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The Ultimate Test of Society’s Patience and Compassion

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ON A BRIGHT, CLEAR MONDAY MORNING, DOWNTOWN PEDESTRIANS move briskly along the sidewalks of Figueroa Street. The glassy flanks of the modern office buildings reflect the warm sunlight into the recesses of the chilly shadows below. All seems early-business-day energy, confidence, purpose.

Then comes Paul.

He is small and slight, and in what ought to be his middle years. His dirty jacket is zipped to his chin. His right eye socket bulges with bandaging and is covered with a black patch. The right side of his sparsely bearded face sags inexpressively.

Paul is barefoot. His right ankle has swollen taut the leg of his dirty jeans, and the denim is soaked with blood. Dried blood has marbled his feet and hands and purpled the edges of his toenails.

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Gerald Minsk and George Rivera, street outreach workers for the homeless-assistance program LAMP, stop Paul and offer him a small bag lunch. But Paul is not interested. “I already ate something,” he mumbles.

Minsk asks to take a look at the ankle. Paul shrinks back, shaking his head no.

The LAMP men try to get him to understand that free shoes and socks, clean pants, a shower and medical attention are available at LAMP’s drop-in center on nearby Skid Row. But Paul isn’t listening. He hobbles away on an indistinct mission.

Paul is one of those whom LAMP focuses on--the homeless mentally ill. Minsk and Rivera will describe him in the written report of their day’s labors so that other LAMP outreachers can be on the lookout for him.

Perhaps after a few encounters, or 50 or 100, Paul finally will drop in at the drop-in center, and from there maybe progress to LAMP Village, a transitional residence, and eventually to LAMP Lodge, a permanent residence hotel. Progress, that is, to a life of helpful medicines, gainful work, trustful human relationships.

It’s a longshot, but longshots are the only kind the LAMP people play.

The mentally ill are the most homeless of the homeless, unable to take shelter even in themselves. Conservatively figured, they make up about a third of L.A. County’s estimated 84,000 homeless. Almost to a man and woman, they are also addicted to drugs and/or drink.

By dint of sheer wretchedness they’re the most visible of the homeless, the ones the rushing rest of us most loathe seeing, perhaps because they remind us how tenuous are rationality and respectability. We’re grateful when they’re kept from our sight and their urine smells and contextless rantings are banished from public places.

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Mental illness is the ultimate test of society’s patience and willingness to understand because it can masquerade so convincingly as willfully distasteful behavior. Enormous numbers of mentally ill people, often through heroic effort, live productive, integrated lives. Those who fall into homelessness and addiction are another matter.

Most homeless are homeless only for a time; with a bit of help, they escape the condition and don’t return. This, however, is not true of the homeless mentally ill. “They account for the majority of services used and of days in shelters,” says Ruth Schwartz, the founder of Shelter Partnership in L.A. “They have more health-care needs, more dependency, less ability to manage their lives on their own and to work and to keep public benefits.”

Mollie Lowery, the founder of LAMP (the acronym once stood for “Los Angeles Men’s Place”), long ago learned that what serves them best is patience, non-coercion and, most important, a community that enduringly supports them.

Such a community is evolving in the 50 blocks of skid row east of downtown, where about 40 nonprofit homeless agencies are located. There are now about 5,000 single-occupancy rooms in 65 skid row hotels, the lion’s share owned by such nonprofit agencies as SRO Housing Corp. and Skid Row Housing Trust, which keep them clean, bright and otherwise conducive to life reformation.

This concentration--some would say quarantining--of the homeless has its beneficial economies of scale. For one thing, they are able to walk among the agencies that provide the various services they need. The downside is that it provides a teeming hunting preserve for drug dealers and other predators, who descend on the place at the start of every month after SSI and General Relief checks are issued.

For proof that the hardest-of-the-hard cases can be softened and kept socially malleable, one need look no farther than LAMP outreach workers Minsk and Rivera. Both men have mental illnesses and spent years being homeless.

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Minsk, a big, garrulous man of 48, has bipolar disorder. Rivera, 43, is wiry, excitable and schizophrenic; for many years he was a hard-core heroin addict. Both men monitor themselves constantly for early signs of relapses and take medications every day.

Now married and clean, they troll the downtown streets, chatting up their melancholy targets. Not even as wrecked a man as Paul, they believe, is beyond restoration to a community willing to look beyond troubling behaviors when they occur, to tolerate occasional relapses and to accept that with mental illness there are no final victories, just endless coping.

If the estimated 28,000 Pauls in this county alone are to be restored, that community can’t be limited to the service-givers and the tenuously functioning on skid row. Ultimately, like it or not, it has to be us.

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James Ricci’s e-mail address is james.ricci@latimes.com

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