No Safe Harbor: McKees Rocks, Homestead left with clusters of mentally ill residents
From 'psychiatric ghettos' to prisons, the mentally ill have few havens
January 3, 2016 12:00 AM
The Homestead location for CORE, Capitalizing On a Recovery Environment, is run by Philadelphia-based Resources for Human Development.
By Rich Lord and Joe Smydo / Pittsburgh Post-Gazette
This is the first in a periodic series, “No Safe Harbor.” The Post-Gazette this year will explore the places in which mentally ill residents live, now that most institutions have been shuttered.
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A mentally ill man with a gun was inside the Sto-Rox Neighborhood Family Health Center, the dispatcher announced on a December morning. McKees Rocks police Chief Jim Lauria promptly steered his SUV toward the Thompson Avenue clinic.
This could be anything, he noted to Patrolman Thomas J. Pelkington, as they sped several blocks to the federally subsidized health center. Officers in two other cars also answered the call and hurried inside.
They emerged minutes later, visibly relieved. “He’s OK,” Chief Lauria said, explaining that the patient, a McKees Rocks resident in his late 20s, has bipolar disorder. “He says to the psychiatrist, something something something, I have a gun at home,” the chief related. A staff member didn’t hear the “at home” part, panicked and called 911.
It was the kind of mental health-related call that has become a common occurrence in McKees Rocks, Homestead and other disadvantaged municipalities that host higher-than-average concentrations of housing for people with mental illness.
With the closing of the region’s state hospitals, including Mayview in 2008, subsidized housing and state-backed services for the mentally ill have clustered in some communities, according to state and county records. By and large, those communities already faced outsized economic and law-enforcement challenges.
George Dudash, chief of Northwest Emergency Medical Service, said he’s heard communities with high concentrations of mental health consumers referred to as “free-range mental health institutions.”
Scholars have questioned how well people with mental illness are served in communities experiencing blight and high crime rates but say more research is needed.
Police just know they’re stretched thin and struggling to master new skills.
“We’re called for a reason. Somebody out of control. Somebody yelling. Somebody off the wall,” said Homestead police Chief Jeffrey DeSimone. “All I know is that it seems more prevalent lately.”
McKees Rocks: Regulars on the street
When Chief Lauria cruises the streets, the signs of a burgeoning mental health population are as plain as the church steeples rising from Helen Street.
“We have five people who walk the streets all day long. We know them,” he said. There’s the tired-looking woman who returns over and over to a bench next to a building. There’s the man who lives on the porch of a run-down house along a busy street at the edge of town. And there’s the reclusive guy who sits, day in and day out, on a wall at a downtown intersection.
He “never causes a problem. Doesn’t talk to anybody. He just sits there and watches,” said Chief Lauria, who has considered recruiting him for surveillance work. “He’s a perfect set of eyes for me.”
But some residents with mental health issues do cause problems, the chief said, recalling the day officers took two juveniles for mental health evaluations for assaulting their mothers and the time a 6-year-old acted out to a level requiring police response. Those incidents suggest that the scope of a municipality’s mental health population ranges from those in government-supported housing to families with mental health issues who settle there on their own.
“It consumes a tremendous amount of time,” Chief Lauria said.
Chief Dudash, whose ambulance service covers about a dozen municipalities, said he has a steady stream of calls involving patients in mental health crisis.
The call volume varies by municipality, with the poorer, more densely populated communities producing the bulk of mental health calls. His crews annually average no calls in Ben Avon Heights, four in Emsworth, 76 in Stowe, 88 in Bellevue and 96 in McKees Rocks.
Chief Dudash said the numbers speak to gaps in the mental health service system. “A lot of these people are just not having their needs met.”
Besides the health center, McKees Rocks, a borough of 6,000, is home to a 33-bed personal care home serving clients with mental health needs. Neighboring Stowe and Bellevue have 11 beds and 10 beds, respectively, of licensed housing for people with mental illness, according to county data.
But as indicated by the juvenile cases that Chief Lauria recalled, government-supported beds are incomplete measures of the borough’s mental health population. Low housing costs are believed to attract more mental health consumers to private apartments and dwellings.
Herb Flaherty, 28, who has a mental illness and has struggled with heroin, said he lived in the Stowe-McKees Rocks area for two or three years, at least part of the time with a Section 8 voucher. As he tells it, it’s a difficult place for a person trying to outrun his demons.
