Program Gives a Step Up to the Mentally Ill : Walk-In Center in Santa Monica Offers Supportive Community Care

Pat Seaton looks like a carefree Bohemian.

But he worries like a sailor adrift in a leaky boat.

Like many frequenting a cavernous building in Santa Monica, there is a duality in Seaton’s nature. With his long hair tucked under a jaunty, bemedaled black beret and twirling his fancy cane, Seaton seems self-assured, if eccentric.

But in conversation he admits to persistent feelings of confusion, uncertainty and fear.

Seaton, 26, is a former mental patient.

He says he was hospitalized “four or five times” because of his reactions to psychedelic drugs. These days--carrying a guitar, cane thrown across a shoulder to support a bindle--Seaton often shows up at Step Up on Second Street, a two-year-old program that seeks to provide a pressure-free atmosphere for the homeless mentally ill and others with wounded minds. Earlier this year Step Up--formerly known as Project Return Center--was one of the programs in the state praised by the authors of a widely publicized report criticizing California and ranking it 42nd among the states in quality of care for the mentally ill.

Seaton, who lives in a rented room and has made Step Up a regular stop for about a year, used a nautical metaphor to explain why he comes to the former retail store and warehouse--to play cards, strum his guitar or take part in discussion groups.

“I feel I can grow a lot easier being around people that have been through the same things I have, that are on the same level I am,” he said. “ . . . It’s kind of like a ship being out at sea and being able to come into a harbor during a gale. It’s kind of like a long time ago ships used to go close to the coast so they could always come into coves. Hopefully later on I’ll be able to go further out in the ocean but right now I’m kind of hugging the coast.”

For reasons like Seaton’s, about 60 to 70 men and women show up at Step Up most weekdays. They are lured by a center that shuns bureaucracy and--to their way of thinking--the intimidation of many programs for the mentally ill.

About 10% of the “members” of Step Up are homeless. But director Susan Dempsay estimated that 90% of the 700 people who have participated in the program this year have been homeless at one time and could find themselves without shelter at any time--often because their behavior forces their eviction from board and care homes. Many of the members receive monthly Social Security disability payments of a few hundred dollars, she added.

Elaborating on Step Up’s open-arms policy, Dempsay said, “Anyone is welcome to walk through the door. They don’t need to be referred, which is unusual. We don’t do an in-take (an assessment). We are not considering ourselves a treatment center; we’re not professionally trained as far as being mental health professionals. Our concept is to look at their abilities and not at their disabilities. We don’t require that anybody even be seeing a psychiatrist or be on medication.”

However, members aren’t allowed to idle away the time, either, Dempsay pointed out.

“After we get to know them, we begin to make suggestions. We give them a calendar (of events at the center),” she said. “They can come as little or as often as they like but we do insist that when they’re here, and there is a group, that they participate. So we’re not a drop-in center. We figure that wherever they’re living they can sit and do nothing. If they make the attempt to come here, we want to encourage them to participate.”

A Dual Purpose

Dempsay, an energetic woman of 50 who became involved in working with the mentally ill when her 26-year-old son Mark became schizophrenic, said she sees two missions for the program.

“My feeling is that, as important as serving the clients here is, it’s as important to change the public image of the mentally ill and to convince the county to move away from their medical model because they have proven not to be workable in the long run,” she said. “And that doesn’t mean you don’t need your hospitals, you don’t need your day treatment programs. But those are very time-limited. We need to create in the community a place that those who are not going to recover immediately have a supportive environment no matter how long it’s necessary.”

In some cases, just making contact with a person who has come through the doors can be difficult.

“We have a man in here who we know nothing about,” Dempsay said one day recently. “He’s been coming for one month. He is just totally . . . he’s quiet so he hasn’t been a problem and we’ve let him just be but now we’re trying to find out who he is, if he has a place and why he’s coming.”

But most of Step Up’s members have learned how to at least maintain an appearance of normalcy, Dempsay said.

“A lot of these people look like they should be functional and you look at them and say, ‘Why isn’t this person working?’ It’s a facade,” she said. “They can’t handle the competition, they can’t handle the pressure. Most of them have paranoid thoughts and even if they’re out there doing an excellent job, shortly they begin to feel that people are talking about them, that they know they’ve been in a mental hospital and they’re going to get fired because of it.”

Step Up’s members are a varied lot who defy stereotyping. Generally, their ages range from the early 20s to late 40s. Many are articulate and personable. Many have college or high school diplomas, Dempsay said. Some are meticulous dressers, including one man who arrived recently in an immaculate, matching green plaid golf slacks and cap teamed with yellow jacket and socks.

A Common Thread

Most are not so flashy. But whatever they are wearing--from the grimy, multilayered cast-offs of street people to neatly pressed slacks and shirts--the common thread they share is a mental one. Generally, they are manic-depressive, given to extreme swings in mood and self-perception, or schizophrenic, suffering from a baffling brain disease whose symptoms can include separation of thoughts and emotions, distortions of reality, delusions, hallucinations, fragmenting of personality and motor disturbances.

