Breaking Down Silos

Meadows Institute leaders share homegrown solution for addressing homelessness for people with complex behavioral health needs at NatCon25

May 7, 2025

From left: Meadows Institute Senior Vice President for Specialty Care Darilynn Cardona-Beiler, Vice President of Complex Care and Executive Director of the Meadows Institute – Dallas Jen Erasime, and Chief Policy Officer John Snook

Darilynn Cardona-Beiler began her remarks at NatCon25 this week – the largest conference in mental health and substance use – with a question for the crowd: What is the cause of homelessness?

One audience member hazarded a guess – addiction? – but that answer didn’t seem to satisfy the other 100+ attendees in the room, among them social workers, clinicians, health care executives and policy influencers from across the country.

“There is no one root cause,” another audience member said. Cardona-Beiler, the Meadows Institute’s senior vice president for specialty health care, agreed. “Homelessness is a multifaceted issue – no single factor causes it – but our system tends to design programs that just focus on one of them.”

The solution to this complex problem, Cardona-Beiler said, is to break down the silos between the systems that support people experiencing homelessness—including mental health and housing—that too often operate in parallel when they must work together to be effective.

In Dallas, “our mental health system was waiting for the homeless system to respond, and our homeless system was waiting for the mental health system to respond,” said Cardona-Beiler. “There was no connection between the systems. They realized that they needed to do something differently.”

Now, a first-in-the-nation alliance is bringing these essential resources together in North Texas, serving as a model for the nation and offering real remedies for chronic homelessness. The need, Cardona-Beiler stressed, is urgent. In 2023, around 40% of people experiencing homelessness in Dallas and Collin counties had a serious mental illness, and 32% had a substance use disorder, figures that track nationally.

Last summer, the Meadows Institute, the North Texas Behavioral Health Authority, Housing Forward North Texas, and the All Neighbors Coalition launched an innovative program that aligns the community’s homelessness response system with its behavioral health care system, bringing life-changing mental health care directly to people experiencing homelessness.

What makes this program unique, said fellow panelist Jennifer Erasime, vice president of complex care at the Meadows Institute, is the integration of permanent, supportive housing and mental health support – a critical combination for people with complex behavioral health needs.

“We don’t want someone’s symptoms to make a person lose housing they worked so hard to get,” stressed Erasime. “These systems are working together so that we’re not asking a person to navigate both systems separately.”

To make this partnership happen, the community secured a first-ever waiver from the U.S. Department of Housing and Urban Development that allows federal funds to be spent on providing supportive care. Dallas can now combine state and federal resources, including a portion of the $22 million in funding from HUD to provide housing and comprehensive care, helping people transition off the streets for good. As a result, the community is now rehousing more people than ever before.

Meadows Institute Chief Policy Officer John Snook presents at NatCon25

Fellow panelist John Snook, the Meadows Institute’s chief policy officer, said the Dallas model is a strategy other communities can embrace at a time when cities across the country are grasping for solutions and federal housing policies are being reshaped.

Said Snook: “At a moment where there is uncertainty, and a real risk of being frozen in amber, here is an opportunity, a model, and a way to move us forward.”