Growing up with Mental Illness in the Foster Care System

1. What can Katie do within the next few months to assist Peter?

Katie can continue to advocate for Peter and to help him boost his own self advocacy skills. She can keep looking for housing, reach out to different organizations, such as Schizophrenia Society of Nova Scotia to inquire about programming and housing opportunities. She can assist him in applications for disability assistance to give him more of an income.
2. What are structural barriers that impact Peter?

Mental health stigma, trauma, being in care, hisory of abuse, history of addiction, poverty.

3. What are alternative resources that may be helpful to Peter?

Organizations that can work with him to find housing and employment, such as Reachability or Schizophrenia Society of Nova Scotia. Programs such as Laing House, or Connections. Getting a cat again could be a way of coping.

4 Is this more of an individual or systemic challenge (or neither)?

It is both. Mental health issues compounded with poverty, abuse, addiction and precarious housing.

5. Should Katie fill out Peter’s rental applications (as he struggles to fill them
out correctly and apply by the deadlines)? If she does, should she mention Peter’s
tenancy history?

Katie can fill out, and/or help him to fill out his rental application. People of all walks of life get help in doing things they don’t excel at. I don’t see this as an ethical issue.

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1. What can Katie do within the next few months to assist Peter?
There is obviously a priority on finding Peter a safe and stable place to live. Katie should reach out to local organizations that specialize in supportive housing for people struggling with severe mental illness to start. New Dawn Enterpirses is a Cape Breton based organization that looks to seek out apartments for people suffering from mental illness. If this is not an option then it is also a priority to maximize Peter’s income potential through disability in order for him to afford an apartment traditionally.
2. What are structural barriers that impact Peter?
Peter is dealing with mental illness and a substance abuse problem which obviously makes him marginalized and facing stigma, however he is also facing a lifetime history of feeling or being powerless within the child welfare system, both as a child in care and now as a parent of a child in care.
3. What are alternative resources that may be helpful to Peter?
I mentioned the supportive housing for people suffering from mental disabilities. Peter is also in a tumultuous relationship with the mother of his child, it may bring peace to his life if they attend relationship building.Also, Peter is involved in many social services like child welfare, addictions services, mental health services. There should be one person in charge of assisting him and bringing all of those arenas together , making sure to look after the whole package that is Peter.
4 Is this more of an individual or systemic challenge (or neither)?
Both, Peter faces many individual marginalization and vulnerabilities but one major thing that is bring all of these issues to a crux is the fact that he is “aging out of the system”. The fact that Peter has multiple vulnerabilities that he needs assistance but will not be receiving it because of a timeline/deadline is an example of how the system is failing him and possibility escalating his problems.
5. Should Katie fill out Peter’s rental applications (as he struggles to fill them
out correctly and apply by the deadlines)? If she does, should she mention Peter’s
tenancy history?
yes, Katie should fill out Peter’s applications. I think it would be more un-ethical to expect him to do it himself knowing his history and challenges. Any person relies on people within their support system to help where they can. Katie may not be family but she is a major part of his support system. She should lie on the applications but she should set up supports for peter that she can discuss with landlords as being in place to help Peter be successful in his tenancy.

1. What can Katie do within the next few months to assist Peter?

Katie should take a number of approaches to assist Peter in the coming months. I think, foremost, she should talk with Peter about helping him find an apartment and, with his permission, attend his apartment showings with him. I think in doing so Katie could assist with Peters’ housing as a whole as he attempts to navigate the sparsely-available housing within his budget. Katie could also provide Peter a degree of advocacy as a clinician, potentially being able to provide support to Peter by discussing his need for affordable housing to landlords, explaining his situation, and, if needed, addressing some of the symptoms that he often presents with during apartment showings. Katie could also assist Peter in filling out housing paperwork and applications for additional funding, which would help address his difficulties concentrating when trying to fill out such forms.

In the meantime, Katie could connect Peter with Phoenix youth shelter (which serves youth up to age 24) to see if they have any short-term or long-term beds available for Peter, so as to help with his housing situation in the interim.

If Katie and Peter, together, were able to locate housing for Peter, Katie may also want to talk to Peter about some of the programs available through the SPCA that allow people to foster cats for short periods of time or to adopt older cats. Many of these programs offer ongoing support for foster/adoptive care providers, including free vet care if needed. As noted in the case, a cat has provided Peter with considerable support for his anxiety in the past; connecting him with a foster cat or an older animal with ongoing support from the SPCA or another organization would therefore benefit his symptoms and provide a client-centered intervention based on Peter’s self-identified needs.

