Tuesday, March 22, 2011

Homeless and mentally ill people in Michigan struggle to find their place

From The Grand Rapids Press in Mich.:

At 38, Lara Class never thought she would be living with her parents. But when she suffered a breakdown that led to a diagnosis of bipolar disorder, she lost her job and her apartment in Washington, D.C.

Now, rebuilding her life, career and credit rating, Class is struggling to find an affordable place of her own in the Grand Rapids area.

Roland Tibbe (pictured) never dreamed he would have his own apartment, a light-filled sanctuary that overlooks the streets he once wandered.

“I’ve gone from hell to heaven,” Tibbe said, as he sat in a recliner and recalled the nights he slept in doorways, weighed down by depression and alcoholism. “That’s the only way I can explain it.”

The situations in which Class and Tibbe find themselves highlight the housing challenges that can surface when a person’s life is turned upside down by mental illness. Local agencies have crafted approaches to meet those challenges, though mental health officials say gaps remain.

The housing picture is complex, in part because mental illness encompasses such a wide range of conditions. About one in every four people has a mental illness in any given year, according to the Mental Health Foundation. They are part of the fabric of every neighborhood and every community, and most don’t need help securing a place to live.

But for those whose illness interferes with their ability to maintain jobs or relationships, or who encounter discrimination because of it, finding safe, affordable housing is no easy task. Yet it is crucial to recovery, experts say.

“They’re more likely to take their medications because they can focus on other aspects of life, like seeing a doctor and a counselor, getting involved in employment and contributing to the community,” said Paul Ippel, executive director of Network 180, the mental health authority for Kent County.

The housing challenges for people with mental illness are as varied as the individuals affected. No one solution fits all. But the programs developed to meet those needs share two premises:

Everyone deserves a home.

The consumer, not a case worker, is the decision-maker.

The “person-centered” approach represents a change in attitude over the past 15 years, said Pat Hawkins, a case manager for Pine Rest Mental Health Services. In an office at 339 S. Division Ave., she works with people who are considered chronically mentally ill. They have schizophrenia, bipolar disorder or severe depression. About 60 percent to 80 percent also have substance abuse issues.

When she meets clients, she doesn’t assume she knows what they need; she asks them to tell her. What she hears repeatedly is, “They want their independence.”

Depending on the level of support they need in day-to-day living, the options range from independent apartments to adult foster care homes. Many choose an in-between option — subsidized housing facilities where they live independently but have support services available.

A popular choice is the four apartment complexes run by Genesis, a nonprofit formed in 1998 by the Inner City Christian Federation, Dwelling Place of Grand Rapids and Hope Network to provide housing for people with disabilities, including mental illness.

“They’re wonderful,” Hawkins said. “I would love living there.”

A social worker at each complex helps with problem-solving, paying rent, accessing benefits and other tasks. Using Section 8 vouchers, residents pay 30 percent of their income toward rent. About 85 percent of residents have annual incomes of $10,000 or less, so the subsidy is crucial, said John Wynbeek, executive director of Genesis.

The bad news is the waiting list for the 127 Genesis apartments can be as long as 10 years, Hawkins said.

Wynbeek said he was not sure how long the waiting list is today, but he acknowledged there are not nearly enough apartments.

“It’s frustrating because we get calls sometimes from someone in need, and they will present a valid need and a challenging situation, and I have to tell them, ‘You have to go on a waiting list. It’s multiyear, and we can’t help you meet your needs today,’” he said.

For those struggling with a severe and persistent mental illness who are not ready to live on their own, Hope Network provides facilities that help in the transition. Many residents come to the programs following discharge from a psychiatric hospital. Often, they have a history of trouble fitting into the community, said Pat Howe, the network’s vice president of behavioral health services.

The 26 homes in West Michigan provide a structured setting where residents receive treatment and help with daily activities. On average, they stay for nine months before moving into the community.

If a person has no money and does not qualify for Social Security disability, Hawkins said, often, the only place she can refer them is a shelter.

One of the biggest needs is housing for people who have a mental illness and a criminal record — a combination that is not uncommon, Ippel said.

“Frequently, people are using drugs or alcohol as an alternative to medication to manage schizophrenia or bipolar disorder,” he said.

Those who have drug convictions are barred from federal housing programs, and most landlords will not rent to them. The same is true for those convicted of criminal sexual conduct or found not guilty by reason of insanity, Hawkins said.

“They really are shunned,” she said.

