Untouchables in the tree city
One part of my job involves keeping office hours three afternoons per week at one of the large subsidized housing complexes in town, a.k.a. “the projects”. I have discovered that when a building full of people with mental illness, substance abuse problems and some status with the corrections system who are living so far below the federal poverty line that most of them cannot afford local telephone service have a captive audience with a social worker, shenanigans ensue.
Today I spent most of the afternoon deflecting suggestive remarks from the in-house maintenance crew and trying to convince multiple employees of the city Housing Commission not to evict one of my clients. I was then accosted by a woman who is convinced the burial procedures at her church do not pass muster with the Lord, and is now afraid that she is mistakenly attending a Church of Satan rather than a Church of Christ as she had previously thought. (She then asked if the star tattooed on my elbow was a pentagram and whether Iwas a Satan worshipper. I am not altogether sure I convinced her when I said no.) Another woman cried for nearly twenty minutes straight about the fact that her “boyfriend”, a nefarious individual well known to the local police force for near-constant misdemeanors (urinating in public, aggressive panhandling, trespassing, etc.), had been banned from the building grounds after he put a knife to another resident’s throat and threatened to kill him. The “boyfriend” had also stolen her building pass, vehicle and all of her Social Security money for the month, but, “I’ve known him for so long and I know he would never actually do anything to hurt me! Why won’t they let him back on the grounds?” and so forth. I then had to play the bad cop with an extremely overweight elderly man who camps out in the building lobby for about 20 hours out of every day and refuses to shower or change his clothes or use toilet paper after using the bathroom, which has contributed to an untenable living situation for many of the other building residents as one can imagine. Then another client absconded from the university hospital–for the second time in four weeks–where he had been on the inpatient chemical dependency detox and treatment ward for nearly a month. He rolled up to the building in his hospital-issued gown and wheelchair, bearing a colostomy bag in one arm and a 40-ounce bottle in the other (drinking it out of a paper bag, of course). How did he get out of the hospital without anyone noticing? I don’t know. He was already too drunk to respond to my questions. It’s remarkable that he was able to find his way home.
The last half hour or so of my day I was paid a visit by a Vietnam veteran I’ll call David, who is paralyzed from the waist down and unable to speak due to some kind of accident many years ago in which his esophagus, tongue and other organs necessary to produce vocal sounds were removed. He communicates by taking out a laminated piece of paper on which is written the 26 letters of the alphabet, the words “yes”, “no” and “OK”, and numbers zero through nine. When he “speaks”, he points to each letter and spells the words he wants to say. Unfortunately he is an atrocious speller and so when he gets excited and moves his finger around to the letters quickly, I lose track of what he is trying to say and there have been several times where he has fairly thrown up his hands in disgust following my inability to comprehend. It must be extremely frustrating for him, but still he comes back nearly every week to tell me the same stories over and over again: how he went to Vietnam and was shot three times in his right leg. How he lived in a state hospital for three years and a nursing home for ten following the car accident which left him paralyzed. How his wife left him after the accident. How he was born without the ability to digest food and almost died as an infant. How he thinks God must have a reason for keeping him alive so far. Occasionally when I respond with a comment he finds amusing, he opens his mouth extremely wide without really smiling (he is unable to smile all the way because of paralysis) and lets out an extremely loud, piercing, high-pitched shriek–his laugh. When I first heard the David laugh I thought he was having a stroke or some other kind of medical emergency requiring a bustling crew of paramedics, it’s that disturbing. He is also a regular in the lobby downstairs, where he quite openly stares at the rear ends of every female who walks through the doors. He’s less of a breast man, I’ve heard the maintenance men joke, because he can’t lift his head to look up to chest height.
In a city as affluent as Ann Arbor, flush with resources from a prestigious and wealthy university and an equally renowned hospital system, views on how to “manage” those who are poor and mentally ill are often contradictory. On the one hand, there is a large NAMI chapter, an innovative county government with a blueprint for ending homelessness within 10 years, and a research hospital with a seasonal crop of bright doctors and visiting scholars. The city’s shelter, drop-in center, specially trained police force and plethora of area food banks are well known throughout Michigan as a sort of haven for travelers and others who experience chronic or long-term homelessness despite the county’s stuffy rules regarding substance abuse. The Housing Commission, a city agency that administers the federal subsidized housing programs (funded through HUD), while generally staffed with unhappy and incompetent people, at least runs the cleanest housing projects I’ve ever seen.
