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When Andre reaches the Pathways minivan, he opens the door and stops. "Are these for mentally ill people?" he asks, pointing at the seat belts. "Like, restraints?"

Stanton shakes her head. "No, Andre," she says. "You can get out whenever you want."


It took about three weeks to win Muriel over to the idea of moving indoors. Mostly, the whole thing just seemed unreal to her. Once she signed up, though, everything happened in a rush. She loved the first apartment she saw, a one-bedroom with light lavender carpeting and a brand-new kitchen with gleaming white tile. She wanted to move in that afternoon. But there were errands to take care of first. Like a shopping trip to Target, out in the suburbs.

As the wide glass doors whoosh open, Muriel draws a few stares. She has on a metallic gold jacket, a bra, and jeans, with two silver-studded black leather belts slung low around her hips. Her prematurely gray hair is cropped short and topped by a pair of metallic blue wraparound sunglasses, the UV-protection sticker still covering one lens.

The scene that ensues is like something out of a social conservative's welfare nightmare. Stanton steers Muriel toward the cheaper sheets and blankets, but talks only about colors, advising her like a girlfriend. Muriel has a thing for purple, so purple it is -- purple sheets, purple towels, purple dish soap. "Do you want two pillows or four?" Stanton asks. "Four!" Muriel says. Four it is, each one thick and squishy. New dishes and glasses in Mardi Gras colors, new pots and pans, a television, a microwave, ice cube trays: Housewares pile precariously high in two shopping carts.

The financial model that makes all this possible is ingeniously simple. Raise what you can from foundations and government grants (in Washington, D.C., a $750,000 start-up grant from the Department of Mental Health). Then draw the rest from the federal and state benefits the disabled and the desperately poor are eligible to claim but don't -- because they can't navigate the system, for instance, don't have an ID or mailing address, or don't know the benefits exist. Andre is entitled to more than $1,500 a month in veterans' benefits, disability benefits, Section 8 rent assistance, food stamps, transportation and local telephone discounts, and a range of handouts from the city's informal network of churches and nonprofits. All he is collecting when Stanton meets him is an occasional free breakfast. When homeless clients accept Pathways' offer of an apartment, the program collects their benefits and puts them in a bank account. Each month, rent money is withdrawn, while other spending, on food or clothes or cable TV, is left to the client's discretion. Pathways staffers offer ample, friendly budgeting advice.

Pathways also fills in a number of gaps, like providing $1,200 to set up house. That's what has made Muriel's shopping spree at Target possible. It's what will pay for the pillows and a fish-shaped toothbrush holder -- though eventually Stanton steers Muriel away from a beach towel and a Nickelodeon kiddie cup with a big plastic Dora the Explorer figure perched on the lid. She also vetoes a car. "I think you'll have to wait on that," Stanton says with a laugh. "Today is just the essentials, to get you started."

Andre has wild gray hair, like a pompadour undone by a fierce wind, and a black patch over one eye (the result of an accident he refuses to talk about). He and Stanton are huddled over a map. "One of the apartments is here," she says, pointing to a stretch of Georgia Avenue near the Maryland state line. "Another one is over here, near Catholic University. We'll take a look at a couple today, see if you like them," she says. "If you don't, we'll keep looking."

"This means they're going to put me in an apartment?" he asks me quietly, when Stanton walks ahead to the car. Even now, after an appointment with Pathways' psychiatrist and several meetings with Stanton to plan for a move, Andre is skeptical. "I've talked to other programs," he says. "They've said there's a waiting list, you have to wait a year, a year and a half, and do all these things."

Normally an incessant talker, Andre is quiet as we drive to the first apartment. Stanton pulls to the curb in a pretty, leafy neighborhood. "This is the suburbs!" he says approvingly. It is not the suburbs, but it is a good deal more peaceful than the traffic circle where Andre usually sleeps.

