L.A. County's current formula won't solve homeless problem

Bob, a man with bipolar disorder, has lived on the sidewalk of a busy Eagle Rock boulevard for a dozen years, with his belongings piled up around him.

Just a few feet from his mattress, an apartment building that was designed to help people just like him is nearing completion. But it's not clear that Bob will get in.

"We'll see if it works out," Bob told me last week.

In Koreatown, a gent named Khan lives next to the L.A. County Department of Mental Health's parking lot, under a tree with dozens of tea bags dangling from its branches.

"I chuck them up there," he said. Then he asked me to get him some hot water from IHOP so he could brew himself another cup.

I looked into this and learned that the mental health department has tried to help, but Khan, who says he's been in that spot for five years, claims his many problems are not mental. So there he lies, talking about all the forces out to get him.

Situations like these are unnaturally common in Los Angeles, where encampments have sprouted far beyond skid row. And it sometimes seems as if people with standard living situations who drive by the encampments have come to accept that other people, including very sick people, live on the streets indefinitely with all their belongings at their side.

Some street-dwellers claim they don't want help, though in my experience, that's seldom the case.

Others want help that doesn't exist.

And merchants and residents in regular houses, apartments and condos understandably get fed up with some of the unpleasant things that happen when people who live in tents or boxes without closets or kitchens or plumbing become their neighbors.

But instead of meaningful solutions, what we get are disjointed efforts often aimed at addressing symptoms rather than causes. Case in point: the L.A. City Council's current move to confiscate the belongings of homeless people.

That might clear a walkway for a few hours, but it's in the same league as writing jaywalking tickets to skid row schizophrenics.

I've been paying more attention lately to the topic of people living on Los Angeles streets for three reasons:

First, I've been focusing on issues of income inequality in Los Angeles of late, and housing is a key part of that problem.

Second, I'll be moderating a Zocalo discussion next Monday about what programs and strategies keep people off the streets.

Third, a contingent of mental health advocates have been asking me to oppose a proposal to fold the county departments of mental health and public health into the health services department to make one super-sized conglomerate.

They fear that this fusion of already big departments poses the greatest threat to mental health services in years, that the new department will favor meds over more holistic mental health recovery programs and that a drawn-out reorganization will distract from key challenges such as helping the chronically ill homeless population.

Are they right?

I don't have a definitive answer. That's partly because L.A. County supervisors, who voted to move toward consolidation, first considered the idea in private and have since done a lousy job of explaining why it should happen or how it would work.

Supervisor Mike Antonovich is gung-ho for the change, saying it will break down barriers and produce a savings. That sounds good but doesn't mean much without more detail.

And county health services Director Mitch Katz, the likely czar of the new three-unit department, has said it would integrate care for patients who suffer from physical, mental and addiction issues.

That happens to be a good description of the most hard-core homeless population, so I can't reject the idea out of hand.

And I'm also influenced by my respect for mental health advocate Mollie Lowery of Housing Works, who favors consolidation.

In the current setup, she said, there are far too many barriers to getting treatment and housing for people like Bob. She's had more success, she said, going through the county health department than the county mental health department.

The mental health department wants Bob, for instance, to fill out lots of forms and show that he meets all sorts of criteria, when the obvious thing to do is take him by the hand and give him the first unit in the supportive housing that's about to open 20 feet from his mattress. I'd like to hear the proponents of consolidation explain how to speed that process.

Here's another concern:

Katz gets generally high marks for his work. But the county has not had a particularly proud history when it comes to picking department heads.

What if Katz gets ticked off one day by a supervisor's imperial tantrum, or grows weary of a screwball system in which he's got to appease five kings but no one's in charge of anything? What if he turns tail and runs for the hills?

We could be stuck with a weaker administrator running what would be a super-entity that handles county hospitals and clinics, disease outbreaks, nursing home and restaurant inspections, and the largest county mental health department in the country.

So I need more evidence that things will change for the better if three departments become one.

And to get back to the Zocalo question, what works to lure homeless people in and keep them housed is not a mystery.

You have to begin with the understanding that improving the lives of some homeless people, like Bob and Khan, takes a lot of work.

It took me a full year to earn the trust of Nathaniel, the homeless musician I've written about. It took time to understand his illness and help him past his fears.

Even when our health agencies and service providers invest in that kind of outreach, however, there is nowhere near enough housing. And nowhere near enough supportive services, with emphasis on mental health treatment, addiction therapy and long-lasting case management.

Until the city invests seriously in all of that, encampments will be with us here in the land of below sea level wages and sky-high real estate. And confiscating property or redrawing government hierarchy won't change that.

steve.lopez@latimes.com

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