How Compassion and Relationships Reduce Chronic Stress

This podcast and blog post is presented by the National Nurse-led Care Consortium (NNCC) and describes the unique needs of residents of public housing, underserved racial and ethnic communities, and other special and vulnerable populations and the role community health centers can play in addressing healing and trauma recovery. The below blog post will detail the examples presented in the podcast and provide additional resources for health centers.

What is chronic stress, and how does it manifest?

In this episode, our speakers deliver a topical conversation about the impact of chronic stress on personal and community health. Chronic stress refers to constant overwhelming and pressured feelings over a long period. Chronic stress can manifest from poverty, traumatic events, and environmental and interpersonal triggers. Chronic stress can impact individuals and communities.

Guiding principles in treating those with chronic stress

Both speakers share best practices in treating those with chronic stress; below is a highlight of some of the guiding principles mentioned during the podcast episode.

Relationship building

Building trust is essential in gaining and strengthening a relationship with the community. It is very important to bring people into the community to find common ground, collaborate and bring resources that better serve the health and daily lives of the residents. Observing the strengths and assets of the community will have helped to give a foundation for the relationship with the community. It is also vital to ask what areas need the most support and not just assume what the problems are.

At an individual level, Jeneen shares strategies to get to know a person and build a bedside relationship. This can be as simple as asking questions such as “Are you okay?” “Who are you as a person?” and “What brings you joy?” We ask participants questions with many repetitions of telling the story of why they came in to seek care. Showing genuine compassion and care opens the door for a person to become more comfortable and feel seen. It makes a difference when health professionals see the person, not just the explicit medical reason.

Listen at 8:21 to hear how Uzuri’s community is collaborating with the San Francisco police to strengthen the relationship between the two.

Meeting people where they are

Uzuri reminds us in this episode that we live in a melting pot, and meeting people where they are is indispensable and recognizes we all come from different walks of life, whether it’s a background of addiction, housing instability, or coming out of the hospital. It is key to remove implicit bias and actively listen to people to meet their needs best.

Jeneen shares the COACH model made in partnership with the CHOP PolicyLab. This model has been implemented to identify a person’s strengths to help people get from where they are to where they want to be, which can include to better relationships with healthcare providers, connections to transportation, housing and benefits, to name a few,  This sets patients up to successfully navigate barriers and advance their health and well-being.

Listen at 14:38 to hear the details and action steps of the COACH model.

Workforce 

The workforce and hiring process relates back to relationship building. It is necessary to have the right people working within the community, including culturally competent individuals and those who practice trauma-informed care. The workforce should be willing and able to support people every step of the way, from combating barriers and navigating insurance to finding the correct clinician. In this episode, both speakers highlight the resistance one can have in seeking and accepting care. This can be due to past experiences, fear of being retraumatized, or it simply being an overwhelming experience for them. Professionals should meet people with genuine compassion and be there for the patient when they are ready to accept care.

Listen at 25:00 to hear Jeneen share the hiring process that her organization uses to ensure the right people are in the field.

Lesson Learned

Fix it mentality 

The “fix it mentality” puts community members at a deficit. This happens when people outside the community don’t build relationships, collaborate with the community, and ask what support is needed. Working with the community and observing what they are experiencing helps to get a clearer picture of these communities with complex social needs and stressors.. Finally, When working in a community outside your own, it is vital to avoid assumptions about individual and community needs. 

Poverty Pimps

Similarly, Uzuri also speaks about “poverty pimps” in resource desert areas and their negative impact on the community by coming in, getting their numbers, and leaving.

Meet the Speakers 

Uzuri Pease-Greene is the Executive Director of the Community Awareness Resource Entity (C.A.R.E.) in San Francisco, a nonprofit organization founded in San Francisco public housing by Uzuri’s husband. C.A.R.E. has since evolved as an organization that serves residents of public housing and various communities. As Uzuri explains in the episode, C.A.R.E. prides itself on building the communication bridge between community members and law enforcement. At C.A.R.E., staff works to connect people with additional resources by collaborating with local organizations to help better the lives of the community.

Jeneen Skinner works in Camden, New Jersey, and is the Senior Clinical Manager for care management initiatives for the Camden Coalition of Healthcare Providers. Camden Coalition is a multidisciplinary nonprofit organization in Camden, New Jersey, working to improve care for people with complex health and social needs by implementing person-centered programs and piloting new models that address chronic issues and social barriers to overall health and well-being in Camden and nationally.

Additional Resources

To learn more about the issues discussed in this episode, check out a related training webinar available online: Chronic Stress, Housing, and Health: Patient Experiences and Strategies for Comprehensive Care

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Support for this episode comes from the Health Resources and Services Administration (or HRSA) of the U.S. Department of Health and Human Services (HHS). It is part of an award totaling $550,000 with zero percentage financed with non-governmental sources. The contents of this podcast are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government.