# Presentation: 333835

## META HOUSE, Inc.

**META HOUSE, Inc.**

**A Gender-Responsive Program for Women with Co-occurring Substance Use & Mental Health Disorders & Their Children Who are Homeless**

**Notes:**
The door that mothers with children come through at Meta House is the substance abuse/mental health door.

The vast majority are also homeless.

The program is designed to gain sobriety and in doing so, address all barriers to this including homelessness.

Basic needs must be met before treatment process can begin

## Characteristics of Homeless Mothers at Meta House

**Pregnant or Postpartum (50%)**
**Long History of Poverty**
**Unemployed**
**Serious Addiction**
**Co-occurring Mental Health Disorder**
**Childhood History of Sexual & Physical Abuse**
**Chronic Physical Disease**
**Poor Literacy Skills**
**Child Protective Involvement**
**Criminal Justice Involvement**

## Gender-responsive programs for homeless women with substance use/mental health disorders are predicated on:
Female physiology
Women’s roles
Socialization 
Relative status within the larger culture

**Female physiology**
**Women’s roles**
**Socialization **
**Relative status within the larger culture**
** **

**Definition of ****Gender-responsive Treatment for Women**

**Notes:**
Physiology -  We have been educated people about the effects of alcohol and drug abuse on the body as if men and women respond in the same way - the way the male body responds.
Women’s roles-  We have set up treatment systems that do not particular favor the kinds of roles women play in this society.  We have ignored the fact that women tend to be the people that take care of others, making treatment inaccessible because of this responsibility and framing the focus of recovery on the need to separate from those responsibilities in favor of focus on self (the self for women is the connection to others.
Socialization-  Women are socialized with a diminished sense of control and power that is brought into the treatment setting.  We misunderstand this and tend to see women as less motivated as opposed to lacking a belief that there is really anything they can do that can make a difference.
Relative Status-  Despite gains women are second to men in their status in society.  This means that opportunities are not equal and that women are much more likely to be violated.  If we act as if all this is equal, we will see women as failures in employment and ignore the impact of violence.

## Definition of Agencies that Provide Gender-responsive Treatment for Women

**Agencies that support staff in providing gender-responsive programs for women have:**
**A theoretical approach that supports the  psychology of women**
**Administrative & structural support necessary to provide the needed services**
**Policies & procedures that support families**
**Funding that sustains appropriate approaches and services to women**

**Notes:**
It is not enough for clinicians to buy into the need for differential treatment approaches for women.  
They really must have an infrastructure that supports this idea.  
A buy-in that supports a different theoretical approach will need to provide administrative and structural approach.
Need policies and procedures that define the way in which the agency will operate
 and need the funding that will support a whole new way of dong business

## Theoretical Approach:A Relational Model

- Programming needs to take place within each individual’s cultural context.
- The culture of gender is what most defines us as individuals.
- The psychological growth and development of the female ego is different than that of males.

**Notes:**
I talk a lot about a different theoretical approach.  

These are the reasons that I talk about that.
Next Slide

## Theoretical Approach:A Relational Model

- The social reality for women is one of discrimination, victimization, and iniquity.
- The experience women have with homelessness and substance use is very different from the experience of men.
- Women engage and remain in programs for different reasons than men.

**Notes:**

These are concepts that I will discuss in detail later in the year when we do some educational symposiums about the going-ons at Meta House

Take a little walk around Meta House

## The Sexual Abuse Interface

- Women’s experience of sexual abuse in childhood leads to substantial subsequent serious health problems.
- Impacts the quality of life, high levels of  somatic symptoms, medical problems, psychiatric problems, poor mental health and social functioning and quality of life.
- Perpetuates the cycle of poverty and ultimately homelessness.

## Services at Meta House

**MEDICAL SERVICES**

**MENTAL HEALTH **
**SERVICES**
**Trauma Treatment**

**HOUSING**

**NATURAL SUPPORTS**
**& SERVICES TO **
**FAMILY MEMBERS **

**RESILIENCY SERVICES**

**CHILDREN’S**
** ****SERVICES**

**VOCATIONAL/**
**EDUCATIONAL SERVICES**

**CASE**** ****MANAGEMENT **
**SERVICES**

**AODA TREATMENT**
**& EDUCATION**

**Services at Meta House**

## Housing

**Meta Housing – 60 Structured Communal Beds & 28 Family Units**
**Section 8 City & County**
**St. Catherine’s Women’s Residences Program – partnership**
**Community housing**

## Case Management Services

**Assessments**
**Coordination and integration of services**
**Single care plan across systems**
**Community integration**
**Resource access**

**Notes:**
This is the mechanism for coordinating all the services at Meta House

## AODA Treatment & Education

**Counseling:**
**	****Individual**
**	****Group**
**Relapse prevention for women**
**Relapse prevention for perinatal women**
**Depression and substance use**

**Postacute withdrawal **
**12 steps for women **
**Family dynamics**
**The substance-exposed child**
**Self-identity**
**Relationships**
**Sexuality **
**Spirituality**

**Notes:**
Here you can see how the gender issues are addressed specifically within the context of substance abuse education

## Mental Health Services

**Prescribing Onsite psychiatrist**
**Psychological testing**
**Treatment**
**Medication monitoring**

**Trauma resolution**
**Trauma informed**
**Seeking safety treatment program  **
**Anger/stress management**
**Perinatal mental heath treatment and education**

**Notes:**
Meta House is an integrated AODA/MH program.

Models:
Sequential
Concurrent
Integrated

## Medical Services

**Onsite RN**
**Health assessment and triage**
**Referral and coordination: **
**Medical and dental care**
**Perinatal care**
**Emergency & hospital care**
**Prenatal care coordination**
**Presumptive eligibility**

**Health and reproductive education:**
**Infant care**
**	****Substance exposed child**
**Preconceptional care**
**HIV/AIDs transmission to infants**
**Infant Mortality**
**HIV/AIDs**
**STD's**
**Nutrition**
**Medication monitoring**

**Notes:**
Medical is another integrated component.  

This year is first time we will actually do medical care on-site with the RN.

