Advocates Seek to Open Doors for Mentally Ill

A phone call at the right moment has saved many lives, but Joyce Barnett is fighting to save even more because of one call that was never made. Her crusade is a memorial to her son’s foreshortened life.

Barnett, a soft-spoken former nurse, found her son’s body slumped in the bathtub in his bare apartment earlier this year. Greg Barnett, 37, died of an overdose of medication he took to control his schizophrenia. His mother believes he would still be alive if he had a phone and made a 911 call when he began to lose consciousness.

Angry at the shabby conditions

in which many mentally ill people live, Barnett joined a grass-roots movement dedicated to providing better housing for them. The county treats 3,100 mentally ill adults, but there are only 253 supervised beds in the entire county.

The grass-roots campaign reached its peak earlier this month, when Barnett addressed the Board of Supervisors.

“A phone may have saved my son’s life,” Barnett said, breaking down in tears.

It was a crucial moment. “Her story had an emotional effect on me,” Supervisor Frank Schillo said. “It was a very sad story. Hers and other stories had a cumulative effect.”

Shortly afterward, supervisors for the first time acknowledged the housing crisis and promised to make the building of more subsidized housing for the mentally ill a top priority. The board adopted a five-year plan to add 250 beds, at a cost of $5 million. The plan also includes a transitional, subacute hospital that would provide 24-hour care while patients prepare themselves to live more independently.

It was a victory, but an unfinished one.

Meeting that housing goal will require overcoming several hurdles, including reversing long-held policies that have favored moving the mentally ill swiftly back into society to live on their own. While that approach has worked for some patients, the fact that hundreds of mentally ill people are homeless in Ventura County shows that others are simply too sick to manage day-to-day life on their own.

Another hurdle is finding the money to build new facilities. Until the county pays off a $15.3-million penalty levied by the federal government for years of illegal billing practices in mental health care, there will be little money for any ambitious building projects.

But these problems shouldn’t be an impediment to making things better for the mentally ill, advocates say.

“The money is there if the political will is there,” said Supervisor John Flynn, who said he was disturbed by what a nursing supervisor at Hillmont Psychiatric Center told him recently.

“She said she cringes every time she discharges someone,” Flynn told his colleagues at a recent board meeting. “She doesn’t know where the people are going to go. She doesn’t know where they’re going to live.”

Warehousing of the Mentally Ill

For decades in this country, treating the mentally ill meant warehousing them in large “hospitals” that functioned as little more than jails.

A backlash against such inhumane treatment caused many of the old institutions to be slowly emptied. But too often there was no place for the mentally ill to go and they ended up wandering the streets of large cities or shouting at passersby in front of the Capitol building in Washington.

In Ventura County, Camarillo State Hospital was closed in 1997, pushing 600 mentally ill people out on their own.

At the same time, Ventura County pushed forward with its own independent living policy, which it called a “social model” for treating the mentally ill. That model teamed social workers with psychiatrists to help the mentally ill get jobs, find apartments and live on their own, rather than in supported housing. The model called for patients to receive services in the “least restrictive environment” possible.

Reinforcing that philosophy, supervisors in April combined the county’s social services and mental health departments. Under the merged agency, social workers often took the lead role in dealing with patients. The move was controversial from the first.

Supervisors Judy Mikels and Frank Schillo vehemently opposed the merger.

“We are not by doing this, addressing the problem of mental health from a medical standpoint,” Mikels said before casting her no vote in April. “We are, by doing this, once and for all creating a social model for this county and I will not support it.”

The federal government didn’t support it either.

Ten months after it was formed, supervisors were forced to dismantle the superagency. After that, federal authorities began looking more closely at the county’s programs, and eventually uncovered millions of dollars in fraudulent practices in which social workers and others often signed physicians’ names on bills and prescriptions.

The government ordered the county to repay more than $15 million.

The failure of the merger caused a major personnel shake-up at the county’s health department. Behavioral Health Director Stephen Kaplan, a social worker and strong proponent of the merger, was forced to resign.

Kaplan was replaced by David Gudeman, a psychiatrist, who immediately took steps to address the housing void. But when they adopted a new budget last month, supervisors voted against allocating any money toward the five-year housing plan, in part because of the ongoing billing crisis.

“We would have loved to have gotten some money,” said Patricia Kosich, a psychiatric social worker who helped draft the housing plan. “Then we could have aggressively pursued the plan for supported housing. But we’re not totally discouraged. It just means things will go a little bit slower for us.”

Local Efforts to Improve Conditions

Even under the old social model, some progress to improve housing conditions had been made. A year ago the county contributed $456,998 to help build a 21-unit supported housing complex in Camarillo, Villa Calleguas. That complex is expected to be completed in nine months. The county also contributed $25,000 toward a 13-unit complex in Simi Valley.

“Those efforts started sometime ago,” said Marty Robinson, a chief deputy administrator who has worked 20 years for the county. “It’s not like the Board of Supervisors has not allocated funds for housing in the past.”

Robinson also noted Las Posadas opened in 1996 under the mental health department’s previous administration. The county spent nearly $2 million over four years to help build the 24-hour residential care facility on the former Camarillo State Hospital grounds.

