Building Community Ties: It Takes a Village

To spend time at the Mental Health Association (MHA) Village Integrated Services Agency in Long Beach, Calif., is to see recovery personified—not just among the 450 “members” receiving services there, but among the staff, who long ago parted with notions that people with serious mental illness can't fully recover.

In fact, some of the staff were once homeless, psychotic, or addicted to drugs, or all three, and today they are showing others through example that it is possible to work, live independently, and maintain successful relationships.

The Village was launched by the MHA in Los Angeles County in 1990 as a statefunded demonstration project. It offers people with serious mental illness assistance with community integration, employment, housing, money management, and education, among other services.

All services are offered in a “culture of recovery,” according to MHA Village Medical Director Mark Ragins, M.D. This means that staff views members as “colleagues” and empowers them with “meaningful choices and meaningful education” regarding treatment, he told Psychiatric News.

Ragins said he realized long ago that his job is “not to treat people with mental illness, but to help people with mental illness have better lives.”

Instead of asking people coming to the Village for the first time to describe symptoms they have experienced or medications they have taken, staff are more likely to ask first, “What is it that you want?” or“ What would you like to accomplish?”

This was the question posed to Village Housing Coordinator Diane Figgins the first time she walked into the red brick building on Elm Street in Long Beach more than five years ago.

“That question threw me, and I was unable to answer it for a long time,” she said. Figgins said she had been living on the streets around the Village for some time, struggling with symptoms of schizophrenia and depression. She was also addicted to crack, which gave her energy and clarity of thought, she said.

“I Didn't Want to Be Homeless Again”

Once she began benefiting from medications and staying sober for longer and longer periods, the Village hired her as a life coach and then a personal service coordinator, a position similar to that of a case manager.

In this capacity, Figgins quickly housed all of the people on her caseload, and she was promoted to the position of housing coordinator.

At first, she said, “I didn't know how to develop a program. I was scared, but I was surrounded by love and encouragement.”

Necessity also fueled her will to succeed, she said. “I didn't want to be homeless again.”

It was anything but easy in the beginning, she recalled. Door after door slammed in her face as she approached apartment managers and landlords about renting to Village members.

Not one to be deterred, Figgins made the rounds again with home-baked cookies and asked, “Why won't you work with us?”

Most replied that they were afraid that if they needed assistance with members who were having problems, Village staff would not be available to help.

After promising to be available to the managers 24 hours a day, Figgins's contacts agreed to rent to Village members who were ready to live independently.

Several said, “We don't want schizophrenics in our building.”

“I replied, `I'm a schizophrenic.... Do you remember chasing me off that bench on the corner a couple of times?' ”

“ `That was you?' ” they asked incredulously.

Since that time, she has helped house hundreds of Village members.

Employment Empowers

The concept of working full time can seem overwhelming to members with serious mental illness, so at the Village, they have an array of employment options, explained Paul Barry, M.Ed., associate director of the Village.

Members can work the number of days a week that suits them.

Job developers working at the Village can also find steady part-time or full-time positions for members.

Members may opt to ease into employment in the community by first finding work through the Village Job Club. Paid positions are available at the Village's deli, Café 456, washing dishes or preparing food. Members can also work in janitorial services or answer the agency's phones and complete other clerical tasks.

Village employment specialists never tell prospective employers that Village members have mental illness, and members need not be symptom-free to find work in the community, he said.

“This is real work that has real risks and real benefits,” Barry said. Benefits for working Village members include salary, new friends, an increased ability to handle success and failure, and “developing an identity that is not defined by a disability.”

“No one needs or deserves the empowering advantages of a real job more than adults with mental illness,” he continued.

Strengthening Community Bonds

After finding a job and a place to call home, some members still may have trouble making friends or becoming involved in their communities.

By organizing group activities, Village community integration staff encourage members to make new friends, become more connected to those around them, and participate in enjoyable pastimes.

Valerie Jones, a director of one of the Village treatment teams, said that members meet at local parks and beaches to play soccer, surf, and kayak. Others run a Bible study group.

Some even get lost together, Jones said. Part of the job for community integration staff is to help members locate resources in the community, including local bus and subway routes. Since some members are hesitant to take public transportation because they are afraid of getting lost, staff has boarded several buses with members, ending up in an area with which they are unfamiliar. “With staff support,” Jones said, members interacted with people in the community and found their way back to the Village.

Community integration staff have also forged relationships with administrators at local colleges and helped a number of Village members go back to school, according to Jones.

Outcome measures that compare members' status for 12 months prior to entrance into the Village with follow-up results adjusted for length of stay in the program have found significant reductions in hospitalizations, incarcerations, and homelessness.

There were also significant increases in the percentages of consumers who became employed or who lived independently while in the program.

Each April, Village members who reach a certain milestone on their journey to recovery are honored at the Golden Ducky Awards ceremony, which is held in a church next to the Village.

Members may win a Golden Ducky award for moving into their first apartment after living in a supported environment for years or they may have stopped using drugs.

Others are lauded for contributing to their families in an exceptional way.

For some, the ceremony marks their graduation from the Village, but members can continue to receive support through the Village Wellness Center, located just blocks away from the main building.

John Travers, director of the Wellness Center, told Psychiatric News that Village graduates can make an appointment with the psychiatrist or nurse practitioner for continuing medication management. In addition, people living in the community come to the center to participate in small self-help groups and educational workshops.

The Wellness Center is also a place where members can participate in a“ core gift” interview.

Travers said that “each person is born with a unique talent or attribute” that enriches the lives of those around him or her. His talent is lifting the spirits of those around him.

By helping people identify their core gifts, Travers said, “we will unlock the capacity for change, create acceptance, promote a purposeful way of living, and heal the wounds that exist whenever broken relationships and broken dreams occur.”

More information on the Village Integrated Service Agency is posted at<www.village-isa.org>.▪