Few of these symptoms are apparent at Step Up. But many of the members exude a feeling of discomfort with themselves and their environment.

For instance, during a discussion group on homeless issues last week, Richard Ruston, 46, seemed to have mixed emotions about finding a better place to live than his current board and care home.

“I wake up to shave in the morning and there are cockroaches in the sinks and spiders crawling across my shaving lotion . . . I haven’t seen any rats,” commented Ruston, who said his mental illness coincided with his divorce and the breakup of his family. “It’s not really unbearable. I just carry my unhappiness with me. I’ve got a picture of my daughters and I look at it and I think of all the lost years. . . . I’ve got unhappiness.”

The program itself nearly became homeless over the summer when a financial crunch threatened to force Step Up out of its building, Dempsay said. The program’s chief expense then was $7,000 in monthly rent, she explained. However, the building at 1328 2nd St., Santa Monica, has since been purchased by the nonprofit Los Angeles Mental Health Assn. with money from an anonymous bequest and will be leased to Step Up for a “nominal” amount, she added.

Dempsay is convinced that the program would be mortally hurt if it ever had to abandon its current site.

“This location is at least 50% of our program,” she explained. “The feeling of this place is what gets people here and continues to have them come. We’re not located in the basement of a church or inside a mental health clinic . . . walking through the doors of a clinic they think that if they act up, they’re going to be grabbed and put in a hospital. This kind of place, which has a real relaxed and open and airy feeling is extremely important.”

The 7,000-square-foot building with a high ceiling does seem to have a low claustrophobia quotient. Small sections of the building have been partitioned off for offices and a thrift store, but nearly all of the structure is taken by an echoing, concrete-floored room. This huge room houses a small library, a clothing section where members may purchase apparel cheaply, pool and Ping-Pong tables, circles of chairs for discussion groups and a cafe-like grouping of umbrella tables where members drink decaffeinated coffee and talk about a multitude of subjects, from President Reagan to the latest movies. It is open to all comers between 9:30 a.m. and 5 p.m. Monday through Friday.

Not Without Controversy

Step Up’s recognition and financial support haven’t come without controversy, however. Before it was approved at a lengthy hearing by the Santa Monica City Council two years ago, the program had to overcome opponents who voiced concerns about Step Up’s clientele gathering in the town’s business district two blocks from the Pacific Ocean.

For example, Bernard H. Matthews, the 73-year-old manager of an apartment building behind Step Up’s headquarters, said he circulated petitions against the program throughout the neighborhood.

“We were dead set against them. We didn’t want them here. Nobody wanted them here,” he said. Now Matthews is a supporter and has donated a television, radios and clothing to the program, he said. “They turned out to be surprisingly different from what we thought they’d be,” he said.

Step Up is one of five such centers or clubhouses in California modeled after New York’s Fountain House, which claims 186 imitators in nine countries.

Dr. E. Fuller Torrey, a Washington psychiatrist and co-author of the Ralph Nader-affiliated Public Citizen Health Research Group’s report on national mental health care, said programs such as Step Up generally have proven to be cost-effective, as well as therapeutically valuable social centers. Their effectiveness stems partly from the fact that “they don’t pretend to be hospitals or prisons,” he said. While such programs are numerous in some states, they are “thin on the ground” in California, Torrey said.

Don Richardson--a Mar Vista resident who is president of the National Alliance for the Mentally Ill, a 65,000-member support group for families of the mentally ill--said that the Step Up program is “by far one of the most successful I have seen.”

Richardson, whose two sons suffer from mental illness, added that the program is good for the mentally healthy was well as the sick.

Many mentally ill people live with their parents, Richardson explained, and the center gives relatives a respite from the taxing, often infuriating, presence of a mentally ill person in the home.

Step Up was organized by the Mental Health Assn. of Los Angeles, a private, nonprofit agency involved in many mental health programs in the county. However, Dempsay, who was instrumental in getting the association to start the program, is putting together a seven-member board for the center that eventually will allow Step Up to “spin off” from the association.

Richard Van Horn, the association’s chief executive officer, said the move away from the association has happened with other programs, and for good reasons.

Local Support Needed

“It really needs a local board,” he said. “It needs the kind of support that only local boards can give.”

By Van Horn’s account and that of others, Step Up would not exist without Dempsay’s efforts, largely because she is not the kind of person who takes no for an answer. “I’m sure that some people consider her pushy,” he said.

Dempsay doesn’t deny that she goes after what she wants. Recalling her early gropings for support as her son’s illness developed, Dempsay said, “I just get real frustrated when I hear people expressing need and not moving ahead. I don’t say I was in any way a catalyst but I sat down with five or six others and said, ‘What can we do?’ ”