If a conviction occurred many years ago, a caseworker can sometimes persuade a landlord to make an exception. If not, Hawkins said she knows of one option: the Exodus Building, a nonprofit that opened in 2009 in the former correctional facility at 322 Front Ave. SW. It provides dormlike housing for men, as well as mentoring, job assistance and Bible studies.

Some people dealing with mental illness and substance abuse become caught up in a cycle of homelessness. Five and a half years ago, a program called Street Reach was launched to help them find permanent homes.

Social workers go into the Heartside area, visit missions and attend free meals to let homeless people know help is available.

“We don’t force treatment on them because some people might just not be ready for that,” said Howard Falkinburg, clinical supervisor. “We let them know who we are and what services we can offer. It might take several months before they make that leap.”

The approach has reached nearly 100 clients, providing mental health services, substance abuse treatment and help with housing. Its housing placement success rate is 65 to 70 percent, Falkinburg said.

‘God gave me this’

One of those success stories is Roland Tibbe, who contacted Street Reach in May 2008, after years of homelessness. Tibbe now lives in Verne Barry Place, a renovated building at 60 S. Division Ave. that provides 116 apartments for the homeless and disabled.

“God gave me this,” Tibbe said, as he opened his door to visitors recently. His bedroom, small kitchen and sitting room were neatly furnished with items rescued from Dumpsters and carefully restored: a table built from a lamp base and door panel; a clock repainted, a teddy bear washed and placed on a shelf.

“I’m an alcoholic,” he said. “I still drink from time to time. I go to the recovery center every day because I don’t want to drink.”

Tibbe, 54, talked about how he turned to alcohol in rebellion against a strict father but found it was a trap that dominated his life. For about nine years, he said he bounced from rehab to the missions to the streets, where he slept in doorways, under trees or in abandoned cars.

When Clyde Sims, a Street Reach worker, helped him find his Heartside apartment, Tibbe couldn’t believe he had his own home. Now, he said, he is determined not to lose it.

“I see my past life every day — people carrying bags,” he said, pointing out the window at the street four stories below. “I carried them for nine years. But I’m not going back.”

Housing challenges are directly tied to poverty, Network 180’s Ippel said. Some people with severe and persistent mental illness qualify for disability, which averages about $900 a month. A third of that goes to rent if they live in federally subsidized housing — but there is not enough available, Ippel said.

Even the mentally ill who are able to hold full-time jobs encounter challenges.

Class, who moved back with her parents, said she lived on her own for about 15 years after college, running group homes for the developmentally disabled. She was diagnosed with major depression as a college student, but she said anti-depressants never helped her much. Two years ago, she hit a low point.

“I finally had a horrible breakdown in Washington, D.C.,” she said.

As depression overwhelmed her, she resigned from her job and shut herself in her apartment. She didn’t check her mail or answer her phone. At times, she sat in the closet and cried.

“I was actively fantasizing about jumping in front of a subway train,” she said.

After a friend insisted she get help, Class was treated in a day program at a psychiatric hospital. She also met a psychiatrist who diagnosed her condition as bipolar, rather than depression, and prescribed mood stabilizers. The crying spells stopped, and she was able to get out of bed and move on with her life.

In the transition, Class moved into her parents’ comfortable Wyoming house.

“I was fortunate to have parents who were willing,” she said. “They have been absolutely amazing about it. Very few get that.”

Class now works as a peer support specialist at River Valley Crisis, a short-term residential facility run by Hope Network. Even as she helps the clients find housing, she faces a housing crisis of her own.

Her parents plan to sell their home and move to New Mexico. Earning $9.50 an hour and handling co-pays for medication and counseling, Class said she doesn’t know how she will find an apartment she can afford. The $200 a month she pays her parents is about all she can manage. She also worries about how her credit history was affected by her breakdown, when bills went unpaid.

“I don’t qualify for anything,” she said. “I work full-time. I don’t have Medicaid or Social Security disability. I’ve always been high-functioning enough that I haven’t done any of that.”

Many others face similar problems. They may be capable, talented, and smart, but symptoms of mental illness disrupt their work life, affecting their bank account and, ultimately, their housing options. Those on disability may earn only a limited amount before their benefits, including Medicaid, are cut off, Ippel said.

He said more flexibility is needed to accommodate people who can work part-time. That, in turn, would improve their ability to afford housing.

And the ability to secure housing in turn improves their mental health, said Howe, of Hope Network.

“We ultimately want to put ourselves out of business,” she said. People with mental illness “should have access to the community and live lives to their fullest potential, just as you and I do.”