Cornerstone Gives the Homeless a Place to Start : Social services: The program offers a daytime haven for mentally ill transients.

It is late in the month, three weeks since the monthly $341 welfare checks arrived, and the living room and kitchen in the nondescript, stucco house on Van Nuys Boulevard are filling up.

As many as 70 men and women, virtually all of them homeless and diagnosed as suffering from a serious mental illness such as schizophrenia or manic-depression, will stop in during the day for a meal, a shower, to wash clothes, pick up mail, make a telephone call or attend a group counseling session.

Called Cornerstone, the program run by the San Fernando Valley Community Mental Health Center is unique in the Valley and one of the only places where those who are homeless and mentally ill can touch down in safety.

“I don’t know what I’d do if it wasn’t for this place,” said Michael Brown, 35, who has lived on the street for three years, ever since he quit his job after domestic and drug problems and the death of his mother caused him to have several nervous breakdowns. “We can hear from relatives, take a shower, eat and be with people who can talk to us about our problems or as a friend.”

But while it is a haven for the mentally ill homeless in the Valley, the Van Nuys drop-in center also serves as a reminder that services for them are inadequate and that most are still forced to spend their nights on the streets.

Advocates estimate the number of mentally ill homeless in the San Fernando Valley at between 1,500 and 2,000. Many bed down for the night in downtown Van Nuys, parts of North Hollywood, the Hansen Dam area of Lake View Terrace and some of the parks in Chatsworth.

Although as many as 50% of those with severe mental illnesses could work and live relatively normal lives with proper treatment and medication, experts said, clinic closures and other reductions in services mean that they must go without.

As a result, they often end up on the street until, in many cases, their illnesses send them into a downward spiral so deep that they are a danger to themselves or others. Once homeless, the mentally ill are faced with endless red tape, a mismatch between services and needs, and interminable waits created by stingy funding--hoops that many are unable, or unwilling, to jump through--to get off the streets.

Cornerstone, whose four-person staff is supported by a budget of $197,000 through a contract with the Los Angeles County Department of Mental Health, helps them negotiate the maze. Its clients are referred by crisis centers, hospitals and law enforcement and welfare agencies.

“When they first come to us, they’re in a crisis and we work with them,” said Ludelia Cowan, Cornerstone’s program manager.

Cornerstone’s staff has them evaluated, then referred for treatment, sometimes in a four-month residential program run by the program’s parent agency. Others are sent to the agency’s doctors for anti-psychotic or anti-depressant drugs and counseling. They’re also helped to apply for welfare and Supplemental Security Income benefits and, if possible, housing.

“Most people don’t know a lot of services are available, unless they come to a place like this,” said Calvin, a 40-year-old ex-janitor and bus driver with the Los Angeles Unified School District who has been homeless since 1989 and is now a Cornerstone client. His name has been changed at his request.

“I see people on the street who . . . should be on medication and they just can’t get it,” he said. “I’ve seen guys on the street who are just shaking so bad, they’re totally dysfunctional with alcohol or drugs and they just can’t get any care.”

Even though they are still homeless and return to alleys, doorways and parks around downtown Van Nuys at night, Calvin and other clients of the drop-in center said they feel as though they are in an upper class compared to such street denizens as the “dirt man” or “Thelma.”

The “dirt man” deliberately covers himself in dirt and “Thelma” stands in the same doorway on Van Nuys Boulevard every day, spraying the sidewalk with liquid detergent.

With the number of people receiving county-funded mental health services slashed from 100,000 a few years ago, to about 50,000 now, the mentally ill “suffer a lot longer and it just gets worse and worse” before they get treated, said Calvin, who is well-informed, he says, from the hours he spends reading in the library to pass time.

Over the past 30 years, huge mental health institutions were shut down because they came to be considered mere warehouses of misery. Many of their patients were sent into communities, theoretically to receive treatment and other services at local clinics and board-and-care homes. Over the past decade many of those services have disappeared.

“What it really means is that . . . the street has become one of the largest ad-hoc mental hospitals we have,” said Dr. Ian Hunter, executive director of Cornerstone’s parent agency. “There is simply nothing left, and that is where they end up.”

A study of homelessness in 22 major cities including Los Angeles, released last month by the U.S. Conference of Mayors, concluded that at least 30% of the 208,000 people living on the streets in those cities were mentally ill. Their ranks had increased 7% from a year earlier, and the number of the homeless who were both ill and addicted to either drugs or alcohol had increased by 9%.

A committee of providers, advocates and county officials who prepared Los Angeles’ responses to the survey concluded that 85% of the county’s mentally ill must wait at least two months before they can see a doctor and obtain anti-depressant, anti-psychotic or other mood-altering drugs that will help them cope. Drugs and alcohol are exacerbating the problems, they said. And long-term solutions, such as an adequate supply of permanent, affordable housing, linked to out-patient mental health services, are not in sight.

Eva McCraven, assistant executive director of the Hillview Mental Health Center in Lake View Terrace, said MediCal, the state’s health insurance program for the poor, once paid for mental health services and her program thrived. With their housing and food paid for by Social Security disability payments and food stamps, and their mental health treatment also paid, those who were poor and sick were able to live stable lives in apartments or board and care homes, she said.

Then, however, MediCal auditors began refusing to pay for the treatment and the programs disappeared as they sought to save money, she said. Now, Hillview’s residential and counseling programs are much smaller and are run under contract with the county.

