Healing the Homeless

For many people living on the streets, healthcare is hard to come by. In Malibu, Dr. Coley King is on a mission to help change that, providing weekly healthcare and housing assistance for the community’s burgeoning homeless population.

Written by Ramsey Abushahla / Photographed by Julie Wuellner

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Dr. Coley King steps out of a grey minivan, his handlebar mustache freshly waxed and his neatly- kempt hair resting on his shoulders. It’s a Thursday afternoon, which means Dr. King’s team, which includes, Dr. Wes Ryan, a psychiatrist specializing in addiction, and Alex Gittinger, a social worker with The People Concern, is on its weekly outreach mission to provide healthcare and support for Malibu’s homeless population. While the team serves the Los Angeles area the rest of the week, a joint initiative from the Malibu Task Force for the Homeless, Venice Family Clinic and The People Concern allows them to assist the Malibu area every Thursday. The minivan is specially equipped, with sterile plastic over the seats and plenty of food and medical supplies in the trunk. The rest of the team follows King out of the van at our rendezvous — a gas station alongside PCH — and explains the plan for the day.

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We are to venture into the Santa Monica Mountains and through Malibu into several homeless camps to provide healthcare and supplies to both new and existing clients. The team has a bigger solution in mind, hoping to eventually get all their patients housed. “If you’ve fallen out of society due to addiction or mental illness, and you lost your wallet, your paperwork and your birth certificate, you’re nobody,” King says. “How do you recreate who you are and prove it to the local government so that they can get you legitimized and housed?”

The team of four is often short-handed while tackling this difficult mission. Before the team was assembled, Dr. King began practicing street medicine with the Venice Family Clinic 10 years ago. After five years of solo work, the clinic was and physician assistants, followed by psychiatrists, which King says are especially helpful.“It’s not surprising for someone that has been on the streets for 20 years to have a serious major mental illness,” King says. “That’s why it’s really important to have psychiatry on the team. Often they have an addiction. That’s a part of being in a rough living situation. It’s much easier to have a drink.”

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In addition to Dr. Ryan, Gittinger and Michel, The People Concern are also essential components of the team, tackling outreach and case management. Without the organization’s help in obtaining necessary paperwork and documents and instructing clients on which offices they need to visit. The team’s work towards providing housing for the homeless would be impossible. “First comes the outreach, which is all about building relationships and trust,” Gittinger explains. “When we started this, we didn’t know much of the [area’s] homeless population. Slowly over time, we built relationships and gained trust. Now, we’re less in an outreach phase and more into the case management phase of getting people housed.”

Most of the locations are found through word of mouth, and Gittinger often asks their existing patients where they can find others who need help. On the day we accompanied them, the team met and enrolled new patients and left supplies and food for those away from the camp. Overall it was a successful trip, but in the field of street medicine, no two days are the same. New clients aren’t willing to accept treatment right off of the bat, and the team needs to be especially careful when approaching someone they have never interacted with before. “Usually I’ll make eye contact and say hi, introduce myself, and simply in a generic way ask them if they need help,” Gittinger says. “If they don’t, we ask them if we can come back later. I don’t want to put any pressure on anyone.”

Another challenge the team faces is helping clients with severe mental health disorders who cannot communicate what they need. Often, the team must interpret incoherent words because the patient is under the influence or mentally ill - both of which can be next to impossible. Oftentimes it’s only after Dr. King and his team have built a trusting relationship with a patient that they will begin to open up and reveal the traumas of their past. Gittinger says that many times, the trauma is so deeply repressed that it could take months before it comes up in conversation.

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“When we get to know these folks, the depth of their trauma is jaw-dropping,” King says. “That’s when we become endeared to these patients. We get their stories of the really disastrous and traumatic things that have happened through their lives, and the fact that they don’t have any sort of family backbone to fall back on, and we really get to like these folks and want to help them out. They become our friends.” One of the team’s most recent success stories involving a Vietnam War veteran made it evident that building a relationship was vital.

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At first, the veteran wanted nothing to do with them, refusing treatment and drinking heavily. After three or four months of interacting with the team, he began to open up to the prospect of getting housed. Around the seven-month mark, he finally accepted that in order to be housed, he needed to sober up — which he did all on his own. “I’m excited for him, because I know that if he kept drinking that much he wasn’t going to be living much longer,” King said. “I’m really excited that he has a prospect to gain health again, and I see it in his face. He looks different, like he’s got a little bit of pep and vitality. That’s a big deal.”

The team regularly interacts with veterans, many of whom left the army with dishonorable discharges. King explained that these discharges were usually a product of mental illnesses developed due to the intense stress and trauma often encountered while serving. King has been around long enough to witness the nationwide growth of street medicine first hand. In his early days, King had only his instincts to trust — no best practices handbook, annual conferences or even a team to rely on. Today, street medicine has become its own entity, thanks to pioneers like Pittsburgh’s Jim Withers and Boston’s James O’Connell.

“The biggest satisfaction for doing homeless health care is that point A to point B for these patients is immense,” says King. “If you bring in a regular patient in your clinic you can get them a little better, you’re proud, you did a nice job, and their numbers got better. But if you take someone that is really, really sick and living on the streets and give them healthcare and get them housed, that’s amazing. That’s a huge point A to point B. MM

Holly Bieler