New VA Director of Mental Health: ‘We really want to end homelessness among veterans’

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Dr. Alicia Semiatin, the VAMC’s newly appointed Director of Mental Health. Photo/Pat Grossmith

MANCHESTER, NH — It’s been 10 years since the Manchester Veterans Administration Medical Center (VAMC) began sending out teams of social workers and case managers in an effort to find and help homeless veterans.

Since then, the program has developed “wrap-around” programs to help these veterans with immediate needs such as safety, housing, food, clothing and medical treatment.  They also key in on long-range needs including treatment of any contributing medical or mental health issues in an effort to reconnect them to family, other veterans, work and community.

Dr. Alicia Semiatin, the VAMC’s newly appointed Director of Mental Health, said the number of homeless vets in New Hampshire fluctuates, decreasing in winter when many head south for warmer climes, and increasing in the spring and summer upon their return.  At one time it was as high as about 200.

According to the New Hampshire Coalition to End Homelessness, the number of homeless veterans in the Granite State as of 2018 was 143, an increase of 16 percent from 2016.   The vast majority of homeless veterans — 95 percent — are staying in an emergency shelter or transitional housing.

The numbers come from the annual Point in Time Count, which in 2018 was held on Dec. 18.

Hillsborough County accounts for the majority of those veterans (108), although the city of Nashua effectively ended homelessness among veterans in their city and the surrounding region.  

Semiatin, a psychologist who came to VAMC five years ago,  explained that Nashua addressed “housing with everyone eligible and those that are interested in taking housing have been connected to those services.  All other communities are working to meet that same goal.”

The outreach team consists of two social workers and a case manager, all trained in substance abuse and mental health disorders.  The teams go to soup kitchens, shelters, homeless encampments and underpasses in search of veterans in need of help.

Sometimes, they search for leads from other veterans and members of the American Legion and Veterans of Foreign Wars clubs who may know of a homeless veteran.

Semiatin said the training allows the team to effectively strike up conversations with veterans.

“They start a conversation and hand out flyers that provide the national homeless hotline (1-877-4AID-VET or 1-877-424-3838) which is staffed 24/7,” she said.

That one call results in immediate help with the local team being alerted for follow-up.

“One of the serious challenges is really building trust and starting those conversations,” said Semiatin.  “We really want to end homelessness among veterans.”

There is also a Homeless Primary Care Team consisting of a nurse practitioner, a nurse, social worker and a veteran that Semiatin says really practices “battlefield medicine.”

In focusing on all the needs of a homeless vet, the hospital also hosts a daily walk-in clinic, Monday to Friday from 1 to 2 p.m.

A bedroll, made by veterans for use by homeless veterans. Photo/Pat Grossmith

The VA also has eight beds for emergency unhoused veterans and 80 beds in its transitional housing program where veterans and their families can stay for up to two years.  Its VA Supported Housing Program (VASH), in coordination with the U.S. Department of Housing and Urban Development, has another 308 housing vouchers.

Its Veterans Justice Outreach program covers six county jails, the New Hampshire State Prison, and there are three Veterans Courts in Manchester, Nashua and at the Rockingham County Superior Court.

Semiatin said Veterans Court advocates for a defendant to be placed in a diversion program where the individual goes into treatment for a year.

When a veteran is being released from jail or prison, an advocate is there to help the veteran avoid becoming homeless.

“It’s a dynamic program we’re really proud of,” said Semiatin.

The difficult part is obtaining the trust of a homeless veteran and getting the individual to come in.

When a veteran who has been homeless for a long time, living on the streets under an underpass or in a homeless encampment, finally comes in seeking help, “it’s really a culmination of a long journey and there is a lot of stigma around homelessness so it’s important to us that we make that experience a really positive one,” Semiatin said.

It’s a chance to connect with the veteran and to build up trust.

So the VA, over the years, expanded their program to include pantries with food and toiletries.  For the veteran who isn’t ready to come in from the streets, there are sleeping bags and tents.

There’s even a bedroll, knitted out of garbage bags by veterans.  The knitters signed their names and added a note: “This bedroll was made especially for you by a fellow veteran.  May it give you comfort when you are tired and security knowing it travel with you. God bless you on your journeys and always keep you safe from harm.”

There is clothing as well as racks of new coats to ensure the vet is warm in the colder months.

“I find it a really rewarding experience,” said Semiatin.