Stakes Are So High, It's Hard to Wait

Steve Lopez
LA Times, Points West
October 30, 2005

I could tell something was bothering Casey Horan and Shannon Murray, and it wasn't hard to guess what. They're in the business of patience, and I've got very little of it.

Horan and Murray work for Lamp, the skid row agency that's been trying to help Nathaniel Anthony Ayers. When I bumped into them last week, I had just written about seldom-used California legislation that allows involuntary treatment of people with serious mental illness. I had also said I was coming around to the conclusion that it might be the only way for Nathaniel to get help.

Murray couldn't hold back.

"We're so close," she pleaded, describing their six-month effort to seduce Nathaniel off the streets.

Being forced into treatment against his will, Horan warned, would set him back years and kill any chance of helping him. Just hold on a while longer, pleaded Murray, who has told me for months that Nathaniel would come around "in his own time."

He appears to be ready to at least look at a place to live, they added. Just imagine him with a set of keys to his own place.

The timing of this discussion was fortuitous. We were on a bus with members of the commission established to implement Proposition 63, which will tax California's highest incomes and generate nearly $1 billion a year for mental health services. The commission hopes to leverage a portion of that money to build more than 10,000 housing units over the next 20 years for the likes of Nathaniel, so commissioners came to Los Angeles for a tour of housing options.

"Are we going to end homelessness in three years?" asked Commissioner Darrell Steinberg of Sacramento, a former assemblyman. "No, but we're going to make progress every year."

On the day of the commission's tour, Los Angeles Mayor Antonio Villaraigosa unveiled a $50-million plan to help get people off the streets. He also proposed a $1-billion housing bond issue that could aid the legions of Angelenos squeezed out of the real estate market.

The potential impact is enormous, particularly for the mentally ill, who were left to rot on city streets after California shut down mental hospitals and reneged on a promise to build community clinics. But what do you do with the Nathaniels, who are too ill to believe they're sick and too set in their ways to take advantage of the chance to come in from the cold?

Steinberg said that can be overcome with the kind of outreach and intervention that Proposition 63 will fund.

Sounds good. But I told him about being on skid row with Nathaniel and pointing out apartments, none of which interested Nathaniel. No thanks, he said. He wouldn't want to be cooped up. Out on the streets, he said, he's got his freedom.

And all the perils, from drug dealers to bum-bashing and disease. Nathaniel insists he can defend himself with the concealed club he carries and a hubcap he would use as a shield. He's also got the stick he uses to chase away the army of rats.

So how aggressive is this outreach Steinberg is talking about?

He said he wants it to be "in your face" aggressive.

But if comprehensive mental health facilities such as the Village in Long Beach and Lamp in Los Angeles were the models for Proposition 63, is that in-your-face enough for the hard-core resistant population?

"We're very aggressive," said Dick Van Horn, who is on loan to the Proposition 63 commission from the agency that runs the Village. He talked about outreach workers going into the streets again and again to try to lure people in.

In the midst of this discussion, the bus pulled up to Portals, a mental health rehabilitation and housing agency that has been rescuing lives for 50 years. Murray, who used to work there before she moved over to Lamp on skid row, went and got two caseworkers, and they talked about bringing in lots of Nathaniels over the years.

First, they said, you offer food or clothing, then you establish a relationship and earn trust.

And then you have a chance.

Sure, Steinberg admitted, involuntary treatment may be the best approach in some cases. But let's not make that the focus of the Proposition 63 discussion, he suggested, until we first fortify services that have been scarce or nonexistent for decades.

This makes sense. In theory.

At least it did until after the bus tour. While the commissioners at the front of the room talked about the proven benefits of housing backed up with all the essential services, the conversation in the back of the room was about how hard it is to convince people they're sick, let alone steer them into housing.

Nancy Carter, whose son is mentally ill, approached me in a state of near-hysteria over the news that a dear friend of hers had just found out that his schizophrenic son was in a hospital burn unit after climbing an electrified fence. If we wait until such people come around for help "in their own time," it may be too late.

Carter, a member of the National Alliance for the Mentally Ill, also told me of someone who had just jumped off a building, and she reminded me and Commissioner Mark Ridley-Thomas of the mentally ill woman who allegedly threw her children to the sharks in San Francisco Bay.

"This is what we deal with," said Carter, who knows of countless people who are so exasperated they would opt for the involuntary treatment of desperately ill loved ones who refuse help. "Every day I get one story after another."

I've heard too many of those stories to rest easy. But while I cringe at the thought of what could happen to Nathaniel on the streets, where he lugs two violins and a cello everywhere he goes, I cringe, too, at the thought of him being carted off against his will.

This is a man who is very excited these days about the news that a member of the Los Angeles Philharmonic has offered to give him lessons, which may, in the end, be the best therapy he can get.

That's a column for another day. For now, I wait, fingers crossed.

Patience, patience, patience.


Serving the needy of skid row

In response to queries from readers about how to help improve things on skid row, here is a partial list of established agencies:

•  Los Angeles Catholic Worker
Catholic Workers say their mission is to "feed the hungry, shelter the homeless, care for the sick, clothe the naked, visit the prisoner." They run a skid row soup kitchen.

•  Central City Community Outreach
A ministry of the Church of the Nazarene, Central City provides, among other services, an after-school tutoring program for children on skid row.

•  Chrysalis
Chrysalis offers a wide range of job training and employment services.

•  Downtown Women's Center
Women on skid row can drop in here for showers, meals, restrooms and mail services. The agency also provides permanent housing to 47 previously homeless women.

•  Fred Jordan Mission
This mission focuses on mothers and children.

•  Inner City Law Center
Focusing primarily on housing and benefits, the center offers legal services.

•  JWCH Institute
The institute runs programs that provide medical services to the indigent.

•  Los Angeles Mission
Offering such services as meals, shelter, medical treatment and drug treatment, this mission has served L.A.'s poor since 1936.

•  Midnight Mission
Founded in 1914, the mission offers temporary shelter, food, longer-term housing and recovery programs.

•  Para Los Niños
This agency aims to raise "at-risk children out of poverty and into brighter futures through positive educational opportunities" and other support.

•  Prototypes
Serving "high risk" women, it offers outreach and medical services.

•  St. Vincent's Cardinal Manning Center
The center runs a skid row shelter as well as longer-term housing programs.

•  United Coalition East Prevention Project
An agency aimed at preventing substance abuse.

•  Union Rescue Mission
The mission offers services including food, shelter, medical and dental care, legal aid, mental health services and job training.

•  Volunteers of America
With two locations on skid row, the organization offers shelter, food, clothing, vocational training and treatment for alcohol and drug addiction.

•  Weingart Center
The organization provides services for the homeless and mentally ill, and is a leader in the discussion of innovative solutions to homelessness.

•  SRO Housing Corp.
This agency develops and manages housing for people who might otherwise be homeless. (213) 229-9640

•  Little Tokyo Service Center
The center provides a range of social services, including family counseling. It also sponsors downtown housing projects.