Home Remedy

“How I’d like to settle down and have a home. One is attached to a house one has arranged oneself, and feels at home in it. I cannot tell you how much pleasure it gives me ...”

-- Vincent van Gogh, before entering an Aries insane asylum

Boxed away in institutions, board and care homes and “custodial congregate living” arrangements, society’s most neglected group--the homeless mentally ill--are now being given the chance to establish affordable, permanent homes.

Creating that housing is a challenge fraught with obstacles. Mental health budgets are crippled by waning state and federal dollars. Some banks consider such housing a sorry risk, believing the projects are backed by unstable funding streams and filled with tenants whose paltry incomes barely finance the phone bill.

The clincher: Many homeowners disdain a neighboring household whose residents’ chronic diagnoses peg them as schizophrenic, manic depressive and schizoeffective.

After years of fragmented transitional housing solutions that only exacerbated the problem, a promising approach is being tried nationwide. Labeled “service enriched” or “service enhanced” housing, it blends public and private agencies to provide housing buttressed by mental health services.

In California, the new generation of housing is spearheaded by A Community of Friends (ACOF), formed in 1988 by housing activists and the Los Angeles County Department of Mental Health.

ACOF has since completed two projects, both located in Hollywood: the Orbison House, a four-unit apartment complex fronted by a spacious five-bedroom house, and the Selby Hotel, 29 single-room-occupancy (SRO) units adjacent to a two-bedroom house. Nine other projects are either under construction or in development.

The projects total 380 units and will double the county’s sparse 165 permanent units that house the homeless mentally ill. Still, the units represent a bare nick in housing a population estimated at about 25,000, a conservative number for Los Angeles County.

The key to ACOF’s success, say mental health experts, is that it never wavers from what it does best: housing development. Emotional and mental health needs remain the exclusive domain of ACOF’s team partners--service providers that lend a hands-off approach in ensuring that residents survive with autonomy, not dependence.

A University of Vermont study recently found that the mentally ill “overwhelmingly want housing that is not developed by mental health professionals--they don’t want to live in mental health programs,” said Paul Carling, the survey’s conductor and executive director of Center for Community Change, a national research and training group.

Mental health agencies that develop housing “have to worry about financing, cash flow and equity--they can’t focus on what they do best,” said Carling, adding that a few manage to be successful.

Carling and others said the task that ACOF has taken on is monumental.

In Spartan Wilshire District headquarters, ACOF’s five staff members initiate projects by leveraging small sums of seed money from numerous sources to spark the interest of banks. (ACOF was founded by Tanya Tull, who also created three other Los Angeles agencies that promote housing for low-income groups.)

“It’s extremely important to build credibility with construction companies and lenders,” said ACOF Executive Director Robert Sanborn, who received his start in Boston, where he developed low-income family housing. “There’s a fair amount of skepticism (of ACOF’s intricate funding system), but banks are finding we’re an extremely safe bet.”

Sanborn uses credit lines, bridge loans, “creative forestalling and just plain old persuasion” to string projects through numerous phases. Up to seven sources of financing must be layered to develop each site.

Initial loans for both Hollywood projects, completed in 1991, have been paid off, “no matter how painful it’s been,” said Sanborn, adding that one-third of his developments are new construction.

Working with a slim $300,000 annual budget, Sanborn estimates that ACOF leverages $8 for every $1 in start-up money it receives--a third each from federal, state and local sources. The group developed 300 units in 1991, but maintains an annual goal of 200 units. Rents range from $200 to $325.

ACOF prefers to own the units it develops, but also co-owns and lends technical assistance to service providers desiring to act as developers.

Portals, the service provider that co-owns Orbison, assists residents with employment searches, crisis intervention, episodic health care, counseling and general case management.

With its successful Hollywood projects, ACOF’s track record is sterling, say mental health experts who are eager to see the models copied widely.

Sanborn is nearly parental about his success, knowing that one dropped ball in the juggling act his agency performs can slam doors shut for future development.

He is all too aware that for many homeowners, the ideal location for a mentally ill housing project is anywhere but in their neighborhood.

“We hit a real backlash here in Santa Monica with those who feel this community has more than its share of the homeless,” said Susan Dempsay, executive director of Step Up on 2nd Street, a day center that provides services for recovering mentally ill people. “Ironically, that’s what we’re trying to do--get them off the streets.”

