Facing The Homeless
Living With The Mentally Ill

By RICHARD SCHACK & LIZ GOFF

Queens is bleeding from vicious and random attacks by the mentally ill and although there is no clear blame to be directed, there is currently a major call for reform in the way New York handles those with special needs.

Critics charge the city mishandled treatment of Andrew Goldstein, thereby causing the death of Kendra Webdale, whom Goldstein pushed from a subway platform. A new law in her name will provide involuntary outpatient commitment for those mentally ill who refuse their prescribed medications and treatment programs.

And aside from "Kendra’s Law," there is a call for more community-based programs in the area as well as a series of recommendations for improved care.

HOUSING FOR THE HOMELESS

Between 1990 and 1997, the city and the state built housing units absorbing more than 9,000 mentally ill homeless off the streets of New York. The housing units costed only $12,000 a year per resident opposed to an average of $30,000 per year per resident in jail, and $120,000 a hospital stay. The units were working, as there were less homeless on the streets of New York during these years.

Though advocates for the mentally ill praised the system as extremely effective, state funding subsequently ended in 1997. There has been no new housing for the mentally ill homeless since. Mayor Giuliani, feeling the units were an effective answer to the widespread housing problem, requested Governor Pataki add 10,000 more units in 1998. Pataki only agreed to 1,000 units, and since then housing for the homeless mentally ill has come to a screeching halt.

HELP IN THE COMMUNITY

Assertive Community Treatment (ACT) provides a full range of services to clients in their home environments rather than an office setting. An effective program comprised of mental health professionals, it is aimed at those at-risk of failing to take their medications.

Although the program has many supporters, some feel there are not enough of them, with 11 in New York and only one in Queens. The lone Queens-based ACT team is located in Far Rockaway

"It is inconceivable that after the recent tragedies, we are not taking sufficient steps to ensure patients take their medication and aren’t a danger to themselves, or others," said Senator Dan Hevesi, a member of the Senate’s Committee on Mental Health and Developmental Disabilities, which also includes Queens Senator Frank Padavan.

"It is simply a matter of common sense that the most effective method of treatment is community based, where we can ensure a level of continued care. How then can a borough with nearly two million people have only one ACT team?" Hevesi questioned.

GOVERNMENT PROGRAMS

The Department of Mental Hygiene was established in 1978, and is responsible for planning and administering programs for people diagnosed with mental illness in New York.

A part of the Department of Mental Hygiene, the Developmental Disabilities Offices includes a number of programs called Developmental Centers (DC’s), directed by Queens Village resident Janet Wheeler. DC’s include special programs such as the Office of Alcoholism and Substance Abuse Services.

The 24 member Mental Health Services Council, also established in 1978, advises the Department of Mental Hygiene on mental health needs and services available to individuals who are chronically mentally ill. The program services all in need, including the elderly, disabled, children, and adolescents. The Council also advises on the financing of community based services.

There is also the Office of Mental Retardation and Developmental Disabilities, another program responsible for people in New York in need of help. The New York State Psychiatric Research Institute is constantly studying and researching new methods to help improve care for the mentally ill.

QUALITY OF CARE REPORT

The New York State Commission on the Quality of Care for the Mentally Ill recently released a report on whether service for the mentally ill is adequate, and whether they represented a cost-effective expenditure of public funds.

The report was highly critical of the fact it cost nearly $100,000 to treat Goldstein through repeated short-term hospital stays, a failure of which resulted in the death of Kendra Webdale. In 1998 alone, mental health services for Goldstein cost over $80,000.

The Commission noted that for an estimated $25,310 a year, Goldstein could have lived in a supervised, state financed housing with day services, clinic visits, and intensive care management.

Included are alternatives to current treatment programs, alternatives that have proven more effective and less costly. The report recommends the Office of Mental Health conduct a comprehensive study of state and voluntary community residences and supported living programs, as well as the current availability of Intensive Case Managers and ACT teams.

KENDRA’S LAW

"Kendra’s Law" itself is an act to amend the current mental hygiene laws. The bill would enhance the supervision and coordination of the care of persons with mental illnesses.

