Caring for LA’s Mentally Ill, Whose Job is It Anyway?

Caring for LA’s Mentally Ill, Whose Job is It Anyway?

JUST SAYIN’-We see them all around us.  Sometimes we stop to chat and maybe give them a few dollars or buy them a sandwich, but have we ever thought about what happens to them after we go about our business?  Do they become invisible to us, especially as night falls?  Do they sleep during the day and stay up all night for their safety?  Do they live in camps or a tent town along downtown sidewalks?  Do they eat refuse out of garbage cans and wear throw-aways for garments?

Do we ever think about all that?

Well, earlier in December I attended a town hall meeting sponsored by the Van Nuys Neighborhood Council (co-sponsored by the North Hollywood NC) and featuring speakers from a variety of organizations.  They had somewhat similar stories to tell, but all agreed on the linkage between homelessness and mental illness.

Mayor Garcetti certainly recognizes this problem and has committed his administration to ending veteran (about 6600 under the present count) and non-veteran homelessness in our City by 2016.  Idealistically, the goal is to find permanent housing at the rate of 300 per month which should virtually eliminate veteran homelessness in the near future after which the other two categories of homelessness—the short-term and the chronic—would be addressed.  There is a program called Home for Good (under the umbrella of the United Way) which is already trying to accomplish these goals.

One problem that we face is the proliferation of non-profit organizations (as well-intentioned as they are) which keep re-inventing the wheel and often working at cross-purposes.  Thus, a coordinated effort must be designed.  Such an endeavor, however, would require more resources than are available at the moment—something that poses another challenge.  In addition, it is necessary that all stakeholders be involved in the decision-making:  intake, diagnosis, treatment with follow-up, determination of and then application for assistance eligibility, provision of good nutrition and clothing, job training suitable to their abilities, and (in many ways, especially) permanent housing—each person being placed in an affordable apartment or licensed home (perhaps sharing SSI funds with others in their situation to help cover costs).

It is also important to get an accurate demographic count of who the target groups are, the age range and gender, where clients usually stay, what kind of income and/or assistance is available to them and for what benefits are they eligible, and so forth.  These statistics will help the established programs know how to allocate offices, staff, and resources.

The City Attorney’s Office (Mike Feuer) is deeply involved.  It has established a program called Operation Healthy Streets.  It works with the respective City Council districts as well as the Department of Sanitation (locked storage for personal items is available to the homeless—a situation which can minimize the robberies that too often victimize this very vulnerable group all over again).

Among the speakers were representatives from Councilmembers Paul Krekorian and Nury Martinez who shared information about programs like the Valley Rescue Mission and the Homeless Connected Program.

The Chief of Staff from the office of Congressmember Tony Cárdenas spoke knowledgeably and enthusiastically about the Congressmember’s passion for addressing the twin issues of homelessness and the mentally ill.  He stated that veterans’ homelessness must be a shared responsibility from the local community all the way to Washington.

Since the Congressmember sits on the Health, Energy, and Commerce Committee, he wants to be a leader in finding ways to create more jobs and better job training.  This, in itself, will contribute to mitigating some of the homeless and mental illness concerns.  In addition, by maintaining, expanding, and improving upon the Affordable Care Act, all people will be better served in terms of physical and mental health.

Barbara Wilson, a prominent Mental Health Policy Specialist, spoke passionately about the connection between homelessness and the proliferating numbers of the mentally ill.  She reminded us that in 1970 California was number one in the nation for providing for the mentally ill population.  However, it was when Reagan was our governor some years later (1981) that many of those people were literally thrown out on the streets to make it pretty much on their own.

The reality is that those with mental disorders are still in great need of ongoing, in-patient care; follow-up by medical personal; provision of prescription drugs, etc.  Currently, Los Angeles County has the highest rate of the mentally ill in the nation!!  From first to nearly last (California now competes with Mississippi), California and Los Angeles, in particular, share the onus of offering the poorest mental health delivery system for these patients.

