Over eight years, Melissa Schroeder’s life was taken over a little at a time by her addiction to methamphetamines and alcohol until she became homeless, sleeping on friends' couches and staying in motels.

In that time, she overdosed eight times and had tried treatment in four instances. Her last overdose was on Jan. 24, 2014.

“There are reasons why every addict drinks or uses drugs,” Schroeder said. “We just don’t wake up one day and say, 'oh, today I’m just going to jump up and become a meth addict and completely tear down my whole world.'”

Addiction, though, is just one of many factors within the increasingly complex problem that is homelessness in North Dakota.

“There’s a process of trying to understand what the larger situation is and that can be a hard thing, especially when you’re dealing with scarcity of resources in terms of law enforcement and service provision,” said Christina Sambor, executive director of FUSE, a coalition with the aim of ending human sexual exploitation. “When you have a corner of our state that has just been bombarded with both positive and negative impacts from the oil boom, you have competing interests.”

The solution is in understanding the connections between homelessness and addiction or mental illness, said Michael Carbone, executive director of the National Coalition for Homeless People.

“Educating the public about those linkages is really important so that we can provide additional services without stigma and without judgment,” he said.

Both addiction and homelessness have their own sets of stereotypes, according to Schroeder.

“Some of the stereotypes are that all addicts are criminals, that addicts have no willpower, that addicts choose to live like that and that they are born that way,” she said. “It’s far from that. Homelessness and addiction have many, many faces.”

Schroeder was an educated woman with a teaching degree, she was a wife and a mother before her life slid downhill when her husband died of esophageal cancer.

“The moment he was gone, I knew my life was never going to be the same,” she said. “At that moment, I couldn’t imagine living life without him.”

Schroeder said she doesn’t fit the stereotype of an addict and people can’t tell she is one just by looking at her.

“I think because people aren’t educated on addiction and homelessness that the stereotypes come out,” she said.

Cause, effects blended

Addiction is not the only way that drugs or alcohol play a role in homelessness. It can be the cause, but it also can be an effect.

Carbone said he knew a man from Fargo who would stand outside the hospital emergency room and drink enough alcohol to be admitted for detox because it was better than remaining out in the cold.

The man did this for 200 nights in one year, he said.

Kate Brovold-Stoa, extended care director at West Central, said that it’s also common for people with mental health problems to self-medicate with alcohol when they can’t get medication.

“There’s a pattern with most addicts that, if they have a mental illness or they have a disorder, that once they’re unmedicated, then their use progresses,” said Schroeder, who also suffers from bipolar II and needs medication daily.

Brovold-Stoa said there are numerous reasons why someone might be off of their medication.

“When people don’t get nutritious meals, their medication doesn’t work properly or they struggle with taking their medication because they are homeless,” she said. “Maybe they’re used to someone giving their medication to them or they can’t fill it because they can’t afford medication."

Symptoms can deepen as instability sets in.

“If you’re a paranoid schizophrenic and you’re struggling with your medication, you may think that your neighbors are trying to take your money or they’re going to hurt you, or God may be talking to you,”said Brovold-Stoa, adding that the situation can become unstable and unsafe for everyone.

Supportive housing and emergency housing for people in need of professional care are components missing from the system, Carbone said.

Deterioration of mental health can occur in a homeless person with no history of mental illness.

“You may develop it when you become homeless, depending on the trauma you deal with. People always think of the psychotic piece. Mostly, you’re going to see situational mental health, depression or anxiety," Brovold-Stoa said.

The key to helping people with a disorder or an addiction is to connect them with professional services and a treatment plan, but it only works if that person wants the help at that time, she said.

“People just want us to take care of the problem and that’s really not the way to go to recovery. We truly believe for somebody to recover they have to go in the direction they want to go,” Brovold-Stoa said. “It isn’t black and white, because every individual is different. They have rights and just because they don’t meet your standards of living doesn’t mean that that’s not OK.”

Schroeder went to treatment four times before her treatment program in 2014 stuck.

“My reason for treatment is that I know me as a person,” she said. “I have another bout of drugs in me, but I don’t have another recovery in me. For me, treatment meant saving my life.”

According to Schroeder, treatment won't work if there is not a stable environment.

“How can you go to treatment without the stability of a place to live?” she said. “That’s setting yourself up for failure. You have to feel safe, you have to be drug-free and in a drug-free environment.”

Jail a poor option

Without the required stability, mental illness and drug- and alcohol-related issues have spilled over into corrections.