ACOF has teamed up with Step Up to propose tearing down the center’s 7,000 square-foot downtown Santa Monica warehouse and replacing it with a new $4.6 million four-story building that will include 36 apartments for the mentally ill.

Worried neighbors recently attempted, without success, to appeal the planning commission’s approval of the project. The coastal commission is now considering final approval.

Neighbors were concerned that the building and its residents would stand out in the neighborhood. Dempsay and others say ACOF’s housing does attract attention--because of its well-kept appearance and cordial occupants. The Orbison House stands in sharp relief to surroundings that pale in contrast with the home’s cheerful peach siding and tidy, white picket fence.

“People lack knowledge about what serious mental illness really is,” said Dempsay. “The perception is of a violent, out-of-control individual because that’s what is played up on television. The majority of them are not dangerous people. Some do get desperate and act out--usually if they aren’t receiving the proper care and support, which is what we’re here to provide.”

The mentally ill have long remained on the lower rung of a housing priority list that favors families and women. Researchers, however, say the group makes up about one-third of all homeless, a sizable chunk of those who require low-income housing.

Informal surveys of homeless mentally ill participating in county programs find that nearly 63% are adult males, nearly 50% are white, 30% are black and about 12% are Latino.

Since mental illness tends to be cyclical and life-long, ACOF housing stresses variety. The Orbison project’s four one-bedroom apartment units offer autonomous living while the five-bedroom house is designed for shared living.

ACOF housing residents either work or attend school and must take their medication, keep a clean house, manage their money and remain drug-free. Property management is performed by an outside agency.

Orbison resident Ted Jackson calls his new home a “training wheels approach to independent living.” Gone is the controlling environment found in board and care and transitional housing, said Jackson, 35, whose condition has been diagnosed as manic depressive. Gone also is the built-in transience often furthered by such programs.

“I like being able to do what I want to do--when I want to do it,” said Jackson, who never lived alone before October, 1990, when he moved into the apartment he now keeps stocked with his favorite books and music tapes. “They’re here if you need support and will give you guidance. But they won’t do things for you.”

Although Jackson’s immediate neighbors all have a mental illness, researcher Carling said that “most mentally ill people do not want to live with other mentally ill people,” citing a recent study showing housing preferences of the mentally ill. “Most want to live alone or with a spouse, friend or romantic partner--just like anyone else.”

Sanborn said his agency has recognized the need for mainstreaming mentally ill residents in plans for upcoming projects. Future ACOF sites may also serve other populations, such as the developmentally disabled and AIDS patients.

ACOF has targeted San Bernardino, Orange, San Diego and Santa Barbara counties as future sites. The five-year goal also envisions 1,000 units in such priority areas as Boyle Heights, South-Central Los Angeles and the South Bay.

ACOF buildings, which often require extensive rehabilitation and major systems replacement, average 50 years of age. Ideal locations are accessible to transportation, shopping, job markets and mental health agencies.

Developing outside of Los Angeles (such as a proposed Signal Hill SRO project) is a cautious support-winning process since more agencies require courting--city councils, police, housing departments, neighborhood groups and the city manager’s office.

Numbers of projects similar to ACOF’s have risen nationwide in the past three years. A recent survey of 12 cities found more than 80 groups providing permanent housing enhanced by mental health services.

Some projects involved service providers who develop their own housing, but “the most exciting, promising projects are those developed by groups like ACOF,” said Julie Sandorf, survey conductor and president of the New York-based Corp. for Supportive Housing, which lends financial and technical assistance to developers.

“ACOF is charting new territory, clearly defining what they do best and leaving the rest to service providers. They’ve taken on a very difficult mission--and they’re succeeding.”

The federal government is replicating the new housing model with two programs for enhanced housing that total nearly $400 million in assistance. Both programs serve the mentally ill.

The plans mark an unprecedented collaboration between Housing and Urban Development and Health and Human Services departments, which have teamed up to treat the mentally ill homeless problem.

Overall, however, federally assisted housing for low income and special needs groups has been cut by nearly 80% since 1981, according to Washington D.C.-based Low Income Housing Information Service.

Affordable housing stock has dwindled and waiting lists for federal rent subsidy programs have stretched to 9.6 months.

Sanborn said such changeable funding sources force ACOF to walk a “precarious tight rope act.”

“There are pitfalls in this type of undertaking, many financial, but they’re overcome by a good solid plan to stabilize lives,” said Sanborn. “We want our residents to know one thing: You can say for sure that when you enter one of our homes or apartments, you’re there for as long as you want to be.”