I also think that Katie could work with community mental health to put in a self-referral for Peter (again with his permission), so as to potentially connect him with a long-term clinician for support with his schizophrenia. Another service that Peter could also potentially benefit from is the Early Psychosis Program through the NSHA: given that his diagnosis of schizophrenia is recent, the team at Early Psychosis may be able to help him identify coping, self-care, and recovery-oriented strategies for the betterment of his mental health. They could also help address the ‘fog’ that he experiences, and strategies to help him deal with the voices that tell him to do things. Additionally, Katie could explain the role of the Mobile Crisis Team to Peter, and that he can call the service to connect with a clinician during times he has difficulty coping.

Lastly, it might also be worth it for Katie to have a discussion with Peter to gain insight into his perspective on his relationship with Bailey, including if, and how, he feels that the relationship is affecting his situation. Katie would have to approach this conversation cautiously to ensure she did not impose any biases that she holds onto Peter and his relationship. However, I believe it is a conversation that is worth having to help understand Peter’s viewpoint and what he intends to do moving forward in the relationship given how it has impacted his housing situation.

2. What are structural barriers that impact Peter?

A number of structural barriers are impacting Peter. Foremost is the lack of affordable housing readily available for people with disabilities. Indeed, the fact that he has not been approved for housing based on his budget and his disability is indicative of a structural barrier regarding a lack of affordable and/or accessible housing in his area.

A second structural barrier is the stigma associated with his mental illness. Such stigma may be impacting his ability to access housing, especially given that he often presents with psychosis-based symptoms during apartment viewings. Should the landlords that he interacts with hold biases and stereotypes concerning mental health, Peter would therefore be negatively impacted by such stigma.

Another structural barrier is his rental history, which is impacting his capacity to seek out a new place to live. Especially given his history of damaging property, Peter is implicated in a low likelihood of approval from landlords.

Assuming this interaction occurred in Nova Scotia, another structural barrier that may be interplaying within Peter’s situation is the lack of readily-available mental health services to help him with his schizophrenia. Long wait-times and a lack of clinicians for proactive support currently plague the province, leaving those experiencing mental illness without access to services for lengthy periods. Hence, this structural barrier may be perpetuating Peter’s situation insofar as leaving him without mental health support.

3. What are alternative resources that may be helpful to Peter?

I have noted a number of alternative resources that may be helpful to Peter in my answer to question one. In addition to these resources, Peter may also be able to access Out of the Cold emergency housing for a short-term bed to keep him off the street. Peter may also be able to connect with Metro Community Housing for additional housing resources and connections to government-based affordable housing. Laing House (a non-profit mental health agency serving youth age 16- 29) may also be able to provide Peter with ongoing support in which he could connect with peers and engage in client-centered activities based on his self-identified interests and needs.

4. Is this more of an individual or systemic challenge (or neither)?

I don’t believe that any challenge faced by a client is purely individual or systemic-based. In Peter’s case, I believe that there are certainly some individual factors impacting his situation—namely, his difficulty concentrating, his history, his relationship with Bailey, and his symptoms—but I also think that these factors make up only small percentage of the larger context of his situation. Additional factors that are undoubtedly interplaying to perpetuate Peter’s situation are the above-noted structural barriers that I have discussed. These factors, I believe, serve to interplay within his situation to render him without readily-available solutions to the issues that he is facing. They also serve to perpetuate and amplify some of his individual-based factors including his symptomology by leaving him with this overall lack of solutions and support. As a whole, then, I think Peter is caught in a cycle in which systemic forces of oppression and his individual factors are interplaying with one another to foster and perpetuate the situation that he is currently in, and that interventions are needed to address these forces in their entirety.

5. Should Katie fill out Peter’s rental applications (as he struggles to fill them
out correctly and apply by the deadlines)? If she does, should she mention Peter’s
tenancy history?

I believe that Katie should not take full ownership of filling out Peter’s rental applications, but rather that she should help him in completing the applications. I think that Katie could work with, and support, Peter in filling out the applications by filling out the forms together and helping him with his concentration. Doing so, I think, would be a much more client-centered intervention that would ensure Peter still has agency over the forms and his situation as a whole.

Mentioning Peter’s tenancy history within his rental application is a much more difficult ethical question. I think, personally, she has an obligation to fill out the forms truthfully, without holding back information that is being requested. That said, I think I would personally leave out information not explicitly necessary to include within the application, and to only highlight aspects of Peter’s rental history that are required as part of these forms. Withholding such information, I think, could cause more issues for Peter in the future, and potentially implicate both him and myself in the law. I would therefore work to ensure that the information I include is truthful and acknowledges Peter’s history, but also that any unnecessary information or any information not explicitly requested is left out of the application.

Jordan Z