The law provides involuntary outpatient commitment for mentally ill individuals refusing to follow prescribed medications and comply with treatment plans.

The legislature found there are mentally ill persons capable of living in the community with the help of family, friends, and mental health professionals , but who, without routine care and treatment, may relapse. Following a relapse, they may become violent or suicidal, and require hospitalization.

The bill updates laws passed in 1994 establishing a judiciary program of involuntary outpatient treatment. Now, court-ordered treatment must achieve certain goals, linked to a system of comprehensive care in which the city and state will work together ensuring patients receive case management and have access to proper treatment services.

Who Is Homeless In Queens?

By LIZ GOFF and RICHARD FASANELLA

The face of homelessness in Queens is not just one distorted by the pain of mental disease, according to Lieutenant Steven Klambatsen, supervisor of the New York City Police Department’s Homeless Outreach Unit.

He said the incidents involving violent attacks by mentally ill homeless people — are giving the public a false impression. Homeless people who commit these crimes are actually few and far between.

And the National Coalition for the Homeless confirms that only 20 to 25 percent of single, adult homeless people suffer from some form of severe and persistent mental illness. The majority are homeless as a result of two citywide trends over the past 15 to 20 years: a growing shortage of affordable rental housing and an increase in living costs.

Most homeless advocates and the public place the blame for the state of the homeless on the current city administration. But in effect, what Queens has now is a homeless population left almost entirely to govern themselves. Moved from community to community by authorities responding to local complaints, they remain anonymous — in need of help, but unreachable.

According to Care for the Homeless, a local advocacy group that provides assistance to area soup kitchens and shelters, approximately 100,000 people subsist on the streets of New York in a given year.

"It’s a real guess though," said David Wunsch, policy analyst for Care for the Homeless. "You have to consider the people in the shelters, as well as those on the streets who don’t ask for help."

Even those that are seeking help may have difficulty finding relief as the city’s vast network of shelters are often filled to capacity, especially around the holiday season.

On a given night, Care for the Homeless said that shelters throughout the boroughs accomodate about 23,000 people, including 8,000 single adults and 5,000 families — average families including three members.

The five sergeants and 20 police officers assigned to Klambatsen’s unit work with professionals from the Department of Homeless Services (DHS) and members of at least six non-profit groups to monitor the thousands of homeless in the city. The teams offer the homeless shelter, social services and medical care, officials said.

According to data provided by the DHS, many outreach, drop-in facilities and church/synagogue programs provide emergency services designed to encourage homeless persons to move to transitional programs and shelters that offer more intensive services, such as assessment and substance abuse treatment.

However, no matter how good an outreach facility is, no one can force the homeless to take advantage of these programs.

"The city can’t help people with services when they refuse to be helped," said Klambatsen.

Another big obstacle to effectively solving homeless issues in Queens is funding. According to Housing Works, Inc., the nation’s largest provider of housing, support services and advocacy for homeless and formerly-homeless people with AIDS and HIV, 1997 budget cuts have severely limited their ability to effectively serve the most vulnerable communities in New York City.

Terri Smith-Caronia, a spokesperson for Housing Works, said that over the last two years, the number of people that the organization was able to help citywide dropped in half, from about 5,000 to 2,500.

In Queens, a single women can seek shelter in the Jamaica Armory located at 93-05 168th Street. However, single men need to travel into Manhattan where they can find help at the 30th Street Men’s Shelter located at 400-430 East 29th Street.

Otherwise access to shelter programs must be made through the DHS’s citywide outreach services. Either the outreach programs must find the needy, or the homeless can use the emergency number is 1-800-994-6494.

DHS also provides temporary, emergency housing only to families who have no other permanent or temporary housing options. Families seeking emergency housing assistance during normal business hours and must go to an Income Support Center, open weekdays between 9 a.m. and 5 p.m.

If a family is not on public assistance, they should call the Human Resources Administration (HRA) infoline at (718) 291-1900 for the location of the nearest Income Support Center.

Queens Families experiencing homelessness during evenings, weekends or holidays are advised by city agencies to call the toll-free emergency hotline or go directly to the Emergency Assistance Unit (EAU) at 151 East 151st Street in the Bronx.