The building manager, Kenya Brown, welcomes Andre and Stanton warmly. She leads them up to an airy, one-bedroom apartment on the second floor, with big windows overlooking a school yard and a small park. The rent is $850 a month -- for Andre, with Section 8 help, it will cost a third of his $989 veteran's benefit. Brown doesn't know that Andre suffers from severe mental illness -- that, for instance, before he was last arrested, got out, and met Stanton, he wandered around Rock Creek Park with a big Japanese sword. All she knows is that he is extremely poor. But even when landlords know that a Pathways client is mentally ill and homeless, they are far less resistant than they would be if the same person walked in on their own. Pathways guarantees the rent, a bigger issue for many landlords than a resident who might act erratically. The owners' most common fear is utterly mundane: that tenants will stay home all day and run up high utility bills.

Sometimes landlords do kick Pathways clients out, but Tsemberis considers that a normal part of their recovery from homelessness. Once, at a conference, somebody challenged him: "How many apartments do you give people if they lose them? How are they going to learn?" He was standing with one of his first clients, a guy named Jerome. "I said, ‘Jerome, how many apartments do you think a person deserves?' He said, ‘I don't know, but it took me three before I got my act together.'"

Stanton has another apartment lined up for Andre to see, but he is done looking. He wants to move in. "If you're not sure, we can find some other places for you to look at," she offers. He is sure.


Andre appears to survive on less than a panhandler's cup of change; Muriel gets an array of benefits, but always seems desperately broke. Andre is a tough guy, fiercely protective of his independence; Muriel is lonely and needy. But they both share a desire to get off the streets, out of dangerous, depressing shelters, and into a home. Pathways delivers immediately; later, when staffers help with budgeting or encourage them to get counseling, Andre and Muriel will have reason to trust them. Outreach workers will stop by twice a month at a minimum. Ostensibly, they come by to chat -- living indoors can be lonely at first -- or to help out with errands. But subtly, they help clients wrestle with the issues in their lives and in their heads, keep an eye on their health and hygiene, and encourage them to take their psychiatric meds. They also teach living skills, like how to cook. "Fried rice? You can make fried rice?" Andre exclaims, when Stanton suggests that he could buy a wok for his new apartment. For now, he gets his favorite dish only on the nights when he finds takeout boxes in the trash.

It may be a while until Andre has his own kitchen, though. A few days before he's set to move into his apartment, Stanton takes him to the Veterans Affairs office, to help restore his benefits. (Andre enlisted in the Marines at 17 and served a tour in Vietnam.) There he meets James Street, an outreach coordinator for homeless veterans.

After filling out some paperwork, Street tells Andre his first check should arrive in the mail soon. But there is more. Street wants Andre to participate in an all-day counseling and activity program for homeless veterans. "I want to see you in that program every day," he says. "It will give you something to do, and keep you out of trouble." Andre withdraws. He says he needs to keep his days free, to work on his sketches and his martial arts, but Street is insistent. When it is time to leave, Andre looks distant and a bit sullen. Although Street cannot enforce his attendance, Andre is convinced he'll have to give up his freedom. The next day, he drops out of Pathways.

"Not for good," Tsemberis stresses. An offer of housing is just the first step in winning over the hardest cases, who tend to distrust those trying to help.

Muriel, for her part, moves right in. She piles her pillows high on her new bed, fluffs the comforter, and positions her cheery toothbrush holder thoughtfully on the bathroom counter. But when her next benefits check arrives, she immediately spends money she needs for food on three pairs of shoes and two brightly colored purses, before Stanton has a chance to help her plan a budget. She has trouble thinking an hour ahead, much less keeping the end of the month in mind. What she wants more than anything else is to reunite with the children she lost when her husband left, but that still seems like a fantasy.

Five months later, Muriel's progress is striking. Once deathly afraid of public transportation, she now gets around on the bus and metro by herself with her disability discount pass. "She's on medication, and doing counseling," Stanton adds. "She keeps her apartment immaculate." She's also learning to manage her money. At first, she asked Pathways to issue her benefits payment as a weekly allowance; now, she's getting her benefits twice a month and talking about looking for a job -- a long shot, Stanton says, given her limitations, but something she wouldn't have aspired to before.