A majority of the homeless in the Burleigh County Detention Center are mentally ill, or are there for alcohol- or drug-related offenses, according to Maj. Steven Hall, from the Burleigh County Sheriff’s Department.

“We are seeing people here that have committed crimes, and the underlying cause of this is mental health. I think our infrastructure for mental health is not keeping up,” he said. “We can’t manage mental health through the jail. It’s not what the jail was meant to fill.”

It takes a great amount of time to move mentally ill individuals out of the jail and to court-mandated services and it only happens in extreme circumstances, according to Hall.

There are usually no services available,  which means those individuals have to stay put, turning the jail into a holding facility, which puts strain on the inmates and the officers because the jail becomes overcrowded, he said.

“Some with mental health issues can’t be housed with other people. They’re not stable to be around other people,” said Sgt. Casey Kapp, of the Burleigh County Sheriff’s Department.

During the winter, many homeless individuals will commit smaller crimes because they want to be in jail for a warm place to stay, according to Kapp.

“We have a pretty good suspicion because we won’t see them throughout the summer and then, all of a sudden, they’ll be back in for criminal trespassing or something,” said Kapp, pointing to such activity as a survival mechanism.

Hall said that a man told him that he was “willing to take the risk because being here was better than being homeless.”

By committing crimes, the homeless decrease the likelihood of getting an apartment or a job because they have records, which can lead to an increase in recidivism, according to Hall.

But there is more.

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“Human trafficking often is an outgrowth of people who are vulnerable to exploitation,” Sambor said. “Homelessness adds to that because you’re in a place where you’re not getting your basic needs met. Anyone that can provide those needs then has the ability to control your behavior to a certain extent.”

Human trafficking is considered a modern-day form of slavery that includes sex trafficking and labor trafficking, according to the National Human Trafficking Resource Center.

The most common form in North Dakota is commercial sex.

Sambor said that victims of human trafficking tend to be victims of abuse or vulnerable individuals, such as youth.

“Most people that are in the commercial sex industry are in the industry because of push factors, whether that’s poverty, sexism, racism or abuse that push them to a point. They’re doing something that, if they had another viable choice in their mind, they would take that choice," Sambor said.

The largest issue facing those pulled into human trafficking is being seen as victims, according to Sambor.

Darianne Johnson, executive director of Domestic Violence and Rape Crisis Center in Dickinson, said that there is a culture of blaming the victim for her situation.

“There’s a lot of reasons she doesn’t leave,” Johnson said. “In some ways, it might be safer to stay there because they know what will happen.”

There might not be anywhere for these women to go. In the case of domestic violence, mothers will stay in bad situations for their children, Johnson said.

“When you are living in a domestic violence situation and leave, you are immediately homeless,” she said.

Stretched beyond capacity

Women also choose to stay in their situations because North Dakota lacks domestic violence and victims services. The shelter in Dickinson only holds 18 people.

“The women know that the shelters are full, so then what are they going to do, freeze to death or stay with your abuser,” Carbone said. “We’ve got a lot of women right now who are in abusive situations that need and want desperately to get out, and they’re trapped.”

What many women don’t realize, that even if the shelters are full, they won’t be turned away, according to Johnson, explaining they can be sent to 

“I don’t want victims to feel like they have nowhere to go,” she said. “Shelters will never turn away a domestic violence victim. We’ll find a way. We will do everything in our power to help them.”

The services and the solutions they can provide are overtaxed.

“Everyone deserves and has a right to basic safety and secure housing that’s appropriate for their needs,” Carbone said. “What it means is we need to develop the types of housing opportunities that meet the needs of our most vulnerable people.”

An increasingly large issue is the lack of housing support for individuals with records, including victims of human trafficking that may have prostitution charges on their records, according to Carbone.

“Landlords are getting more and more particular about who they let in,” he said. “When someone goes to corrections and comes back out, we, as a society, are expecting them to be mainstreamed and to offend no more. Well, if we don’t allow them to rent an apartment and a job, the odds of them succeeding are very slim.”

In the end, the homelessness problem in North Dakota affects the entire state, he said, and the state should lead the fight on ending homelessness.

“For any community that’s got people living on the streets, it’s not healthy for the psyche of the community and it’s not healthy for the reputation of the community,” Carbone said. “If we want to be strong vital communities, we need to care of all of our people.”

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(Reach Karee Magee at 701-250-8251 or karee.magee@bismarcktribune.com.)