Publication Date

Spring 5-29-2023

Item Type


Executive Summary


Since 2016 King County’s unsheltered homeless individuals have increased by 24% and families experiencing homelessness have increased by 26% (National Alliance to End Homelessness, 2021). In the past 5 years, homelessness has risen by 10% in King County alone (NAEH, 2021). Our agency was an emergency family shelter located in King County that “ensures that no child sleeps outside by centering equity and opportunity for women and families” (Mary’s Place Seattle, n.d.-a). This facility has 5 other family center facilities that provide shelter and resources. Since 1999, our agency with its 6 facilities have aided thousands of women and families transition from homelessness into stable situations (Mary’s Place Seattle, n.d.-a).

As students pursuing a Bachelor of Science in Nursing at Seattle Pacific University, we worked alongside this agency in their vision of making its shelter a community where families have safety, stability, and housing. We have a background in health sciences and have assessed that there was a knowledge deficit in the community regarding access to crisis hotlines. We based our work with this shelter to incorporate their vision of safety and value of collaboration to provide crisis hotline resources to the community (Mary’s Place Seattle, n.d.-b). As professionals with an understanding in health promotion, we provided the community with a breathing exercise to relieve stress and anxiety individuals may encounter when dealing with situations where crisis hotlines are needed. Our goal with this project was to ensure families have knowledge on existing resources in the community for crisis events such as domestic violence, suicidal thoughts, unplanned pregnancies, substance abuse, and more. We anticipate the families are able to utilize these hotlines and spread the resources to others through the use of our flyers and word of mouth.


According to an article published by Harvard Public Health Review, suicide rates amongst the homeless population are nine times that of the general United States population (Holleran & Poon, 2018). This shocking statistic proves a need for better mental health crisis resources amongst the homeless population. To add to that, on one single night in King County, it was found that over 11,750 individuals experienced homelessness (Constantine, 2020). The community served by this organization is comprised of a variety of vulnerable populations with homelessness just being one factor of stress they may be experiencing. Residents of the community center may also be battling other issues such as substance use disorders, domestic violence, or managing medically fragile children. Providing them with a resource of national crisis hotlines and a stress reduction technique will give community members something easy and convenient to refer to in times of need.

Project Activity & Rationale

Our nursing diagnosis for the community was that there is a knowledge deficit related to mental health resources. Our goal was to increase the knowledge of crisis resources available to the community by the end of the quarter. This included providing the agency and their sites with crisis hotline resources in the form of flyers. The crisis hotlines offer individuals a platform to verbalize the situations that they are experiencing. Studies have shown that users feel a sense of relief in being able to talk through their experiences with staff (Rethink, n.d.). It reduces their sense of isolation and helps them to cope with “depression, anxiety, self-harm and suicide” (Rethink, n.d.). However, to benefit from these services, users must first be able to access them (Rethink, n.d.). Health-educational flyers are beneficial in situations where a wide audience of people needs to be reached for an extended period of time (Hasanica et al., 2020). They provide the necessary facts that individuals may need in a concise way. Abid et al. (2022) shows that a simple intervention, such as providing individuals with an information card, can greatly increase client-staff communication.

Another part of the resource we provided to the agency was on the back of the flyer which displayed a box-breathing method. Studies have demonstrated that rhythmic breathing methods are a “practical and effective tool to alleviate stress, improve health, and increase wellness” (Sharma et al., 2015). Evidence shows that youth experiencing homelessness are at an increased risk for violence victimization and perpetration (Petering et al., 2015, as cited in Barr et al., 2021). Mindfulness-based interventions can be used to reduce these violent and aggressive behaviors and cause improved emotional regulation (Gillions et al., 2019, as cited in Barr et al., 2021). Box-breathing is a method that can help control an individual’s breathing pattern to bring it back to baseline. This can help to calm the individual and keep them focused on the moment at hand.


We were given the opportunity to work at the agency’s health fair where we measured our outcomes based on our outreach to the community. 50 flyers were printed to be distributed at the health fair with the goal of distributing 25 flyers. This would result in a desired outreach of 50 percent. By the end of the fair, we distributed 7 flyers not meeting our goal and resulting in a desired outreach of 14 percent. However, clients and staff that received flyers reacted positively, and the remaining flyers were left at the facility for further distribution on intake. The primary limitation of measuring our outcomes was not having enough people visit our booth when we were there. We also found that measuring calls to the hotlines was not applicable to our project as we are not able to track calls to these mental health resources due to their nature of anonymity.


Our project goal was to increase awareness and access to mental health resources and crisis lines. After conducting a windshield survey and touring the site, we recognized a need for a quick and accessible information sheet to be handed out at the agency. We designed flyers containing crisis line resources and boxed-breathing exercises in hopes of addressing a knowledge deficit in the community. Our group went to the site and handed out flyers at the health fair. Although we did not meet our goal of distributing 25 flyers, we were given positive feedback about the flyers. One limitation was the sample size of guests attending the health fair. Next time, we would consider coming in more than once to pass out our flyers, to allow for potentially more outreach. The second limitation was that for the majority of the people at the fair, English was not their primary language, so we hope that in the future, the agency can continue to utilize our flyers for years to come and expand it to be more inclusive by offering translations to different languages.


Abid, M. H., Lucier, D. J., Hidrue, M. K., & Geisler, B. P. (2022). The effect of standardized hospitalist information cards on the patient experience: A quasi-experimental prospective cohort study. Journal of General Internal Medicine, 37, 3931-3936.

Barr, N., Petering, R., Onasch-Vera, L., Thompson, N., & Polsky, R. (2021). MYPATH: A novel mindfulness and yoga-based leader intervention to prevent violence among youth experiencing homelessness. Journal of Community Psychology, 50(4), 1952-1965.

Constantine, D. (2020, July 1). Point-in-Time count estimates a 5 percent increase in people experiencing homelessness, newly updated data dashboards reveal more people receiving shelter and services. King County.

Hasanica, N., Ramic-Catak, A., Mujezinovic, A., Begagic, S., Galijasevic, K., & Oruc, M. (2020). The effectiveness of leaflets and posters as a health education method. Mater Sociomed, 32(2), 135-139.

Holleran, L., & Poon, G. (2018). Dying in the shadows: suicide among the homeless. Harvard

Public Health Review, 20, 1–5.

Mary’s Place Seattle. (n.d.-a). About Us. Mary’s Place.

Mary’s Place Seattle. (n.d.-b). Our Mission. Mary’s Place.

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