But it’s still not good enough.
Strict federal guidelines regarding household income restrict the Housing Commission from accepting all but the most poor, most disabled, most challenging tenants for each of the city’s major project complexes. Many such individuals have lived for long periods of time on the street, in institutional settings like prison or the state psychiatric hospitals, or in other specialized settings (detox, nursing facilities, etc.) where they have had little to no contact with the larger community and thus often have no idea what is expected of them in a “real” landlord-tenant relationship. I say “real” because despite the fact that the vast majority of HC tenants have a serious and persistent mental illness (thus rendering a traditional landlord-tenant relationship obsolete), the HC stalwartly and to its own disadvantage tries to pretend that this is not the case. Therefore they use language in the lease that no one can understand and allow no flexibility when a tenant, having been homeless for many years and until only recently medicated for his paranoid schizophrenia, tries to sleep on his porch in a tent. (Why is this an issue? Liability. He lives on the 7th floor, and their worry is that he will fall. Never mind that he has managed to survive over 25 Michigan winters with little more than his tent and a bottle of whiskey.) Rather than talking to tenants about their odd behavior, they continue to issue noise complaints and/or lease violations on paper regardless of the fact that many are unable to read or understand and then follow the official avenues for redress outlined in the paper. If I had been in prison for many years and was paranoid that my probation officer was going to find out about my substance abuse, I would probably not be opening any mail from an official-looking source and may thus toss the HC complaint into the garbage. Thirty days later, I would be shocked to discover I was getting evicted, and my paranoia about insitutions might only be reconfirmed.
Although I firmly believe that housing is a human right, I believe just as firmly that HUD-created projects have only served to further ghettoize populations who are often already the most vulnerable in our communities by scraping all the “undesirables” to the side and shoveling them in to crowded and often ugly apartment complexes where they will ostensibly be out of sight of the town’s “desirable” citizens–i.e. those who bolster the tax base and don’t push shopping carts around on the sidewalk. Packing people with serious problems and fixed incomes into these facilities, pretending they don’t need any additional supports (and the HC staff and maintenance crews don’t need any training on mental illness or how to respond to a psychiatric emergency), and then expecting them to behave like desirables while continuing to stigmatize them as undesirables since they receive government aid is foolish and astoundingly shortsighted. At the very least, the community mental health system recognizes this and chooses to funnel some of its considerable resources toward stationing a social worker at each of the housing projects to act as a liaison between the tenants and the HC…but I’m only here about 10 hours per week, and that is barely enough time to put out fires, much less do some real advocacy work on behalf of the residents and training on behalf of the HC staff.
Last night a man attempted suicide in his apartment on the fifth floor. He cut his wrists in his kitchen and was taken to the university hospital to be stabilized medically. Barely more than 24 hours later he is being sent home, back to this housing project, with some medications and the phone number to access the community mental health system. The HC staff is in an uproar; there is apparently a considerable amount of blood that still needs to be cleaned up in his apartment and the biohazard crew can’t come in until Wednesday. So, they won’t be able to let him back into his apartment until after the cleanup. He can’t stay in the hospital because they won’t turn a profit if they clutter up the beds with Medicaid patients. So he’ll probably be discharged to the homeless shelter, where he will have to sleep on a folding chair with his wrists wrapped in gauze. Meanwhile I will advocate on his behalf with the HC not to add the cost of the cleanup crew and biohazard waste removal to his rent next month.
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May 30th, 2009 at 3:00 am
Hey, I am a friend of Courtney’s. She sent me a link to your blog after she and I talked about our experiences working at shelters. Ann Arbor’s services sound so much like Portland’s. It’s very interesting to hear about how things look in another city. And I enjoy your writing a lot!