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Damage Control

Congressional Funding Cuts Threaten Help for the Mentally Ill

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By Ben Joravsky

Every morning of every day the social workers of Thresholds search the city's alleys, parks, and viaducts looking for the mentally ill.

They counsel the kinds of homeless schizophrenics and acute paranoiacs most of us ignore. "We go right up to them and ask if there's anything we can do," says Walter Green, director of the outreach program at Thresholds, Chicago's largest psychiatric rehabilitation center. "Maybe we can talk them into going to a shelter or a doctor or a hospital. It could be the first step toward getting them off of the street."

But now these good deeds may fall victim to the latest round of congressional budget cuts. A spending bill passed by house Republicans late last year proposes to take $400,000 in federal funds from Thresholds, which would force them to lay off six or seven social workers, ending their outreach program. But the matter is in limbo while congressional Republicans negotiate with President Clinton over the larger issue of the federal budget.

"If we lose that money, we'd be down to three social workers," says Green. "You can't run an outreach program with three; it'd be a joke."

In many ways theirs is a thankless task. Many of their homeless clients initially mistrust them. Conservatives who advocate for the mass detention of homeless people say they're ineffective at clearing the streets. But the Thresholds workers say they're just the first step toward a humane policy.

Their job isn't made any easier by the threat of the proposed cuts. "We counsel at least 400 people a year, and I don't know exactly how many thousands of others are out there living on the streets of Chicago," says Green. "It's mind-boggling. It's like we're producing homeless people at a factory. The system can't meet their needs."

This is not the first time Thresholds has come under attack from Republicans in Washington. Four years ago the Bush administration slashed a fourth of Thresholds' federal outreach allowance, arguing that the group received more money than census rules allowed.

"Our budget's partly appropriated by how many [mentally ill homeless] people the census counts in Chicago," says Green. "They undercounted Chicago in the last census; they said we had fewer people than we claimed and shifted our money to the suburbs."

As a result Thresholds had to lay off three social workers and discontinue evening and weekend outreach service. Last year they recovered most of that money with a grant from the Department of Housing and Urban Development. "We're able to send our vans out at night and on weekends again," says Green. "But it's debilitating. One year on, the next year off. It adds to the uncertainty about whether the system will work when we need it."

The current attack was initiated by the House Appropriations Subcommittee on Labor, Health and Human Services, and Education, chaired by Illinois Republican John Porter. "It's not as though they cut our program because they don't like what we do; they were just whacking away, and we got cut," says Green. "The Senate's version of the budget is kinder to us; it has no cuts. But we don't know when the House and Senate will get around to reconciling their differences. Some of our board members will call Porter on our behalf. But everything in Washington's so chaotic these days because of the budget fight we don't know what will happen."

Thresholds' efforts to help the homeless have also been hampered by other federal cuts. "The system isn't helping the people who need help the most," says Mark Furlong, a social worker for Thresholds. "Say you go up to a guy on the street and he says, 'I'm willing to see a psychiatrist.' If you can find one in two weeks, let me know. Or you might talk him into going to a hospital, and then they'll turn him away because he has no insurance. That's so deflating. It's not our fault, but it's as though we let the people down."

Medicaid cuts have also hurt. "Medicaid won't even pay for eyeglasses anymore," says Green. "My boss...put it well when he said that the people least equipped to negotiate the system have to jump the most hurdles. Our job is to give them something really fast. But what are we supposed to do if, say, the shelters are closing because budgets have been cut? That's what's so frustrating about our current budget mess. It's just another case of the system letting people down."

On the morning I joined Green and Furlong in the field their first stop was near Diversey in Lincoln Park. On the ground a few feet from Lake Shore Drive was Lou, wrapped in a gray plastic bag.

"Are you OK, Lou?" said Furlong as they approached.

Five fingers snuck out from the bag and waved the social workers away. "Get out of here," Lou snarled, "or I'll file a civil lawsuit."

Furlong and Green walked back to the van. "We met Lou in the summer--he says he can't live inside because the demons drove him out," said Green. "He'll give you bits and pieces about his life--he's a vet, he served in Korea--then tell you to go away. Ironically, a negative reaction suggests he might not need our help. We're just a couple of strangers; why should anyone trust us? It's a good sign of judgment, unless it goes too far into paranoia."

They headed down the drive to North Michigan Avenue, before heading over to Union Station.

There in the main terminal sat a dozen or so homeless people, sleeping or dozing on the long wooden benches. Green and Furlong walked up to one longtime client and gave him $3 to buy lunch. "Please get us a receipt," Furlong said.

Across the way, slumped over a newspaper, sat a man in a tattered jacket and coffee-stained tie. He appeared to be talking to himself.

They approached him uncertainly, trying to figure if he needed their help.

"Excuse me, sir," said Furlong. "We're social workers."

The man looked startled. "Good," he said. "Keep up the good work."

There was an awkward pause. Furlong mumbled an apology and they moved on. Upstairs along the balcony lay a man on the cold marble floor, his frayed coat encrusted with dirt, his hands and face red and raw from the cold. As Furlong and Green came closer the man hastily sat up.

"Don't worry--we're not the police," said Green. "We're social workers."

The man sat along the wall, legs drawn to his chest. He stared at the floor and trembled.

"Are you cold?" asked Furlong.

The man said nothing.

"Would you like some coffee?" Furlong continued.

He nodded.

"Cream or sugar?"

He nodded again.

"I'll get you both," Furlong said. They headed off to a restaurant, returning with a cup of steaming coffee, which they set before the man, who never looked up or stopped trembling.

They sat on the floor and spoke slowly and softly.

"What's your name?" asked Furlong.

"Jim," he said quietly.

Furlong explained that they worked for Thresholds, that they could help him find a doctor, get medication, locate his family, or find food and lodging where he was free to come and go as he pleased.

Gradually Jim answered a few questions, never with more than a word or a nod. He didn't know when, how, or why he came to Chicago. He had been hospitalized in Alabama, where they gave him Haldol, a common medication for schizophrenia. He had a brother named Daniel, though he didn't know where he lived or when they'd last seen each other.

"Would you like a room?" asked Furlong.

He shook his head no.

"Can we see you tomorrow?" asked Green.

He said nothing.

Furlong placed his business card next to the untouched cup of coffee. "That's our number, you can call us anytime. I know we're complete strangers, but we want to help you."

They rose. "Well, thanks for talking to us, Jim," said Furlong. "It was a pleasure meeting you." He held out his hand, but Jim ignored it.

Later Green said, "You can only imagine what's going on in his head. Maybe he's just worn out from so many sleepless nights in the cold. Maybe he's hearing voices in his head that are drowning us out. The thing is we can help him. We'll just have to come back and hope he's there tomorrow."

The next day they returned to the train station and found Jim in the same spot. "He let us buy him a bacon-and-egg sandwich from McDonald's, and he wolfed it down--he could have eaten three of them he was so hungry," says Green. "Who knows when he last ate, or what he experienced on the streets.

"He let us take him to a hospital--I guess he trusted us because we came back, like we said we would. They cleaned him up and deloused him. They'll start him up on psychiatric medication and we'll help him make sure he's getting the [Social Security] benefits he's got coming. If things go well, in a couple of months, maybe sooner, he'll be a much different person."

Art accompanying story in printed newspaper (not available in this archive): photo / Cynthia Howe.

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