Supporting the Counseling Needs of the Unhoused

Gail Nord enjoys taking early morning walks in Minnehaha Park near her home. A few years ago, she began to notice the number of unhoused people who would spend the night there, then gather near the restaurant pavilion in the morning.

“I would just go over there and chat,” Gail says, “not with any goal or anything, just to say 'how are you doing'. It was such a great experience, and I really, you might say, developed a respect for the people who endure that kind of a life.”

Examining Barriers to Treatment

This feeling of respect and compassion compelled Gail, an MPS in Integrated Behavioral Health (IBH) student, to formally explore how she could make a difference. She began to look into the challenges of providing mental health and substance use treatment to unhoused people.

Her research focused mainly on the interviewees’ past experiences with mental health and or substance use treatment. Roughly 80% of them were currently experiencing mental health and substance use issues, so past treatment methods had not been entirely effective.

Her questions were why had treatment not worked for you, what are the barriers to you seeking treatment now, and how do you think we can do a better job of providing treatment to you and others in your situation?

“I think that all of us, given certain life circumstances, could end up in that kind of a dilemma,” she says. “And once you're in that dilemma, it's hard as hell to get out of it.”

Gail reached out to faculty member Fiyyaz Karim to see if he would mentor her throughout the project. She wrote a proposal and went through the University’s Institutional Review Board process. (The IRB reviews research projects involving human participants to ensure investigators provide adequate protection and procure informed, uncoerced consent.)

"She connected with community resources because of the immersive experiences in class," Fiyyaz says. "She took it upon herself to start donating both time and resources to these agencies. As a result of these experiences, she intentionally sought out an internship at the Indian Health Board where she has worked further with the unhoused. Her previous work as both a chaplain and spiritual care counselor helped her to create strong relationships with individuals." 

This research was not a required part of her IBH master’s degree, but she "has a passion for advocacy and social justice for marginalized communities," Fiyyaz adds. Gail's first stop: Camp Nenookaasi.

A First Step to Providing Better Care 

Camp Nenookaasi is an encampment of unhoused individuals that began in the East Phillips neighborhood of Minneapolis. (It has since been moved several times from its original location by the city.)

Accompanied by classmates who served as scribes, Gail interviewed 20 residents, many of whom were Indigenous. “I decided on the number because that's the number of Visa gift cards I could afford,” she says. “Given the interest of the residents I could have probably done a hundred interviews. It was a wonderful experience.”

But it wasn’t easy at first. Gail, a white woman, was initially met with skepticism by camp organizers. “But once I told (them) that I really wanted to learn from the people that were living in the encampment with a goal of providing better care, they were all in.”

What was confirmed through her research is that “pretty much everyone who has substance use issues has mental health issues,” and that the substance use is most often secondary.

Some substance use is situational, but much of it is self-medication for untreated mental health conditions. “You need to prioritize mental health treatment while working on the substance use,” she says.

“I think it would be absolutely awesome to bring therapy to the people where they are. I have this vision—and part of this came from some of the people I interviewed—of an old Winnebago [a large camping van] that's refitted with an office in the back, really cozy and comfy.”

Gail has completed her paper and will be working on getting it published soon. She recently presented her findings at the Minnesota Association of Social Services annual conference. She also received a 2024 University of Minnesota President's Student Leadership and Service Award for her work.

Starting a New Professional Chapter

It might surprise you that counseling is not Gail’s first career. She studied forest management as an undergraduate and worked for several years in that field until she had children.

She later became interested in the intersection of science and spirituality and earned a Master of Divinity from Luther Seminary. She then served as a chaplain in a men's maximum security prison conducting individual and small group counseling.

“I started an LADC (license alcohol and drug counselor) program when I was working at the prison because I saw the hideous impact that drugs were having on these men. It devastates lives, and I thought, this would be a good adjunct to my credentials.”

She later switched to counseling families and patients in hospice care. She returned to the University of Minnesota to complete her coursework that meets Minnesota LADC/LPCC (Licensed Professional Clinical Counselor) educational requirements and embark on a third career. She will graduate in December.

“I'm going to be 71 this year.” Gail says. “My goal is to work another 10 years.”

Memorable Instructors and Courses

• Fiyyaz Karim | Foundations of Group Work
• Tom Hegblom | Counseling Ethics and Professional Counselor Identity
• Keyur Desai | Differential Diagnostics

Advice for Future Students

"It’s not about you. In any kind of clinical work, when it becomes about me and my feelings, I'm not doing justice to myself and certainly not doing justice to the client. Be present in the moment with the person or the group you're working with so that it doesn't become as much about you."

"Go for it. So I would say to someone who's older, basically jump in with both feet. Don't be afraid; know why you're here. Know where you see yourself going. Not everyone who is my age may be physically or cognitively capable of doing it, but I would say for those who feel motivated, just do it, ask for help when you need it, and just have fun."