“I know everyone down there who’s doing drugs,” said Mr. Flaherty, who has been incarcerated 22 times and is now assigned to a residential recovery program in Homestead. “If you’re in an active addiction, you’re going to get what you want.”
Experts stress that people with mental illness are more likely to be victims than perpetrators of serious crimes. That was the case for Julia Mae Dias, one of 305 people released from Mayview from 2005 to 2008 as part of the state’s shuttering of the facility.
After Ms. Dias lived in various communities, her caseworkers placed her in a Stowe building. She ended up wandering the streets of Stowe and McKees Rocks and was arrested multiple times for minor offenses before being shot to death in October 2009 behind a McKees Rocks house.
Deinstitutionalization has been “a great try, but I don’t know if it’s worked,” Officer Pelkington said. “It’s probably worked for some but not others.”
Eric Snodgrass, 45, lives in a room in CORE’s dormitory-style residential rehabilitation program. (Michael Henninger/Post-Gazette)
Homestead: Rehab town
R. Eric Snodgrass, 45, is trying to recover from a rough year, even by his standards. A native of suburban Bethel Park, he’s now in a room atop Homestead’s West Street, in a dormitory-style residential rehabilitation program called Capitalizing On a Recovery Environment, or CORE.
In early adulthood, he had trouble getting appointments with psychiatrists for bipolar disorder. Placed on three-month waiting lists for appointments, he’d get his medications prescribed by general practitioners or emergency room doctors. When they balked, he’d turn to the streets. Marijuana helped, but heroin proved particularly effective.
“I was using drugs to self-medicate,” he said. But drug possessions, thefts and simple assaults earned him a total of a decade behind bars. “If I didn’t use drugs, I would’ve never been in jail.”
He was free in May when his wife died. A few days later, Bethel Park police picked him up driving with a suspended license and found a syringe, heroin and oxycodone, plus an open beer. He ended up in jail, then Mental Health Court, which handles around 200 of Allegheny County’s many defendants with psychiatric problems.
Judge Beth A. Lazzara runs Mental Health Court, in Downtown’s County Courthouse, with the help of a team of probation officers, case managers and attorneys. They placed both Mr. Flaherty and Snodgrass in CORE, one of several social service groups in the former Homestead Hospital complex. State medical assistance usually covers the cost.
“We’ve had people do fantastic work” at CORE, Judge Lazzara said.
In recent months, though, CORE entered what court personnel called “a period of chaos.”
Snodgrass relapsed upon his first Thanksgiving without his wife. Another resident was caught with a prescription narcotic in his system and contraband antidepressants hoarded in his room. Mr. Flaherty started getting aggressive and showing up at area emergency rooms with mysterious complaints. Another resident, the judge said, faced imminent arrest.
“We get a lot of calls up there,” said Homestead’s Chief DeSimone, referring to the Homestead Hospital complex. Among them are calls from CORE reporting residents missing. Since CORE’s residents are adults and aren’t prisoners, he said, “we’re not going to get bogged down entering all of these missing persons reports.”
‘More than our fair share’
Chief DeSimone was not long removed from dealing with a urine-soaked woman who left a trail of discord from the soup kitchen to the gas station to her apartment, where she holed up until police took her to Western Psychiatric Institute and Clinic. It was the 48th time since 2013 that his department helped out with a Section 302 involuntary commitment.
“When she’s normal, on her medications, she’s not a bad person at all,” the chief said of the woman. He doesn’t mind helping her, but an involuntary commitment can take an officer off the streets for hours. “For a small department, say two guys working, that leaves one officer working.”
Chief DeSimone said that Homestead and its neighbors contend with “more than our fair share” of the mental health caseload. Some are indigenous, including a 36-year-old Munhall man, currently jailed with his case in Mental Health Court, who has generated 50 police calls in 22 years.
“One of the biggest tragedies we ever had was a guy with mental health issues,” Chief DeSimone said. “Burned down half a block.” That was Edward McDonald, 28, a Homestead resident charged with setting the fires that last year destroyed or damaged five buildings.
Many of the Homestead residents with mental health concerns moved there for the residential programs that gravitate to areas with low property costs and nearby amenities. Most go about their business peacefully.
On the other hand, Chief DeSimone noted that one man, housed at the Cleft of the Rock Ministries just over the border in Munhall, has been the subject of 21 police calls in just a year, including complaints of loitering, trespassing, theft and drugs.
