Last month, I had a thoughtful conversation with a mentor of mine who expressed concern that the TRIESTE pilot might somehow overlook the clear and pressing needs of the most severely mentally ill people living in Hollywood. He was worried that this project – informed by the whole-person, social recovery principles that guide the system in Trieste, Italy — might leave these people behind. Why? Because people with a severe mental illness can be challenging to treat, difficult to house, unaware of their illness, sometimes violent, lost in their delusions.
Here is what I said: “I got into this world through the portal of trying to help the Hollywood Top 14 get off the street — and it is way too hard playing by the rules of this current system. I’ve seen a better way, and we have to give this a shot.”
My work — and my passion — is informed by what we learned about the broken system that left the Top 14 to languish on our streets. For those we were able to help, I witnessed remarkable life transformation as one moved from lying in their own waste on the sidewalk to living a more independent life, clean, clothed, fed, benefitting from treatment, perhaps reunited with family. Since we do not have the luxury of a robust community care system with a bed for everyone at this juncture, in most cases, the only tool available to us was to make a case for involuntary hospitalization and ultimately a conservatorship. Because three people on our original list died on the streets of Hollywood, seeking a conservatorship may have saved the lives of the others.
So I thought I would just reflect upon the original Top 14 – the list our Hollywood 4WRD coalition identified in March 2013 when we realized that despite three years of working to secure housing for a group of our chronically homeless neighbors, there was this cohort that remained on the street, sometimes on the same block where they had been for decades prior. We had a flip-chart on the wall, and we labelled it “super chronic.” It was intended to be a Top Ten list, but people clamored to add four more names to save.
This strategy originates in the community. Our method was simple but required patience and persistence. We continue to use this formula to this day, because as people move off the list, new people take their place.
- Create a small rescue team. Designate one or two people to develop rapport with the person over time.
- Research everything we can learn about the person, including finding their family.
- Assemble whatever data (including letters from clinicians, photos, letters from businesses, or notes kept about known hospitalizations, arrests, etc) to make a case for grave disability to present to an emergency room or to a court. We call this a dossier. In the past, generally, we did not have the assistance of DMH – or their data – because of HIPAA. As I said; this originated with the community, not the public sector. [Note: in the new DMH under Dr. Jonathan Sherin, a specialized outreach team has been re-invigorated, the HOME Team, which focusses on the most severely mentally ill in L.A. County, similar to the Top 14. We are grateful for this new initiative.]
- With dossier in hand, at least one or two people will have to be available to follow the person to the hospital, or to the jail, or to court – this is important to advocate that the person is gravely disabled, needs treatment and should not be released back to the street.
Meet four of fourteen
This will be a three-part blog. Here is a snapshot of four of our neighbors. The names are changed to protect privacy, except in the case of those we know have passed.
1Mr. S, in his mid-30’s, had been homeless in Hollywood for 10 – 12 years and would also show up in Santa Monica because he would take the bus to the beach area. There was no dispute on our team that he should be the first person to help, because of his severe illness and vulnerability. Mr. S did not have hands and was blind in one eye. He often would be running along the sidewalks barefoot and would be found huddled in doorways trying to keep warm. A You Tube video from seven years ago documents his heartbreaking situation. This may be hard to watch, but it was even more difficult to walk past him every day, feeling helpless about how to help him. We spent time researching everything we could about his background, his family and where he slept or ate. We created a “dossier” to document his grave disability and inability to take care of himself. The dossier was intended for the Emergency Room, the court, the public defender; whomever we could get to read it. In 2013, Mr. S was detained on a 5150 after running into traffic and his journey led him through the conservatorship process, into an IMD and ultimately to a board and care as an FSP client.
TODAY? Mr. S has been reunited with a family member, loves living in his board and care, has a library card, and rides the bus round trip four hours a day one day a week to an adult school where he is working on his GED. When I tell him the story of how our team mobilized to help him, he asks: “what took you so long?” I wish I could show you a picture of what a gentle and happy human being he is.
2 Mr. G experienced a co-occurring disorder of mental illness and alcohol use. He was a young man in his early 30’s, who would wander the streets of Hollywood panhandling for change to buy the two quarts of vodka he would drink each day. He was known to don a bikini and ask tourist for money, or hang out in trash cans along the Walk of Fame. Because of his erratic behavior, there was a stay away order for a large section of Hollywood for a time. The team that assembled around Mr. G grew increasingly worried that he was going to die from alcohol poisoning. One day, laying in the gutter, it appeared that he may have been partially run over by a car. In 2014, he ended up at Cedars Sinai and PATH outreach workers picked him up at the hospital and brought him back to the PATH shelter to detox. It was not an easy process for him. Over the course of the next year, he experienced a radical life transformation. He attended AA meetings daily, his foot healed enough for him to walk again, he started going to church every Sunday, he reconnected with his family in Texas, he was moved into a supportive PATH unit and he got a part time job at a pet store. Six days before his one-year sober birthday, he had a beer and began a precipitous downward slide. He did some time in state prison for a felony assault and was released in November 2017. He came back to Hollywood, never followed the conditions of his parole and fell prey to a meth addiction.
TODAY? We think he may be back in prison.
3 Ms. S was the subject of the photo I used when I started telling the story of the Top 14. She lived for a couple years on a mattress on the 1700 block of Whitley in Hollywood. The neighbors were beside themselves because no one seemed to be able to help her. I am not quite sure exactly how she ended up off the street, but one day she was gone. In 2016, one of our team members, Savanah Walseth, saw her walking near Hollywood and Western. She was dressed to the nines with her hair done and with make up. The transformation was unbelievable. At that point, she was living in a board and care on Western, north of Hollywood, which has since closed. We are not exactly sure how she was helped and we are not sure where she is now. That is one of the frustrations of a “civilian rescue team.” We don’t have access to data to keep track of people.
TODAY? We don’t know where Ms. S is. We would love to know and hear her story.
4 Robert Gillette was a veteran that we met in April 2010 when we first did the Hollywood Homeless Registry (a project by Community Solutions). At that time, he was in his late 50’s and he lived on a bus bench on LaBrea and was always wearing layers of coats, no matter the weather. We never assembled a formal team around Mr. Gillette, but one of our members, Robert Morrison, had created a relationship with him and would continually engage him. Mr. Gillette refused help. In 2015, Robert sent out a photo to our group because he was very concerned about Mr. Gillette’s health.
TODAY? Rest in peace Mr. Gillette. If we knew then what we have learned through this process, we may have been able to see you treated and thriving.
In the next installment, you’ll meet four more members of this inaugural cohort of the Hollywood Top 14.