Meanwhile, Pathways client Dolores is taking her medications, and stops by the office frequently to visit. Michael, who joined Pathways around the same time as Dolores, is going through a rougher adjustment. He has done some damage to his apartment and remains very suspicious of anyone who tries to help him, including Pathways staff. "It's going to be a long journey with him," Stanton says. By early November, Pathways' Washington branch has placed 22 homeless people in D.C. apartments and is increasing that number at a rate of two a week. None are back on the street.

Half a year passes, and nobody has seen Andre. Then, finally, on a warm fall evening, Stanton spots him in the traffic circle where he used to sleep. They talk, and soon Andre is weighing a move indoors once again.

With the country's worst homelessness rate (about 3 percent of the city's residents, according to the Community Partnership for the Prevention of Homelessness), Washington, D.C., seems overdue for a new approach -- and city officials believe Pathways is onto something. Already, they've asked Tsemberis to move 375 more of the city's homeless residents into apartments within the next five years, if they can line up the funding. "Pathways is doing the best work in the country for people who are chronically homeless," says Martha Knisley, director of Washington's Department of Mental Health.

Tsemberis figures Pathways will stick to New York and Washington for a while. But with homelessness czar Mangano's support, he is advising a half-dozen different cities, from Hartford to Fort Lauderdale, that intend to launch similar programs. "In a perfect homeless services world, I think we'd do away with ‘transitional' services altogether," Tsemberis says. "There's no need for them." Homeless people have all lived in homes at one point, he says; they don't need years of training to do it again.

Douglas McGray last wrote for Mother Jones in the September/October 2002 issue. That story, “Biotech’s Black Market,” received honorable mention in Best American Science and Nature Writing 2003. His work has also appeared in the New York Times Magazine, The Atlantic, and Wired.

Photo: Erika Larson/Redux



 

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This sound so much more sensible . Its hard were all struggling its our nature . No matter how much we have we want more . To give people something for nothing is against our nature . Yet this makes sense . I read the above about Michael who is battling rage , dellusions and Aids . My God why isn't he cared for the suffering he must be going through . Its dangerous to him and others for him to be out on the street . Whats he supposed to do ? Litterly he is why people infect other people . I was in a car accident not even my fault . I was in a no fault state I couldnt sue anyone for damages enough to help my situation . Doctors pumped me up with drugs that did nothing they said they would . I am a completely ruined man now . I did nothing wrong . Most of these people did nothing wrong . Most of the mentally ill have been damaged by cruelty . If given a chance they will slowly snap out of it and work their ways back to productive positions . People like Michael want to just live in some comfort , out of veiw from people when their out of their minds in suffering . Still being social when they can . Morphine is such a bad drug , we treat people with it yet dont have places for when they become unbalanced and damaged from it . Places where they can be made comfortable while slowly titrated down as it makes people toxic and that must be done almost quarterly for it too work . Its so painful to be on a lowered dose . Anyone would be considered insane on behavior and our Doctors do this to people all the time then abandon them with improper care when they have problems . They dont educate them first or work out detox protocals in advance of administration with the patient . Herion was supposed to be a cure for opiate addiction ..boy did that work . Suboxone is even worse for some . Nothing but a very long term slow supervised titration down from the substance one is on ,..very slow with nutricional support and round the clock care at first works comfortabley enough to encourage participation to cease opiate use in addicts or even dependant patients . Doctors are killing people with impunity . Our system is not helping sick people that become homeless it lets them die . Then their are the well , you dont have to be mentally ill to be homeless but many homeless become mentally ill . Why not have a conservation corps program , programs such as this even build self supportive or patialy supportive insitutions where people can go rather than live on the street , Get food , a clean bed basic clothes and some work if able . WE can do more . There is so much frivilous energy spent in our society yet we wont help others its sick that we would even question whether to help others . Why we would care if they are getting over on us ? You just help . Our society is mentally ill that it doesn't want to solve suffering and lend assistance everywhere it can at all times . That we allow Doctors to give people all these drugs and when they cuase suffering and problems the people cant escape from without help becuase the side effects are too terrible to stand we dont recognize their needs and force them to just commit suicide one after the other from defective medicine that kills with impunity is criminal. Where did we fall apart . Why wouldn't we want to help people that ask for it and need it and find pleasure in that ? Why is Micheal homeless if we know he is diseased and ill ?
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