The nonprofit Cleft of the Rock, opened in 2001, used to house defendants assigned by prior Mental Health Court judges. Now it appears to specialize in people convicted of sexual crimes. A search of the Megan’s Law website reveals 14 sexual offenders listed at that address. The Rev. Terry Moseley and the Rev. Steven Moseley, who own Cleft of the Rock, refused to answer questions.
Not far away, the Homestead headquarters of state-funded Transitional Services Inc., coordinates housing and services for around 400 people with mental health diagnoses. While about half end up renting from private landlords, many start in the agency’s federally subsidized units in neighborhoods ranging from McKees Rocks to McKeesport to Moon.
Transitional Services CEO Victoria Livingstone said people with mental health challenges can be good neighbors. “Individuals with disabilities are employed and taxpayers and contributors to the community,” she said.
And when they’re not? “It’s because people can’t get treatment and supports that they need,” because of funding cuts and disruptions like Harrisburg’s budget impasses, she said. “They’ve been cutting and cutting and cutting mental health for the last decade. … That’s why we have these mass shootings and tragedies.”
Why Homestead and McKees Rocks?
In some cases, social service agencies or for-profit providers of housing or services have taken over former schools or institutional structures in disadvantaged communities. In other cases, officials said, people with mental illness have moved into these communities on their own because of low housing costs, easy access to transportation or the ready availability of drugs.
PG graphic: No Safe Harbor (Click image for larger version)
“You can get a nice house in McKees Rocks for $20,000, $30,000,” noted the Rev. Regis Ryan, executive director of the Sto-Rox center.
Among county municipalities, Pittsburgh has the highest number of government licensed or subsidized beds for mental health consumers —212. The city’s Glen Hazel neighborhood has the highest number of licensed or subsidized beds in proportion to its population —15 beds for 716 residents, according to a Pittsburgh Post-Gazette analysis of housing data provided by the county. [See map at right.]
There is no way of quantifying the number of people with mental illness who live in private housing in these or similar communities.
But the clustering of housing for the mentally ill is not unique to Pittsburgh. Since the late 1980s, if not earlier, researchers have used the term “psychiatric ghettos” to describe the phenomenon.
Research suggests that socioeconomic status is a key element. Housing choices are limited by the poverty that often goes hand in hand with a serious mental illness, and so people with mental illness tend to live with other poor people.
What does that mean for people who are mentally ill? Research results are mixed.
A 2013 study centered in Philadelphia found that residents with mental illness tended to live in neighborhoods with higher crime, more drug use and higher numbers of vacant and demolished buildings than the general population.
It did not find that such conditions hindered functioning of people with mental illness, perhaps because residents, for all of the neighborhood’s problems, felt comfortable there, said one of the researchers, Mark Salzer, director of the Temple University Collaborative on Community Inclusion of Individuals with Psychiatric Disabilities.
However, a 2011 study by New York researchers found that neighborhood characteristics affected the sense of community felt by residents with mental health disorders.
Father Ryan said he believes the availability of services through the health center and Focus on Renewal, a nonprofit that provides various programs, makes McKees Rocks a better home than many other towns.
At Mental Health Court hearings most Mondays, Judge Lazzara’s team pushes sobriety, mental health treatment, education and eventually employment and a home. (See accompanying story, “ ‘Not Going Back.’ ”) Progress is rewarded with additional privileges, and sometimes even pie or cake.
Relapses or new crimes are punished with anything from a scolding to a jail stint. Those jailed are often released to programs such as CORE, or CASH Club — for Clean and Sober Humans — in Stowe, just outside of McKees Rocks.
The ZIP codes that include Homestead and McKees Rocks host the defendants in 15 percent of Mental Health Court’s current cases, with Wilkinsburg’s ZIP code a distant third place. Judge Lazzara is aware that she’s sending defendants to hard-pressed neighborhoods — because that’s where the programs are — and that some are staying there.
When they’re done with the assigned programs, she said, “what do they want? They want an apartment close to CASH Club. … I think when they build a support structure, it’s a great thing to keep them close to that support structure.”
For police, becoming part of a “support structure” demands skills not taught at the academy.
“It’s basically on the job, and it’s just your natural instincts,” said Officer Pelkington, explaining that he tries to calm a distraught person with casual conversation and simple questions, such as “Do you want a Pepsi?”
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