About 30 percent of people who are chronically homeless in the United States suffer from severe mental illnesses. These individuals more frequently require emergency services and can cost the city of Anchorage up to $60,000 per year. A new program in the city is trying a new tactic to help them, by meeting them where they’re at. Literally.
In August, substance abuse specialist Delroy Duckworth and his colleagues received a call from someone who needed help.
“The first thing we did was went out to find him,” Duckworth recalls. “And we went to the mall to look for this person and we did not know who he was. So we called him on the phone. We heard a phone ring, we saw a man answering his cell phone, I said, ‘Mary that’s him!'”
The man with the phone was 60-year-old Leo Tondreault, tall and bulky with a graying beard, joints achy from rheumatoid arthritis. He’s distrustful in general but knows he needs help.
“I’ve been homeless off and on for four and a half years. And nobody cares about you out there. And people that say they understand? How can they have no idea where I’ve been. Everyday is survival. How I’m going to eat, where I’m going to be for the night. Most of the times I just walk all night, drink coffee.”
Part of the reason he never stayed still was to help cope with his anxiety and bipolar disorder – a severe mental illness.
“I just stayed away from people. Because not a lot of people understand what bipolar is. And the worst part for me is the mania. The hyper vigilance.”
Tondreault says he went to see a case worker at Providence Hospital in August and he learned about the CHOICES program. It’s short for Consumers Having Ownership in Creating Effective Services. Unlike other service providers, CHOICES does everything — mental and physical health care, housing, substance abuse treatment, job skills training.
“We are like a one-stop shop,” says Duckworth of the ten-person team that uses hyper individualized care tailored to each client.
They’re using a model called Assertive Community Treatment. It was developed in the 1970s, but this is the first time it’s being tried in Alaska. Research shows it’s more effective than standard case management models, where an individual meets with many different organizations. It costs more up front, but saves money in the long run because clients are less likely to use expensive services, like emergency rooms and hospitals.
The CHOICES program has a budget of $1.8 million for the next three years. It’s funded mostly through the state’s Department of Behavioral Health and specifically targets people who have severe mental illnesses and are homeless. The team is mobile and adaptable. They carry tablets and keyboards and meet people on their own terms.
“We don’t want to overwhelm them,” says housing specialist Mary Abraham. “If they become angry we say, it’s okay, we’ll meet later on. And usually it works out.” They’ll work with people who are still using substances, too.
Abraham’s goal is to get people into housing first. That’s what she did for Tondreault at Safe Harbor at Merrill Field.
He sits on the edge of his twin bed in a sparsely furnished former hotel room. He has a microwave and a mini-fridge, but shares the kitchen. He often runs into other tenants in the hall, who he says offer him alcohol, but he’s resisting. He’s been sober for nearly two months. Tondreault says he’s tried other programs and received some help, but he’s never felt supported the way he does with CHOICES.
“I’m pretty peaceful today. Delroy came over today and said, ‘Man, you look well rested.’ Well, yeah. You change my situation and give me the things I need to help me survive, I’m a different person.”
Tondreault hopes the CHOICES staff can help him accomplish his goals- like staying sober and going back to school in the spring. He knows he needs to put forth his own effort, but he says now he has support to get there.
Anne Hillman is the healthy communities editor at Alaska Public Media and a host of Hometown, Alaska. Reach her at ahillman@alaskapublic.org. Read more about Anne here.
