Here in Massachusetts, a right-to-shelter state for families, family homelessness can seem invisible compared to adult homelessness, as unhoused families are often placed in scattered site apartments, communal shelters, or motels, off the streets and out of public view. Every day, however, our teams at Boston Health Care for the Homeless Program (BHCHP) see the unseen: parents and children and the unique and unjust challenges they face trying to maintain their health and wellbeing amid homelessness.
Our Family Team patient, four-year-old Marguerite was living in a homeless shelter with her mother, when she witnessed her mother fall down a staircase and be taken away in an ambulance. The pair were then separated for several weeks; Marguerite stayed with a foster family while her mom received care. When the two were reunited, her mom noticed Marguerite’s mood and behavior shift: Her daughter was clingy, anxious, and sometimes aggressive.
What Marguerite saw and experienced would be traumatic for any child. But for her, such an event was disproportionately complex and destabilizing. In the words of our colleague Dr. Rachel Harrington-Levey: When you’re a child and you’re homeless, your parent is your home.
Dr. Harrington-Levey, a clinical psychologist and member of BHCHP’s Family Team, worked with Marguerite to process her fears using play therapy. With her mother present for support, Marguerite continuously re-enacted the fall using two dolls and a tambourine, which she vigorously shook to mimic the loud ambulance sirens. Meanwhile, her mother worked with Dr. Harrington-Levey to further develop her parenting skills and learning techniques for how to soothe a child who is feeling out of control—something that can feel very challenging to a parent experiencing their own extreme stresses.
“My goal was to help repair the breach that happened by helping the little girl engage, and to coach mom to acknowledge what had happened, how scary it must have felt for her daughter, and how much she missed her during the separation,” said Harrington-Levey. “We want the parent-child relationship to be as stable as possible because there are so many factors in their lives they can’t control.”
Marguerite and her mother are just one of the 600 adults, youth and children who every year receive specialized, compassionate medical and behavioral health care and case management from BHCHP’s Family Team. Enabled by your generosity, our behavioral health clinicians, medical providers, and case managers are helping Boston’s most marginalized parents and youth meet and mitigate the health challenges of homelessness—a service especially critical to supporting children’s healthy development through the stress and adversity of spending formative years unhoused.
Our Family Team’s recently-opened medical and behavioral health clinic at the BHCHP Family Clinic at the Horizons Center in Roxbury is welcoming, bright and cheery. Filled with toys and art supplies, BHCHP’s new space there allows the Family Team to care for their young patients and their caregivers who are clients of the Horizons Center or any families experiencing homelessness in the city. The Family Team can also continue to see patients after they’ve
become housed, ensuring continuity of care through the transition to housing, lingering trauma, and any other difficulties that arise.