Community navigators help to bridge the gap between services

By Elena Eberwein

*Some individuals are referred to by their first names to protect their identities.

Communities are adopting new ways to respond to mental and behavioral health crises in an effort to reduce police response and create positive outcomes. The community health navigators and the Hub model have proven to be successful in the city of Chelsea, MA. 

Jason Owens was already shaking hands as he walked from his parked SUV to the Starbucks in Chelsea’s most bustling plaza. He’s a big guy physically with a personality to match. His Boston accent is genuine, he grew up in Charlestown. A tall iced espresso in one hand, he climbed back into his SUV with his colleague Tim Hanifan to start the daily rounds. 

“It’s important for people to know we exist,” said Owens, as he careened the SUV through Admiral’s Hill in Chelsea. He drove up along the waterfront at Mary O’Malley Park and parked the SUV when he spotted a group of men hanging out under a pavilion by the water. 

Owens and Hanifan are community health navigators in the city of Chelsea. Every day they head out in their SUV looking for and checking in on individuals who may qualify for services for substance use disorder, mental health challenges, or homelessness. Their role is supervised by the Chelsea Police department in partnership with the North Suffolk Mental Health Association. They have 24 years of sobriety between the two of them. 

The three men were visibly drunk, and lit up when Owens and Hanifan walked towards them, offering fist and elbow bumps. Owens politely offered services to the men, but they declined. Owens wasn’t surprised. 

Owens had been working on one of the younger guys named Danny for awhile. But Danny didn’t want to leave his friend next to him. The friend had urinated in his jeans, and there was a colostomy bag underneath his shirt. Owens offered the option of going into treatment together, but they still weren’t convinced. 

“When you’re ready you’ve got my number,” said Owens. 

They navigators drove up a walking trail under the Tobin bridge, meant for pedestrians but the SUV made this drive daily. The grass grows too tall in the summer, so they check to make sure no one is hidden behind it. 

The next stop is the Chelsea courthouse. Today Owens is helping to get a young man, Faisal* who he’s known since he was a youth out of jail and into a house for individuals with mental health and substance use disorders. 

Owens walked into the courthouse and was greeted by more familiar faces as he wove his way into the probation office.

He knocked on the door of Jessica Iovanna, the ​​Chelsea District Court Assistant Chief Probation Officer. 

“How’s everything? Business is booming?” asked Iovanna, joking. Owens is looking for Faisal, but he hasn’t been brought over to the court house yet. After asking another office employee about her new Lexus, it’s back out to do some “nitty gritty” rounds. 

“We know the regulars to look out for,” said Owens. Hanifan spotted a woman settling into a spot on the sidewalk and pointed. 

“We need to get a Spanish speaking person to talk to Myra,” said Owens, referring to the woman as the SUV continued by. 

Owens and Hanifan have a police dispatch radio in their vehicle, and even have their own call signs. They use it to listen for calls where their expertise in substance use disorder and mental health may be helpful. Owens said they’ve never transmitted over the radio, “It feels weird.”

The navigators drive past the Chelsea Home Depot and towards the Mill Creek riverwalk. 

“We got a crew,” said Owens when he spots a group of young men. They park adjacent to Chilli’s Grill and Bar and walk out to explore down the pathways. A group of young men are hanging out, and Owens recognizes one from his previous work with Roca.

Roca is an at-risk youth center for 16 to 24 year olds, and their mission is to disrupt racism, poverty and homelessness. Owens traveled around the world teaching police officers and youth workers how to engage young men in the community instead of sending them to jail, “which does nothing but plague the community.”

In the back seat of the SUV, there’s a hefty book with glossy photographs called, ‘Spectacular Ireland.’ Coincidentally, it was a “gift” from the Roca youth Owens ran into— a housewarming present for his new condo down the road. Owens said it needed to be returned to its rightful owner, it was from a local library. 

The navigators are a part of the Chelsea Hub communication model for holding community members and service providers accountable for the well-being of residents. The Hub is made up of representatives from services such as housing, mental health, healthcare, schools, and police.

“Working with everyone is critical,” said Captain David Batchelor of the Chelsea Police Department. “People were falling through the cracks.”

Faisal was one of those community members that could have fallen through the cracks. Before the official weekly meeting of The Hub, Owens and Hanifan drove back over to the courthouse, to tell him he’s being released to Hanton House today. 

Owens has known Faisal since he was 14 years old, he’s now 26. Because of their relationship and understanding, Owens knew jail was not the right place for him. He had eight open charges, mostly for breaking into cars while intoxicated. He’d already been in jail for 90 days, but the charges could have kept him in for two and a half years. 

“There’s no reason for you to be in jail when you’re doing the right thing and you’re respectful,” Owens told him. Then he laid on the tough love. 

“If you eff this up, I gotta back off,” said Owens. “I cannot go to bat for you anymore.”

“I’m gonna take it seriously this time,” said Faisal through the thick plastic glass. He said he has 90 days clean. 

“I’m pulling for ya, I want you to stay in my life,” said Owens. 

Owens and Hanifan headed upstairs and checked in with the DA’s office. They had called Owens asking to help him. 

“They’re such stupid charges,” one DA employee said to Owens. 

“He’s a one man crime wave,” he said, and told her that he’s going to bring him to AA meetings with him. He goes weekly anyways. 

The navigators head across the street to the Chelsea Police Department. The weekly Hub meeting has begun and Hanifan has a case to present to the group. 

First they run through the current open cases. They use a case number so that the identity of the individual isn’t shared. Cases are closed as individuals are connected to services and they approach the level of case management. 

In one case update, an individual was resistant to mental health services due to cultural reasons. If she accepted the services she would be able to qualify for adequate housing for her family. The case was going to be closed until Owens spoke up.

Hanifan presented his case to the group. A young man was exposing himself to his elderly neighbors in the elevator. 

With the Hub model, once an individual meets a specific set of criteria, their identity is shared to see if other services have had contact with this individual before. A nurse from Everett hospital is immediately able to look up a date of birth and things start to move quickly. The Hub team assigned the services that would be best suited for the case and those services would make and execute a plan to intervene. 

“It’s time saving,” said Emily Lopiccolo, a clinical manager within the addictions division at North Suffolk Mental Health Association. She said the Hub is a “silo buster” and helps “cut the red tape” to be able to refer individuals to services more easily. 

After Hanifan presented, Owens motioned that it was time to leave, Faisal was about to be released, and the navigators were driving him to his new residence. 

There were five people in the courtroom on Faisal’s behalf, most from North Suffolk Mental Health Association. He was released with a follow-up scheduled for August 30. 

Faisal emerged up the stairs holding a bag of his belongings in one hand and lunch in the other. 

“The kid gets freedom and a sandwich,” said Owens.