“We said years ago that the streets are going to be filled with people we used to treat . . . and now we see our clients on Van Nuys Boulevard all the time, just walking around,” she said.

She said most of them aren’t dangerous or violent, “but they’re pretty helpless,” she said. “They skirt the edges of the mental health system, and they don’t come off as crazy . . . but no one has time to work with them. They’re just out there.”

Fran Griffith, chief of the county mental health department’s homeless and housing unit, said: “They respond if you do compassionate, sensitive outreach to them over a period of time, and give them the things they want--food, shelter, clothing and their benefits--not necessarily treatment. The treatment part comes once a relationship is established.”

The congenial, low-key atmosphere at Cornerstone seems to reflect Griffith’s philosophy. The clients can rest, pour themselves a cup of coffee, watch television, do laundry and work out the complex details of getting benefits or replacing stolen or lost identification cards. They seem to treat one another with respect and friendliness, both at the center and when they go back to the streets or to an emergency shelter on cold nights.

But once on the street, the rules are simple and violent. “You just hope that nobody tries to cut your throat, so you’d have to cut their throat,” said David, a 32-year-old ex-Postal Service employee who has been living on the streets of Van Nuys for about a year. Such stresses “compound the problems you have within you” and make the companionship and understanding offered at Cornerstone all the more important.

Michael Brown, who tries to see his three children in Los Angeles twice a month, said Cornerstone has helped him start rebuilding his life. He signed up for a job training and drug rehabilitation program, has applied for disability benefits and, with the help of the drug Thorazine and counseling, is beginning to cope with his severe depression.

“I’m learning not to hold it all in all the time and sometimes be able to talk to people, to open up and say stuff and let it out,” he said.

When he leaves the center at 4 p.m. he heads to the nearby library to read. Later, he goes to a storage unit he rents with another Cornerstone client and retrieves the bedding and other belongings he needs for the night. Then he makes his camp near an office building where he knows the night watchman.

The worst part of being on the street is the constant watchfulness that is required for safety, he said. He also hates the disdain he feels from passersby and even bus drivers.

One recent day, it was so cold outside he woke up at 5:30 a.m. To warm up, he caught a bus headed down Van Nuys Boulevard to Los Angeles International Airport. When the bus was to return, the driver told him he could not re-board, even though he had a valid monthly pass. “I was so upset,” Brown said. “He gave me a hard time and it was totally uncalled for.”

Qualifying for $683 in monthly disability benefits could help Brown find a place to live, but so far the state has rejected his application. That is common, advocates for the homeless said.

Even perfectly filled-out applications can take as long as a year to process, because of a 40,000-case backlog in the county, and missing a doctor’s appointment, losing a piece of paper or failing to fill out a form correctly can set the process back to square one, advocates said.

Having qualified for SSI, the choice of living arrangements is still limited because the cheapest apartment in the Valley costs at least $450, and would not leave enough money for medication, food and transportation. Another option is board-and-care homes in the Valley, which require residents to share a bedroom, and to spend virtually their entire benefit check. Experts said few of the mentally ill are willing, or able, to live in those circumstances.

Another possibility is to rent a room in a single-room-occupancy hotel, most of which are located in Los Angeles’ downtown Skid Row.

But Cowan said most of her clients do not want to leave the Valley for Skid Row. “The homeless down there are tough and scary and they’re afraid they’ll get ripped off,” she said.

She would like to get an abandoned or run-down house, which the clients could fix up, run and live in. “It would give them some pride in themselves, so they’re able to do something, and see they can succeed,” Cowan said. “They’ve have had so much rejection . . . and rather than trying again, they just give up.”

Richard Van Horn, the executive director of the Mental Health Assn. of Los Angeles, said one solution to the problem of homelessness among the mentally ill is to establish 10 or more outreach programs, similar to Cornerstone’s, around the county. In addition, permanent housing must be built or refurbished so that people who are sick really have the option of leaving the street.

“If a person has a place to live and something to do during the day and if they have a friend or two in this world, a whole lot of the symptoms disappear,” Van Horn said. “If a person is on edge and anxious and thinking, ‘Where am I going to eat or sleep tomorrow,’ that puts a lot of stress on a person and makes their symptoms pop up again.”

Van Horn sits on a council on homelessness appointed by the Los Angeles County Board of Supervisors that this month will deliver to the board recommendations for dealing with the growing problem. In addition, a group of providers and residents in the Valley are about to issue a set of recommendations for improving the delivery of mental health services, including those targeting the homeless.

In January, the county is due to implement a series of procedural changes designed to quicken the process for helping clients qualify for Social Security disability benefits. Finally, county mental health officials are pushing hard to create more permanent housing, linked to mental health services.

Not only is stable housing therapeutic, it’s cost-effective, said Robert Sanborn, executive director of A Community of Friends, a nonprofit group spurred into existence by Los Angeles County mental health officials. The group is buying and rehabilitating 300 units of housing citywide and is a consultant to two projects being planned for the Valley totaling 67 units.

“By definition, a permanent housing situation creates a safe haven, and the individual is less concerned and improves in their mental health quicker,” Sanborn said. “The cost savings are incredible, because you, in effect, use less and less of the mental health system’s dollars.”

Calvin, the ex-school bus driver who is now signed up for job training and drug rehabilitation programs, said finding a place where he could afford to live “would be a start on something.”

“The main goal,” he said, “is to be self-sufficient. But sometimes you have to start out with something. Sometimes, you need a springboard.”