The Fine Dividing Line of Hope

We are sitting in a circle, about a dozen of us, at a meeting of the 4760 Club, and they are telling me crazy stories. Not stories about boozy high jinks or juvenile misdeeds, but stories about real and painful and dangerous craziness--schizophrenia and bipolar disorder and depression so profound you can’t even move.

Joseph is a 39-year-old father of two. He becomes animated as he tells how family problems left him so distraught that he stabbed himself in the chest with a knife and was hospitalized for five days. He has been coming here three times a week for almost two years.

Eliette, 41, is schizophrenic. Ominous voices in her head controlled her. They judged her, told her she was worthless. Once she began taking medication, the volume dropped. She can still hear them, she says, but they don’t bother her as much.

Elaine, 47, was hospitalized last year for nearly a month. She has bipolar disorder, which used to be called manic-depression. She, too, had voices in her head. They told her to stay inside the house. She spent most of her time sleeping, isolated and lonely. Her doctor steered her to this place--the Didi Hirsch Community Mental Health Center in Culver City. After two weeks on the waiting list, she was accepted as a member of the 4760 Club, named for the center’s Sepulveda Boulevard address. The “club” is actually a day rehabilitation program for mentally ill clients who might otherwise be hospitalized.

After she began attending the 4760 Club, Elaine says, “Everything seemed to fall into place. I started looking forward to getting up every morning.”

As eloquent a definition of sanity as I have ever heard.

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Founded in 1942 as the Los Angeles Psychiatric Service, the Didi Hirsch center (renamed in 1974 for its most avid fund-raiser) is the oldest walk-in mental health clinic in the West and treats hundreds of clients a month.

The center serves its clientele in a number of satellite locations as far away as Pacoima. Its programs meet nearly every mental health need imaginable, short of hospitalization--from tots who wet their beds, to suicidal teens to drug addicts desperate for sobriety to seniors with Alzheimer’s disease. It has dispatched counselors to schools following drive-by shootings, and provided counseling for victims of Malibu fires and the Northridge earthquake.

“Our philosophy is that people are better off if they’re not dislocated from family and community,” says spokeswoman Fern Seizer. “We’re working to promote community acceptance of people who are ‘different,’ including people whose differences shade toward mental illness.”

That goal is elusive, says center executive director Millard Ryker, because “people who smell funny and push shopping carts around are not all that appealing.”

Although depression has had its moment in the sun, with a string of books about new antidepressants and memoirs devoted to it, mental illness is one of the less glamorous causes on the charity circuit. I know of no lapel ribbon that commemorates schizophrenia.

As with any agency that depends on the public coffers for support, there is always a fear of funding cuts. The county Department of Mental Health may have a 10% gap in its $350-million budget next year. Although no one knows how nonprofit, private providers such as Didi Hirsch will be affected, county administrators expect community mental health centers to take some kind of hit.

Mostly, the bind the center finds itself in is not being able to accommodate all the people who need it. Sometimes, for humanitarian reasons, it bends the rules and accepts clients it probably shouldn’t. A couple of weeks ago, a call came in on behalf of a sick veteran. Because the vet was entitled to hospitalization in a VA facility, he was not covered for much less expensive outpatient treatment at Didi Hirsch. But the man’s story is so compelling that Ryker will make an exception and eat the cost of the man’s treatment.

“These are unholy decisions,” Ryker says. “This is rationing in a whimsical and capricious manner.”

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Steve, 46, was a contracts administrator for Hughes until, at age 32, his illness was diagnosed as schizophrenia and his life fell apart.

Today, he is giving me a tour of the 4760 Club--a big room filled with tables and couches. In one corner is a pool table, in another a kitchen. There is an art room. With help from the center, Steve hopes to attend a culinary arts program at L.A. Trade Tech and work in a restaurant.

“I’m in the unique position of being able to restart my career,” he tells me confidently.

Steve also tells me something nearly all the clients have said: When he was ill, he isolated himself; that the isolation exacerbated his troubles, and that being able to come to the center four days a week--being able to interact with others, to participate not just in club activities, but in decisions about how the place is run--has been critical to maintaining his mental health.

“What’s kept me going is hope,” he says, “hope that I could regain the life I had.”

A simple thing, really, and something most of us take for granted. For the members of the 4760 Club, hope means the difference between madness and mental health.

* Robin Abcarian’s column is published Wednesdays and Sundays.