Guest Column

Am I Crazy?

The answer is a resounding “yes!”  But that’s beside the point.

I have been homeless three times. I also have a mental illness, which I believe to be the underlying cause of my homelessness. I recently started taking a medication that appears to be working, and one more time I am at a crossroads that may result in further recovery. Wondering what will happen leads me to ruminate on the decisions of policy makers, program developers and budget gurus that are outside my control.

I believe that sometimes those decisions engender instability in an inherently unstable segment of the population. I wonder how many emergency measures, inpatient hospitalizations, relapses into alcohol and drug abuse, jail days and prison stays could be avoided if they took a hard look at what happens to people like me. Is this what they mean by fiscal responsibility? Don’t misunderstand me. I am truly blessed and more grateful than I can say.

My most recent episode of homelessness involved six months of pitching a tent in local state and county campgrounds, followed by a seven-month stay at the Friendship Shelter. At the end of that time, with unparalleled support from Friendship Shelter and other sources, for the first time in 12 years I had a home of my own, a lovely studio apartment in Laguna Beach. I have lived there for two years.

It took awhile, but eventually I felt stable enough to step outside my front door and look for volunteer opportunities in the community I fell in love with. For almost a year, I have been covering new books at the local library, answering the telephone at Friendship Shelter two afternoons a week, and serving on a Homeless Working Group committee that meets every other month at Mission Hospital. Oh so slowly, since arriving in Laguna in September 2009, I have consistently taken steps to rebuild my life. So what’s the problem?

The ongoing challenges I face in dealing with the county mental health system.

The county’s Health Care Agency employs a myriad of programs and facilities to provide services to a largely indigent population that are mentally ill. I have been one of those consumers for many years, seen in a number of clinics, by several psychiatrists, care coordinators, group facilitators and nurses. They do the best they can within a ponderous bureaucracy that is overloaded and under pressure from all sides.

Sadly, so many times when I see a tiny pinprick of light at the end of my tunnel and begin to stumble toward it, my support structure is yanked out from under me and I am forced to change clinics, psychiatrists or care coordinators, and start all over.

In the summer of 2008, I arrived for an appointment with my care coordinator, one I had a good relationship with, only to be told that she had been transferred to another clinic and I couldn’t see her anymore. Wow. I think this abrupt interruption in my treatment contributed to my relapse into alcohol abuse and eventually my first DUI followed by homelessness in March 2009.

For reasons that I find somewhat unfathomable and potentially damaging, I am once again being told that I have to move on and go elsewhere for mental health services. My psychiatrist said he knew it would be hard. I would call it traumatic. Am I crazy? What are these people thinking? What is the real bottom line of policies like this? Is it possible that the short-term savings end up costing society and human beings with few choices even more down the line?

As a person with a mental illness, it takes a long time for me to recover from every upheaval in my life. I will never get anywhere without stability. I don’t want to be homeless again, lose hope, delve back into drug and alcohol abuse, end up in jail. I want to work again, regain physical health, contribute to society at many levels. I want a hand up, not a hand out. I want to take another look at my dreams and maybe dream new ones. I want to thrive, not just survive.

Yet, how can I be expected to make real progress when I have no long-term continuity of care, when I am unable to build and stay connected to supportive therapeutic relationships? I liken yo-yo treatment for mental illness to yo-yo dieting. The sometimes dramatic and more often miniscule results are impossible to sustain.

Today, some of my very basic needs are met. Among other things, I am grateful that I have clean clothes and fresh bedding, that I was able to force myself to take a shower in the last week and brush my teeth this morning. And, if it comes down to it, I am glad to have established residency in Laguna so that maybe I can stay at the ASL in the canyon if I end up losing my ability to keep my beautiful home and rewarding volunteer work.

Who knows? Maybe the change will be good for me. But if I could formulate the policy, I would give myself at least six months’ notice before moving me to another facility, psychiatrist or care coordinator. I would give clients options and time to explore them before asking them to make a life-changing decision. Even with a plan in place, I would be careful about transferring clients when they are in crisis or where the potential for progress is discernable.

Will I ever be in a position to resume paying into a system that has been so generous and saved my life more than once? I think so, if the system could consistently help rather than hinder me. It’s one of my dreams. And today, I am daring to dream again.

California native Jane Stahlheber, 54, grew up in Victorville, and most recently lived in San Clemente before moving to Laguna Beach in 2009.