By Matt Birchenough, Alissa Gulin and Kandyce Jackson
Special to Capital News Service
BALTIMORE – A recovery center in Baltimore has brought hope to thousands of uninsured Baltimore City residents struggling with mental illness and homelessness — resisting the budget cuts that have plagued other programs in the state mental health system.
The HOPE Wellness and Recovery Center has provided a critical safety net for the homeless since its opening in February 2001, maintaining a stable level of funding and patients while other mental health care services in Maryland have struggled to cover expenses, state health officials say.
It’s the only center of its kind in the state – specifically catering to mentally ill homeless and staffed by workers who have all struggled with mental illness or homelessness, or have seen loved ones touched by this, said Executive Director Thomas Hicks.
“They’re very supportive,” said client Vernell Lewis of HOPE’s staff. “We learn a lot from them because some of the staff have some issues, too. We’re very understanding of each other.”
The center’s mission is simple, and the name says it all: Helping Other People through Empowerment. Hicks, 58, said the nine staff members at HOPE are not interested in forcing clients to get care.
“Our purpose here is to try to get you to understand, to empower you to get a better quality of life if that’s what you want to do,” Hicks said. “And if that’s not what you want to do and you still meet the criteria, you’re still perfectly welcome.”
Despite the state’s ongoing deficit reduction strategy, which has included deep cuts to other programs and services in the mental health care system over the past few years, HOPE’s funding remained stable, said Crista Taylor, director of adult services at Baltimore Mental Health Systems, which oversees treatment facilities for the mentally ill in Baltimore City.
“Wellness and recovery centers — and this being one for homeless individuals — they are a vital part to our continuum” and have been protected from budget reductions of the last three or four years, Taylor said. “We do not want to reduce that level of service, because it’s so unique in our system, and so vital in our system.”
HOPE operates annually on about $100,000 in state funding and about $200,000 from the U.S. Department of Housing and Urban Development, Taylor said.
Individuals must provide proof of a mental illness diagnosis in order to take part in the program. Employees put clients in contact with case managers to help them find housing or therapists to help them manage their symptoms.
The center also provides a number of simple yet fundamental services, such as laundry, showers, Internet access, meals and entertainment.
But clients receive more than just clean clothes and warm food — they see a future through the eyes of others who have overcome similar obstacles.
Because of their common perspectives, employees share in the continual process of recovery with clients, who find their way to HOPE either by referral or word-of-mouth.
Lewis, 58, said he suffers from psychotic depression, a condition he said has led him to attempt suicide six times. He said he has been going to HOPE since 2006, and that simply talking to peers, and being able to relax with them by playing games such as chess or cards, has helped.
“We try to respect each other; that’s one of the things that’s important,” he said.
The employees at HOPE might just be better equipped to provide that push toward recovery, said Brian Hepburn, executive director of the Maryland Mental Hygiene Administration.
“The advantage, of course, is that there may be more trust for people who have previously had a similar life experience,” Hepburn said.
The center’s model sets it apart from many other programs for the mentally ill, officials said.
“Peers play a critical role in service delivery in our system,” Taylor added. “We find them in a lot of programs, but this is a center that provides a relaxed, comfortable environment for people to interact with peers.”
Hepburn said peer-to-peer support is more common in substance abuse treatment and is relatively new to the mental health community. But the advocacy group On Our Own of Maryland, which assists people diagnosed with mental illness, has made inroads with it.
Mental health care has evolved over the past few decades, a movement characterized primarily by a transition from institutional to community care, with patients receiving services they need closer to home. Supporters say community programs allow people to integrate treatment into their daily lives, minimize disruption to their normal activities and increase their autonomy in deciding what level of care they require at a given time.
This on-going process has spawned programs across the country, each aimed at local residents — like HOPE.
HOPE employees said they want to equip clients with whatever tools they need to prepare themselves — mentally, emotionally, physically, financially — for recovery, rather than force any one line of treatment.
“We laugh a lot and encourage them; actually, the hard part is over, because now we know what we need to do and what we don’t need to do. And we just focus on anything positive,” Hicks said.
HOPE serves about 25 clients throughout the day, Hicks said, during its normal hours from 8:30 a.m. to 5 p.m. In 2011, the center served about 400 people, Hicks said, adding that the number of clients has remained roughly the same over the past decade.
However, Taylor said double-counting of people has been an issue in the past because of the drop-in nature of the program. BMHS recently helped staff reconfigure its counting system, she said, so it’s difficult to compare current numbers to past years. Taylor estimates the total for this year will be about 250 clients.
Every morning, the staff holds a meeting with all the clients about what’s going on in the community, said program director Shariff Johns. They distribute information about housing and special events, Johns said, and on weekdays after the meeting, they continue with a structured schedule of support group meetings, educational videos and one-on-one time with peer support counselors.
Hicks said he feels fortunate funding has remained stable since he took over as executive director and that he thinks it has benefited the state because the center can provide services at a lower cost than other options, such as emergency room visits.
“Each and every last one of [our members] on inclement days, they have to find some kind of shelter, and a majority of them are going to that emergency room,” he said. “And I don’t know how much it costs per visit, but it costs a lot of money that the state would have to pay for.”
The average national cost in 2008 for emergency room visits for the uninsured was $1,203, according to a 2011 report made before the U.S. Senate by the Center for Studying Health System Change.
How much of a correlation exists between deinstitutionalization and homelessness is unknown, but it’s widely agreed that mentally ill patients are at increased risk of becoming homeless.
Hicks said he struggled with mental illness and drug addiction on his way to becoming director of HOPE.
“I started sniffing glue, and then I started eating pills and drinking cough syrup and started shooting heroin when I was 14 years old,” Hicks said. “From 10 to like 45 years old, at one time or another I was always under the influence of some type of substance and in and out of institutions and jails and all that.”
Hicks said his attitude changed following an incident with his wife, whom he said he had separated from due to his lifestyle.
“She gave me the boot, and one day her and her boyfriend rolled by where I used to hang out at and ridiculed me,” Hicks said. “I made up my mind that day that nobody [would] ever see me do bad again.”
Hicks rose to become executive director at HOPE in 2007.
Others have completed a similar turnaround.
Sharon Reese, a peer support specialist at HOPE, said she is a recovering drug addict who stopped using in December 2009 after abusing drugs for 31 years. Reese, 52, said HOPE has benefited her as well as the clients she assists.
“I’m enjoying my life now,” said Reese, who is now attending college to become an addiction counselor. “Recovery does work.”
The employees have created a setting in which HOPE clients can feel comfortable.
“I came up here because it’s a good place,” said Robert Hall, who said he has been coming to HOPE for more than 10 years. “It’s like a family atmosphere. They have a lot of resources, they’ll help you.”
Hall, 61, said he is a U.S. Marine Corps veteran who saw combat in Vietnam and suffers from chronic post-traumatic stress disorder. He said HOPE has provided him with services he was previously unable to obtain.
“I couldn’t get the help and stuff that I really needed, not even through the [Veterans Administration],” Hall said.
“The help is here, you just need to come and do your job, do what you need to do to get the help you need,” Hall continued. “It’s not one of those things where people are going to take you by the hand. You gotta make the first step, and they’ll help you from there.”
Hicks said he hopes funding will remain stable so other people can benefit from the services he said saved his own life.
“One of the primary reasons that I love this job is that, first of all, people like myself — mainstream society said we was done, we was washed up,” Hicks said. But, he said, he and others have proven “that mainstream society really don’t know what’s going on about us.”