In February, two mobile treatment teams, on call 24 hours a day, will begin scouring alleys and doorways on The Block and in downtown Baltimore, looking for the homeless who suffer from schizophrenia, chronic depression and dementia.
The teams will include nurses, social workers, a psychiatrist and people once homeless themselves.
For the first time, care-providers will be going to places where the homeless who are severely mentally ill gather, responding to their emergencies no matter what hour and trying to help them stabilize their lives.
The goal is to link this hard-to-reach homeless subgroup with medical, nutritional and housing services on a permanent basis.
The Baltimore Mental Health Systems Inc., a private, non-profit group, is announcing today that it has received the first $1 million of a three-year federal grant totaling $3 million to see if this kind of intervention can change the lives of the homeless.
Baltimore is one of six cities, including New York, Boston and Los Angeles, that have been awarded similar grants from the National Institute of Mental Health, said Stephen Baron, president of the local agency which regulates and coordinates services for the chronically mentally ill.
"The typical persons we anticipate serving are young, black men between 35 and 40 years old," said Dr. Anthony F. Lehman, a University of Maryland psychiatrist, who as the principal investigator of the project also will oversee and evaluate its progress.
"Many have developed their illnesses very young, have been unable to hold down a steady job and come from families who over time have become unable to care for them," Lehman said. "Because they're poor and don't work, they end up on the streets."
In Baltimore, it is estimated that about one-third of the homeless, or between 750 and 1,000 or possibly more of this population, have severe mental illness, Lehman said.
He based his figures on data compiled by Help Care for the Homeless, a local social and medical service agency. The agency's figures show it provided services for 3,000 homeless people during 1989. The figures could be conservative, Lehman said, because Help Care for the Homeless is not the only agency involved with the homeless.
The experimental mobile treatment project, which will operate out of unmarked cars, is expected to start by Feb. 1 after two teams of workers have been recruited and trained.
"This is a rare opportunity to really try something different and new with this group of people who we all feel very frustrated trying to help," Lehman said. "Now, we'll not only be able to do it, but learn whether it's effective and if not, what else can be done."
Initially, the project has been designed to reach 80 people who traditionally do not seek out clinics for health care and other agencies that can help them fill basic survival needs. If successful, Lehman believes funding could become available for an expanded program.
"We do believe we can reach these people, but we have to make a great effort and this is what we intend to do," he said.
Forty of the homeless with severe mental illness will be identified while they are treated at the Walter P. Carter Center.
"We will begin to work with them while they are still in the hospital and the goal with those is to try to prevent them from becoming homeless again and to help them get their lives together," Lehman said.
The other half will be identified by Help Care for the Homeless outreach workers who daily go onto the streets and into the shelters and soup kitchens. Within a few months, the outreach workers will be accompanied by the mobile treatment personnel who will begin to work with the homeless mentally ill "wherever we find them," Lehman said.
Baron said he is hoping that some of the people helped by the federally funded project will find shelter through an "affordable housing" program now being developed by Community Housing Associates, a group established by Baltimore Mental Health Systems Inc.
"By late spring, we'll have property ready to house the mentally ill and some of the applicants we would expect to come from this program," he explained.
"There is a whole range of housing that we are trying to develop in the city that will mesh very nicely with this program.