During the beginning of the COVID-19 pandemic, we as medical students whose clinical rotations had paused, served as volunteers at the Shelter Association of Washtenaw County’s rotating shelters at various community churches in Ann Arbor. Over time, we established trust and built positive relationships with both the staff and community members experiencing homelessness. We were fortunate enough to informally lead writing exercises and to be on the receiving end of powerful narratives shared with us by members of our community experiencing homelessness during the COVID-19 quarantine. It is out of these experiences that the ideas for this project were formed. 

This project centered on the belief that people experiencing homelessness are our best teachers and should be included in work addressing the health disparities and root causes of housing insecurity including unaffordable housing, racial inequity, non-livable wages, and lack of access to substance use disorder treatment and mental health services. We conducted narrative storytelling workshops among people experiencing homelessness in southeast Michigan with multiple synergistic aims: to improve mental health and access to mental healthcare services; build community and trust; and provide an advocacy outlet by elevating these experiences, in the form of digital and printed published stories, written by community members experiencing homelessness. 

Research shows that storytelling may reduce symptoms of depression and build feelings of resilience, self-esteem, and community connectedness (Armstrong 2017; Bornat 1989; Hallford and Mellor 2013). Engagement in artistic activities such as writing can enhance mood (Graham et al. 2008), develop a capacity for self-reflection, heal emotional injuries, build confidence (Hellum, Jensen, and Nielsen 2017), and increase understanding of oneself and others (Stuckey and Nobel 2010). Importantly, there is a disproportionate number of people experiencing homelessness with mental health and substance use disorders who are not in treatment (Center for Substance Abuse Treatment 2013). According to the most recent data, it is estimated that in Michigan over 40% of people experiencing homelessness have both a mental health and physical health diagnosis. It is also well documented that people experiencing homelessness experience a perceived sense of unwelcomeness and discrimination by the healthcare system (Wen et al. 2007); which is worrisome, as it may contribute to one of the many barriers people experiencing homelessness face when attempting to access needed healthcare.  

Over the course of our project, we conducted 5 in-person writing workshops at the Delonis Center in downtown Ann Arbor, MI, with 28 total participants. Seven participants indicated an interest in sharing their stories through publishing, so we worked longitudinally with them, audio recording their oral histories and then documenting them. The final versions were all approved by the storytellers prior to publication and were minimally edited, so as to stay true to the storytellers own words as much as possible. We also connected 9 people with social services to improve their socio-emotional wellbeing (e.g. cell phone assistance, transportation to medical appointments, etc.). We are currently in collaboration with Groundcover News (a print newspaper for which proceeds of newspaper sales provide income for people experiencing homelessness who sell the papers) and Auxocardia (online humanities medical journal at the University of Michigan) with the goal of sharing these stories with our academic and local communities to advocate and elevate the voices of people experiencing homelessness.  

This work has also deeply impacted us, both personally and professionally. Our storytellers were each incredibly unique in their identities and life experiences. We heard stories carrying the weight of childhoods full of trauma and abuse, stories of addiction, medical illness, mental health crises, the hurts of past relationships, and the uncertainties of being an immigrant in a new country. These were also stories filled with deep, meaningful human connections, stories permeated with resilience, triumph, love, altruism, and hope for the future. Besides a shared experience of homelessness, the most prominent parts of our storytellers’ narratives were these latter qualities (resilience, altruism, etc.). As one of our storytellers said so eloquently, “[people who are] homeless are not a monolith. There is diversity and complexity within their experiences.” As newly minted physicians aspiring to serve marginalized patients, this work reminded us to never cease in striving to see people as more than the labels that society or the medical community places on them. The saying “never judge a person unless you’ve walked a mile in their shoes” has never rang so true. 

We have learned that friendships with those whom society has cast on the margins is critical to the work in building a more equitable society. Proximity is perhaps the best word to describe what we believe our society could use a lot more of and was at the core of this project. We were moved and changed by these storytellers, our new friends, and are still in awe at their willingness to share so much of themselves with us. To hear and sit with their immense human suffering changed us. The reciprocal exchange of listening was therapeutic, not only for the storytellers, but for us as well, and we are more compassionate people as a result.  

Perhaps the greatest lesson has been a recognition that brokenness is what unites us as human beings and is the font through which compassion, mercy, and kindness flow. We are all broken by a culture of materialism and busyness that values products and productivity over human health and wellbeing. Some of us are broken by our relationships, by racism and other systemic injustices, by poverty, by addiction, or by our choices. Bryan Stevensen in his book Just Mercy writes: “We are bodies of broken bones. I guess I’d always known but never fully considered that being broken is what makes us human. We all have our reasons. Sometimes we’re fractured by the choices we make; sometimes we’re shattered by things we would never have chosen. But our brokenness is also the source of our common humanity, the basis for our shared search for comfort, meaning, and healing. Our shared vulnerability and imperfection nurtures and sustains our capacity for compassion. We have a choice. We can embrace our humanness, which means embracing our broken natures and the compassion that remains our best hope for healing. Or we can deny our brokenness, forswear compassion, and, as a result, deny our own humanity.”  

Our hope is that these stories cause us to reflect more deeply on our brokenness as individuals and as a society, and that our reflections be turned into action. We must hold ourselves and our local and national governments accountable to caring for the most vulnerable and marginalized members of our society. We must listen to and involve people experiencing the injustices themselves in any efforts to address these issues. We must give space for ourselves and for others to change, leaving room for compassion, mercy, and healing, in the process. This work has irrevocably changed us in ways we are still discovering for ourselves, and we hope that these stories will change others’ hearts and minds, too. 

We would like to thank the Albert Schweitzer Fellowship and the University of Michigan Medical School for their financial support of this work. We also would like to thank Dan Kelly and the Shelter Association of Washtenaw County, Dennis Archambault, Shelley Golsky, Molly Fessler and the editors at Auxocardia, Dr. Brent Williams, Lindsay Calka and the staff at Groundcover News, Wolverine Street Medicine, Mercy House and Mission A2, and each of the fearless storytellers who contributed to this work. 

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