) not to conduct a 2021 count because of pandemic-related reasons.

All of California’s CoCs conducted a 2022 PIT homeless count and were required by HUD to submit their count results to HUD by April 29^th. Historically, HUD will not publicly release the count results until mid-to-late fall.

HER (Homeless Emergency Response) Teams

HER (Homeless Emergency Response) Teams are defined as street outreach and engagement teams that identify and engage women living in abandoned buildings, encampments, make-shift shelters, tents, and vehicles exposed and uncovered on sidewalks, in parks, and in parking lots and other places not meant for human habitation. They are also defined as teams particularly skilled at identifying and engaging women who are chronically homeless and languishing on the streets and who are increasingly vulnerable to illness, injury, and death.

Proposed Legislation

Proposed legislation includes SB 914 HELP (Homeless Equity for Left Behind Populations) Act. The bill “would require the California Interagency Council on Homelessness to set and measure progress toward goals to prevent and end homelessness among domestic violence survivors and their children and among unaccompanied women in California,” which are described “as women, 18 years of age and older, who are experiencing homelessness while not in the company of children or other dependents.”

The goals stated within the legislation include:

• “Measurably decreasing the number of domestic violence survivors and their children and of unaccompanied women experiencing homelessness in the state.”
• “Decreasing the duration and frequency of experiences of homelessness among domestic violence survivors and their children and among unaccompanied women.”
• “Decreasing barriers to services through promoting cross-systems partnerships to expedite access to services, including social services, domestic violence services, regional center services,housing services, and mental health services.”

Effective Legislation

SB 914 acknowledges that there is an “extremely high incidence of trauma, whether physical, sexual, or psychological in nature, that is compounded by their ongoing houselessness.”

In order to help meet the legislative goals above, CoCs should fully incorporate a HER Team approach to current street outreach and engagement activities to effectively connect women to services and housing and deconstruct the notion of “social service resistance” in the presence of high incidence of trauma.

Effective HER Teams Are Trauma-Informed

Creating effective HER Teams involves ensuring that all team members are skilled at integrating a trauma-informed approach into their street outreach and engagement activities to help females obtain temporary and/or permanent housing. All team members need to know that past and present trauma affects the ability of females languishing on the streets to overcome their homelessness experience.

Effective HER Teams members need to know that homelessness is in itself a traumatic experience and that persons experiencing homelessness are living in a constant state of survival. Females living in survival mode have great difficulty focusing on a long-term plan to end their homelessness experience. At best, they are focused on getting through the next 24 hours.

Effective HER Teams members need to be mindful that for females living in survival mode that nearly every daily action is a reaction and that they are rarely proactive. They are in a constant crisis mode that can be both very subtle and very obvious during the same day.

Effective HER Teams members understand that doing what it takes to obtain temporary and/or permanent housing may not be an obvious choice for females living and languishing on the streets over doing what it takes to continue to live in survival mode for another day, week, or month.

For many females, living in survival mode is a reactionary choice because of a fear of being re-traumatized. Failure may replicate elements of past trauma (i.e., feelings of a loss of choice, control, or personal care). Too many past meetings, calls, and appointments to do what it takes to obtain permanent housing may have constantly been canceled or changed. Feelings of never feeling one step ahead, bouncing from one response to another, and there seems to be no margin for error can replicate elements of past trauma.

Living in survival mode on the streets opposed to taking the necessary steps to obtain temporary and/or permanent housing may be counter-intuitive to the average person. However, developing a framework for understanding trauma and developing a trauma-informed approach to help females living homeless overcome a life of survival on the streets should not be counter intuitive.

Next Steps

The Substance Abuse and Mental Health Services Administration (SAMHSA) has developed a framework for understanding trauma and developing a trauma-informed approach for behavioral health specialty sectors that should be adopted to ensure effective HER Teams.

SAMSHA’s work generated the following definition of trauma:

Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.

SAMHSA’s concept of a trauma-informed approach is grounded in four assumptions and six key principles.

Four Assumptions

The four assumptions have helped and propelled a growing number of organizations and service systems to explore ways to make their services more responsive to people who have experienced trauma. A program, organization, or system that is trauma-informed:

1. Realizes the widespread impact of trauma and understands potential paths for recovery;
2. Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
3. Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and
4. Seeks to actively resist re-traumatization.

The four assumptions are described in SAMHSA’s report on pages 9 and 10.

Six Key Principles

SAMSHA noted that

A trauma-informed approach reflects adherence to six key principles rather than a prescribed set of practices or procedures. These principles may be generalizable across multiple types of settings, although terminology and application may be setting- or sector-specific.

The six key principles are listed below and described in SAMHSA’s report on page 11.

1. Safety;
2. Trustworthiness and Transparency;
3. Peer Support;
4. Collaboration and Mutuality;
5. Empowerment, Voice, and Choice; and
6. Cultural, Historical, and Gender Issues.

Next steps involve creating new dedicated HER Teams or making sure existing street outreach and engagement teams are nimble enough to form HER Teams by temporarily combining members from different teams that

• Are skilled at integrating a trauma-informed approach into their street outreach and engagement activities;
• Know that past and present trauma is affecting the ability of females languishing on the streets to connect and engage effectively in services;
• Understand that the lasting effects of trauma and the fear of being re-traumatized may cause too many females to live in a constant state of survival on the streets rather than taking the steps necessary to get off the streets, as counter-intuitive as it may seem; and
• Make sure females living in a constant state of survival on the streets know that HER Team members are committed to safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and cultural, historical, and gender issues while helping them take the necessary steps to obtain and maintain permanent housing.