But until now, housing was never identified as a crisis and top priority by county officials.

“What we have for housing is just the tip of the iceberg,” Kosich said. “It’s a very good first step. But no one has taken on the issue like the present administration. It’s a real priority for us.”

For Georgia Trivanovich, Gudeman’s long-term plan does not change her daily reality. She said she has been on a waiting list for a federally subsidized apartment for five years.

Kosich said 60 mentally ill clients are now on a five- to six-year waiting list for such apartments that are scattered throughout the county.

While Trivanovich waits, she lives in a board and care facility--Ventura Garden Manor--near downtown Ventura. As with most residents, Trivanovich shares a small room with another client.

“I like it here, but I’m ready to live on my own,” said Trivanovich, 43, who has schizophrenia and is stabilized with daily medication.

But John Zobel, 59, wouldn’t mind living out the rest of his years at Ventura Garden Manor. He has had the same corner room where sunlight has seeped through two big windows for 15 years.

Although iron bars cover the kitchen window to keep out tenants, Zobel says the board-and-care facility gives him more freedom than Camarillo State Hospital, where he once lived. He likes the fact he and others may come and go as they wish.

Zobel said he likes to take long walks up and down Main Street, stopping to browse at thrift shops along the way.

“I’ve been in this room for a long, long while,” said Zobel, also a schizophrenic. “It’s a pretty nice place to live.”

Melinda Merritt, 40, also considers herself lucky to have a room at Ventura Garden Manor. She went willingly to the mental hospital after she broke open a plastic shaver, removed the razor blade and began cutting herself.

“I looked up and saw a picture of my daughter and it made me stop,” said Merritt, who suffers from a personality disorder and major depression. “I knew I needed to go to the [mental] hospital.”

Two days later, Merritt was discharged. She feared she would be handed the dreaded motel voucher, but she got her old room back at the board-and-care home.

Now Merritt and Zobel worry they may someday be squeezed out of the facility by developmentally disabled residents.

The owners of Ventura Garden Manor plan to begin accepting developmentally disabled tenants because they would receive a substantial amount more in state funding from them.

Ventura Garden Manor receives $729 a month for each mentally ill resident. It would, however, receive $1,500 per month for each developmentally disabled resident, co-owner Ding Valondo said.

Sixty people now live at Ventura Garden Manor. The facility will begin taking in developmentally disabled residents after 11 rooms are added by year’s end, Valondo said.

“We’re helping people with no place to go, who would otherwise be on the streets,” Valondo said. “But this property is expensive and we make very little money.”

Mental health experts say Valondo’s case is not unique. Many mom-and-pop facilities countywide are beginning to take in developmentally disabled clients, they say.

“It’s not a lucrative business for people to get into housing for the mentally ill,” Kosich said. “The draw is not to take in people with mental illness because of the profit margin. They’re going to go where the money is. It’s a business.”

Two Groups, Different Needs

She said mixing mentally ill and developmentally disabled patients in one board-and-care facility was an unhealthy trend.

“It’s inappropriate to mix the two populations,” Kosich said. “Their needs are extremely different. It’s also difficult for them to develop peers in that setting. But the trend is something we have no control over.”

County housing consultant Lynn Aronson said vociferous advocacy groups were able to lobby state officials for more housing for developmentally disabled people.

“It’s a stigma issue. It’s easier for someone to come out of the closet and say my child is retarded. It’s harder to say my child is mentally ill,” Aronson said.

It took time for Barnett to admit her son had serious mental problems. The smallest player on his Little League team, Greg was a straight-A student and played the violin.

At 16, Greg’s grades suddenly dropped and he began running away from home. Initially, his mother thought Greg was rebelling because his father had left.

But then she realized something was terribly wrong.

“He started doing weird things,” Barnett recalled at her Moorpark home. “He took all the pictures off the wall and wouldn’t allow the TV to be on. Then he’d sit there in front of the TV like it was on and start laughing.”

Greg was diagnosed with schizophrenia, a progressive disease in which victims become intensely paranoid and hear voices.

After being on a waiting list for about four years, Greg was placed in a federally subsidized apartment in Santa Paula earlier this year.

A gaping hole was all that remained of the telephone jack on the wall. The apartment also had no heater and lacked other basic amenities.

Barnett recalled the day she let herself into her son’s apartment with a a bundle of scrubbing powder and sponges. She flung open the bathroom door and found her son’s body, slumped in the middle of the tub. His right hand clutched a bottle of shampoo.

“It looked like he sat on the edge of the tub to rest and fell in,” Barnett said, picking up a framed photograph of Greg as a gentle-faced boy with wispy brown hair. “I ran over to him and he was stone cold.”

Greg knew he was different, Joyce Barnett said. He called himself the black sheep of the family, but he is anything but. He has given his mother something to fight for.

“I am not a pushy person,” Barnett said. “I’m fighting for housing for Greg. But he would do anything for anyone. And I was always there for him, he knew that.”

* SUNDAY REPORT

A look at the lack of institutions for the mentally ill. A1