You only have to look around to know that many of the county’s homeless are in the Valley. What isn’t so obvious is that nearly a third of them also have mental disabilities.
While only a few are the obvious psychotics whose appearances and actions can be so frightening, all have, through no fault of their own, a debilitating illness that contributes to their homelessness and is made worse by it.
Without major changes in the approaches used to get and keep them off the streets, the odds are that most will keep bouncing between street, crisis centers, hospital and clinic for the rest of their lives.
The growth in their numbers makes it clear that our traditional institution-centered approach has not worked.
Now there’s a totally new approach to helping the most severely and persistently mentally ill, and the San Fernando Valley has been chosen as the site of one of L.A. County’s six demonstration programs.
The local test will start with 100 of those who have been the highest, and therefore most costly, users of existing services without achieving long-term positive results. If it’s successful, this approach may be expanded to include larger numbers of clients.
The Hillview Integrated Services Agency, called Hillview Partners, is designed to improve measurably the independence and quality of life of the homeless and others with mental disabilities in such key areas as housing, employment, education and social function.
It differs from traditional provider-driven programs in two major ways:
1) Clients actively participate in decisions about their own care and support.
2) Appropriate services, heavy on rehabilitation, go to where the needy are, rather than being dispensed only in provider facilities.
There is also a major change in finding homes for the homeless. The focus is now on privately owned housing that will accept homeless tenants under the federal government’s rent subsidy program. Unfortunately, the first reaction of many landlords is “not in my building.” Yet community housing is essential since the first step to normalcy is a permanent residence, and the new strategy is built around a rehabilitation approach that gives clients the skills and support needed to live on their own in the community.
The services include treatment, recreation and vocational rehabilitation, designed to give clients as much independence as they can handle.
Vocational rehabilitation, for example, helps those who are capable and interested in developing work skills. With jobs they can supplement their disability income. Even more important, they will develop confidence and self-worth.
We have made contact with about 50 homeless people, using names of appropriate individuals supplied by the county with help from the Rand Corp. The ones who have elected to be part of our three-year program have already started the process.
We’ll seek to offer clients as many choices of treatment and support services as possible, allowing them to make their own decisions. Naturally, we’ll make a full range of mental health services available.
The key to each client’s involvement is a personal services plan, developed by clients with the support of professional staff, family and other significant people in their lives. A primary services coordinator is assigned to each participant as the full time point of contact.
We intend to save money as well. Hospitalizations and other treatment services for the high users of mental health services average about $45,000 per year and can cost as much as $90,000.
Under the Hillview Partners approach, the cost should be reduced in two or three years to about $20,000 per person per year. Obviously, an expanded program might save millions of dollars.
Important to our success is a recognition by Valley residents that there is a growing, established subculture of people who, through no fault of their own, are alienated from their communities. When returned to their communities, mentally disabled individuals now are managed in a manner that locks them out of our homes, apartments and lives, but not out of our neighborhoods. To solve the problem we must bring them back, under the most normal and ideal conditions possible, into our communities.