Mental Anguish

Rescuing the mentally ill has brought millions to the Mental Health Corporation of Denver--as well as complaints of coercion, mismanagement and neglect.

Ask Sam Haigler how things are going and he'll give you that perplexed look, the one that seems to ask: What planet are you from, pal? Twenty years of battling chronic mental illness, just how well could things be?

"That's kind of a hard question for me to answer," he explains. "I hear voices. I can't get them to say who they are. It's been going on a long time."

For almost ten years, Haigler lived at the Highlands Personal Care Living Center, a huge boarding home in northwest Denver. But in early 1995 the city closed Highlands over a zoning dispute; the 47-year-old Haigler now lives at another boarding home, the Vernon L. Valdez Personal Care Center on West Colfax. The voices have traveled with him, especially one voice that comes over the radio.

"He talks along with the music," Haigler says. "He tells me to bend my thumb, bend my thumb. He chants it. But I won't cooperate.

"Then he says, 'When you bend your thumb, I'm having the police come over and cream you and take you to the jail and electrocute you.' After a while he convinced me of that--that the police were going to come."

One time Haigler came home from 7-Eleven with a package of cookies. He got ready for bed and turned the light off. The voice on the radio said, "Eat a cookie for $30,000. Eat a cookie for $30,000." Haigler wouldn't do it. The voice wouldn't leave him alone.

"He just kept going on about it," Haigler recalls. "And he's still on the radio. I have a problem with that."

In recent months Haigler has been troubled by voices of another kind. They are the voices of social workers and therapists, asking him if he would like to move out of Valdez. Like the one on the radio, these voices have been relentless.

When Highlands closed, they persuaded him to try living in his own apartment. It didn't work out; Haigler wasn't used to cooking for himself or being on his own, and he ended up being institutionalized for several weeks. Then he moved to Valdez, one of the few boarding homes left in the city; most of its residents suffer from paranoid schizophrenia, bipolar disorder, severe depression or other mental illnesses. Haigler wants to stay there, he says, but his case manager and others have continued to urge him to think about moving to a smaller group home operated by the Mental Health Corporation of Denver.

"They've brought up moving five or six different times," Haigler says. "I told them I'm not interested, but they keep evading what I say. I say I don't want to move, they just say something else about moving. They don't shut up about it."

Why all this interest in where Sam Haigler lives? Credit--or blame--the Goebel Services Plan, named after Ruth Goebel, a homeless woman who died on Denver's streets in 1983. As part of the settlement of a lengthy, complex class-action lawsuit brought on behalf of Goebel and other mentally ill Denver residents, in 1994 state and city officials agreed to commit millions of dollars to programs designed to "mainstream" the mentally ill, including moving them out of four large boarding homes--Highlands, Valdez, La Bonte and Pontiac--and into smaller group homes or their own apartments.

Forged out of long-simmering disputes over the care of Denver's most neglected citizens, the Goebel plan is a highly ambitious, three-year blueprint for liberating them from living conditions that many mental-health professionals consider to be substandard and even dangerous. The plan requires the City of Denver to develop 250 units of housing for the mentally ill and the state to provide 50 more. It requires the Mental Health Corporation of Denver--the nonprofit group that contracts with the state to implement the plan--to relocate as many of its boarding-home clients as are willing so that they can better "negotiate the community." MHCD is also expected to make various new services available to its 1,600-plus "Goebel clients" around the city--high-intensity treatment teams, independent-living teams, 24-hour mobile crisis-response teams, and so on--to ensure that they have an opportunity to live as independently as their circumstances will allow.

Noble as it sounds, carrying out the plan has proven to be more difficult than expected. While its backers claim much progress in two years--for example, the number of MHCD clients living in the four boarding homes targeted by the plan has dropped by two-thirds since 1994, largely because of the closure of Highlands--some truly formidable problems remain.

The city has yet to deliver on most of the promised housing, despite a court-ordered deadline looming only seven months from now. Many of the remaining 51 Goebel clients living in the boarding homes say they don't want to move, and several who did take the plunge have found themselves in a seemingly endless spiral of waiting lists, temporary housing, evictions and other setbacks that have landed them back in boarding homes or hospitalized, with no end in sight ("Out of Sight, Out of Mind," January 17).

The plan has also encountered resistance from the boarding-home operators, who are offering competing medical services and have challenged the removal of their residents. MHCD is now locked in a tug-of-war with the homes' operators over the remaining Goebel residents, with each side accusing the other of providing inadequate services, trying to coerce clients to stay put or to leave, or otherwise exploiting the mentally ill for their own gain.

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