From certified mental hospitals back in the day (like the one that used to be located in Camarillo) to our Twin Towers, it appears that the prison system has been left to provide services for the mentally ill instead of their being furnished by more qualified mental health facilities. Our LA County’s jail system, in fact,houses the greatest concentration of people that have been or should have been diagnosed as mentally ill.  In considering our options, we must “go back to the future” and no longer leave the jail system as the arbiter of mental health care.

Philp Mangano, of the American Roundtable to Abolish Homelessness, stated, We must have the political will to see these issues through—from the beginning to wherever the needs take us.  Early intervention is essential since severe, chronic, and often disabling mental illness onset takes place between the ages of 18 and 25.  If not treated early on, such neglect can lead to criminal activity (really through no fault of their own—after all, if individuals are ill, they cannot possibly know they are ill, and therefore they will not know to seek help and treatment—a vicious tautological conundrum).  We, at the local level, must do what no other entity can do for us.  We must be the first in the health-care pyramid to mandate measures to mitigate and ameliorate these distressing exigencies.

Mangano is just one more professional who emphasized the need for permanent housing.  Not only will this make a difference to the psyche and feeling of self-worth for these patients, but from a fiduciary point of view, such housing is cost-effective:  what would normally cost the government from $35,000 to $150,000 per person per year for intervention services, would be dramatically reduced to between $12,000 and $25,000 per year.  What a difference!  Just think of how much more can be accomplished and for how many more as a result of this kind of help.  Certainly a goodly part of taxpayer burden would be lifted when the health issues for the homeless and mentally ill are handled properly.

There seemed to be an endless list of expert speakers that night.  The Cornerstone Program in Van Nuys (under the auspices of Dr. Adrienne Sheff and LSCW Bonnie Roth) is providing critical outreach to the neediest in the community.  The program works in partnership with the Van Nuys Police Division of LAPD (many of whose officers were in attendance that evening).

LAPD Captain John McMahon shared just how much police time and energy is taken up with the homeless and the mentally ill, many of whom pose real or potential threats to members in the community.  He added that there needs to be recognition among all people who work with or otherwise come into contact with these individuals that they are human beings first, people who are suffering from issues over which they have no control but whose needs must be met before it is too late.  We need to ascertain suitable and practical ways to address these pressing issues.

Other groups include Village Family Services under which is the TAY Program (Transitional Age Youth) which provides a drop-in center for young people aged 14 through 24.  Many come from foster care and are taught life skills and other kinds of training, in an effort to break the homeless cycle.  There are also classes teaching parenting skills.

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There is PATH (People Assisting the Homeless) with 22 locations statewide.  It concentrates on building new social networks for the previously homeless so that they don’t feel at a loss once they are removed from the previous milieu with which they were so familiar and where they  had often interacted with unsavory characters.  Helping them find a new family of friends who can also serve as good role models is so essential to their ultimate success, improved health, and outlook.

In addition, there is the long-standing Midnight Mission; the LA Family Housing Program; the LA County Health Department; the San Fernando Valley Community Health Center; the Weingarten Center; the National Alliance on Mental Illness (NAMI); the San Fernando Valley Rescue Mission.  These many alternatives necessitate coordination.  In other words, they must work together in alliance instead of separately, thus avoiding inevitable confusion and redundancy by functioning independently of each other.

We must hold our leaders’ feet to the fire.  When we help the most needy, the poor, the abused, the elderly, the hungry and cold, the homeless, and the mentally ill—we all benefit.

We must never fall into the “Who cares?!” trap.   We must act upon our concerns and help others to do the same.  During this season when we are thinking about what we can do for others, consider getting involved in one of these organizations (or others), not just now but throughout the year.

Just sayin’.

 

(Rosemary Jenkins is a Democratic activist and chair of the Northeast Valley Green Alliance. Jenkins has written A Quick-and=Easy Reference to Correct Grammar and Composition, Leticia in Her Wedding Dress and Other Poems, and Vignettes for Understanding Literary and Related Concepts.  She also writes for CityWatch.  This piece is part of an ongoing CityWatch series … Who Are The Real Angelinos … exploring the myriad peoples and cultures that define Los Angeles.)

-cw