## Children’s Services

**Screenings & diagnostic **
**Developmental assessments**
**Pediatric care and referrals**
**Play and filial therapy**
**Referrals for specialized services**
**Coordination with all services and schools**

**Integration of child welfare plan**
**Reunification and supervised visitation services**
**Prevention programs**
**Meta Girls program ages 9–17**
**Teen pregnancy prevention**
**Tutoring**
**Recreational services**

**Notes:**

2 reasons for children being in program

1) removes barrier for women to come to treatment

2)Mother’s sobriety is directly tied to the physical and emotional health of her children

That is why Meta House does not just house the children in residential but also provides services to them.
Also becomes a prevention program for them
Extremely high risk children

## Vocational/Educational Services

**Integration of TANF plan**
**Reading and skill testing**
**Literacy center with GED/HSED**
**Vocational assessments**
**Soft skill vocational training**
**Transitional & permanent employment**
**Job retention services**

**Notes:**
Tied directly to the client need

## Resiliency Services

**Parenting for women with histories of trauma**
**Nurturing Program for Families in Substance Abuse Treatment and Recovery**
**Child development classes**
**Childcare**
**Transportation**
**Basic needs**
**Living skills**
**Community resources & integration**

**Notes:**
This includes the services that assist with parenting and other practical needs of the women

## Natural Supports & Services to Family Members

- Individual and family counseling
- Alcohol and drug abuse education
- Alcohol and drug abuse education for teens
- Parenting for fathers and couples
- Introduction and referral to community resources

**Notes:**
Our goal is discharge people to a community that has many services that will support recovery.

## Meta House, Inc.

**Meta House, Inc.**
**Programs**

**Intake **
**Screening**

**Women with Children**

**Residential**
**60**
**Beds**

**PRIMARY**
**TREATMENT**

**Family Care**
**Center**

**Prospect**

**Day**
**Treatment**

**Meta House Aftercare**
**Outpatient**

**Meta Housing Network**

- Milwaukee County
- My Home Shelter Plus Care
- 16 Units

- St. Catherine’s
- Residence
- 20 Beds

- City of Milwaukee
- Housing Choice
- Voucher Program
- 10 Units

**Notes:**
CIU
Residential Women & Children
Day Treatment Program
Several Housing opportunities including 28 unit of our own housing

The grant was implemented in out day treatment program for those needing primary care

And in our housing for those families who while homeless, had treatment and had made a commitment to recovery.

## Riverwest North and South Women & Children Residential

**Riverwest North and South Women & Children Residential**

**Maryland**

## Whether required or not  -inform, educate, involve and work with the neighborhood.

**Whether required or not  -inform, educate, involve and work with the neighborhood.**

## Structure Housing with Intensive Treatment

**Special license for group living**
**Certification to provide treatment**
**Began in 1963**
**Children entered in 1988**
**Duplex 8 beds, convent 30 beds, Rectory 22 beds = 68 beds (38 women & 22 children)**
**Properties owned by Meta House through foundations, corporations & individual donors **

## Meta Housing

## Individual Apartments with Less Structure

**For women in recovery & their children**
**Operated as apartment buildings**
**Services provided through Meta House outpatient clinic**
**In-home services provided**

## Rehabilitation for 12 Units

**Expenses**
**Purchase & Renovation****	****	****$439,700**
**Landscape/Playground****	****	****	**_**$155,000**_
**	****	****	****	****	****	****	****$594,700**
**Revenue**
**HUD****	****	****	****	****	****	****$155,000**
**WHEDA ****	****	****	****	****	****$  25,000**
**Foundations & Corporations****	****	****$409,300**
**Meta House Reserves****	****	****	**_**$    5,400**_
**	****	****	****	****	****	****	****$594,700**

## Meta Housing

## 3 Buildings - 16 Units

**Expenses**
- Land Purchase				$           762
- Survey,Plat,Permits,Regist.	$  	12,642
- Phase I Environmental		$      32,500
- Project Manager			$      39,100
- Architectural				$    142,000
- Construction				$ 1,593,054
- Landscaping				$        2,000
- Legal – pro-bono			$               0_ _
- Total						$1,822,058

## 3 Buildings - 16 Units

**Revenue**
- HUD						$   568,000
- WHEDA					$     77,500
- Foundations				$1,097,300
- WI Gas Weatherization Prog.  $     27,500
- Meta House Reserves		$     51,758
- Total						$1,822,058

## Operations Funding for the Programs

**Expenses**
**Total Operations ****	****	****	****$3,175,075**
**Revenue**
**Milwaukee County****	****	****	****	****49%**
**SAMHSA (CSAT)****	****	****	****	****17%**
**HUD****	****	****	****	****	****	****14%**
**State of Wisconsin****	****	****	****	****11%**
**United Way****	****	****	****	****	****  3%**
**Child Welfare****	****	****	****	****  1%**
**Food Stamps****	****	****	****	****  1%**
**Medicaid****	****	****	****	****	****  1%**
**Rent****	****	****	****	****	****	****  3%**

## Slide 29