If you think it must be hard to be homeless in a big city, imagine how much harder it is to be not only homeless, but also elderly and mentally ill. Yet 47 people in this painful situation have found a caring and permanent home at Fleming House in New York City’s Chelsea area. Most had previously lived for more than six years either on the streets or in shelters.
“Ours is a mission of accompaniment: we walk with the residents through the daily joys and struggles of life,” the director, Joe McKenzie-Hamilton told me during a visit, adding: “We have a commitment to assist them in achieving the goal of living fully and freely.” The accompaniment leads to what another staff member called “blossoming.” Examples abound. One person who would rarely come out of his room in the months after his arrival, lingers at the dinner table for a few more moments of conversation. Still another, initially terrified at the thought of leaving the building because he was once set afire while living on the streets, now walks to the corner store for chocolate bars.
Fleming House is one of a dozen residences conducted under the auspices of the West Side Federation for Senior and Supportive Housing. The federation provides accommodation for over 1,500 frail, low-income, elderly men and women—many of whom live with physical and/or psychiatric challenges. This may sound like a lot of people receiving the care they need, but numerous mentally ill homeless people still roam the streets, sleeping on the subways or in doorways, often medicating themselves with alcohol. I see them on my commuting trip to and from America House. Part of the thrust of the mayor’s so-called quality of life campaign (the quality of life, that is, for the better-off city dwellers) involves relegating some of these people to jail when they act out in public, rather than to facilities that could provide them with the attention they need.
Other mentally ill homeless persons—often former mental patients from the big state hospitals that were mostly closed in the 1960’s and 70’s— are in for-profit adult homes in the outlying boroughs. Because these (unlike Fleming House) are profit-oriented, both care and accommodations tend to be given short shrift in order to maximize the owners’ profits. A friend in an adult home near Kennedy Airport—a crumbling, 1950’s former motel—lives in a drab room without air conditioning. The grounds with their few stunted trees are an urban dust bowl. By contrast, the rooms Joe showed me during a tour are bright, clean and air conditioned; a garden near the dining room overflows with bright flowers.
Fleming House is also fortunate in being free of the NIMBY stigma: Not in My Backyard. A neighbor, in fact—one who was originally apprehensive about its opening—now helps care for the garden. The local block association even has a Fleming House subcommittee. As Joe put it, the Fleming House model is centered on becoming integrated into the neighborhood in a mutually beneficial and supportive way.
A combination of state and local money pays for Fleming House, and you might think it must be exorbitantly expensive. Not really. A recent study by researchers at the University of Pennsylvania found that the cost of supportive housing for persons with mental illness is basically equal to the cost of their remaining homeless, once the price of their use of crisis services and emergency hospital care is factored in. Why are there not more homes like Fleming House? The fault, Joe said, lies in an absence of the kinds of social values that recognize the worth of each individual, along with a lack of fiscal will at the city and state level. A city-state partnership did provide funds for the creation of some housing for mentally ill homeless people, but not nearly enough to meet the need. And yet in the long run, more funding would represent a savings, as well as the means for imbuing with dignity the lives of some of the city’s most vulnerable residents.