How do we serve homeless individuals with acute needs? By offering refuge, meals, clothing, and shelter like Bethanie’s Room, made possible through community support.
By Scott Kerman, Executive Director of Blanchet House
Over the past six years leading Blanchet House & Farm, I’ve learned an entirely new vocabulary. When I began, I was unfamiliar with many of the terms used in homeless and addiction services. One that I now use often is acuity.
In health care, acuity refers to the severity of a person’s illness and the level of care they require. The higher a person’s acuity, the more critical and complex their condition—and the more comprehensive their treatment needs to be.
Too many people in our community today are living with acute mental illness or substance use disorder. For many, the two overlap, creating even more complex challenges. These are often the individuals we see in crisis on the streets. Many endure chronic homelessness, meaning they’ve been without stable housing for at least a year or have cycled through repeated episodes of homelessness over several years.
High acuity is rarely the result of a single issue. It is often layered with other serious challenges, such as physical disabilities, chronic health conditions, or the difficulties of advanced age.
The Acute Are Often the Last to Benefit
One of the realities of social services is that as new programs and solutions emerge, those who benefit first are often the people with lower acuity, the individuals best positioned to stabilize quickly. The hardest to house independently, and therefore last to receive help, are the ones with the most complex conditions.
Because these individuals are also the most visible on our streets, it can create the impression that “things aren’t getting better.” In fact, progress is being made, but more time and specialized resources are required to reach those with the greatest needs.
When you drive by Blanchet House, you may see people sleeping on the sidewalk or struggling with visible symptoms of mental illness or addiction. It can appear as though we are not doing our job. But in truth, this is our job.
Blanchet House specializes in serving individuals with acute needs by being low-barrier. We don’t require ID to dine in our café. When we must ask a meal guest to take a temporary break due to unsafe behavior, it’s common for the guest to tell us, “But this is the only place that will let me in.” That reality underscores our role as a refuge for those who are unwelcome elsewhere.
We take our responsibility to serve homeless individuals with acute needs seriously. Everyone deserves at least one place in the community where they are accepted.
As the poet Rūmī wrote: “There must always be a door left ajar, for the weary to find rest.”
Bethanie’s Room: A Door Left Ajar
At Blanchet House, we understand that serving individuals with the most acute needs means providing safety and care where few options exist. That’s why we are opening Bethanie’s Room, a new overnight emergency shelter for women. Bethanie’s Room is inspired by a previous guest who embodied high acuity.
Bethanie was chronically homeless, living with a traumatic brain injury and mental illness. Years of violence and sleep deprivation worsened her already fragile condition. Like so many women who come to Blanchet House, very few doors were open to her. Tragically, many like Bethanie do not survive such circumstances.
Bethanie’s Room exists to be a safe door left ajar for as many women as possible who urgently need rest and safety. We recognize that there will still be women whose needs are so great that even our shelter cannot fully meet them. That truth breaks our hearts. But it does not stop us from trying.
Instead, we are committed to working with the city and service partners to advocate for programs that reach even those most difficult to serve. Because every person—no matter how ill, traumatized, or rejected—deserves the chance to rest and heal.
At Blanchet House, we believe no one should be left without a door to walk through. Even when solutions feel incomplete, every open door matters. And every effort to reach those with the highest acuity is a step toward healing not only individuals, but our entire community.
