Catherine Debose has experienced the best and worst of the pioneering effort in Berkeley to allow mental health patients to seek help from one another.
“This place was a safe haven for me,” she said inside the Berkeley Drop-In Center—established in 1985 as one of the nation’s first peer-run mental health centers.
“Coming inside from the hustle and bustle gave me the space to deal with my issues,” said Debose, who now volunteers at the center years after she arrived as a homeless mother. But she acknowledges that the South Berkeley center, which gives homeless people a place to stay during the day and access to services, hasn’t been living up to its potential in recent years.
In May, the drop-in center appeared left for dead. Amid outcries from neighbors and merchants that the center’s clients were responsible for increased drug activity and violence near its home at 3234 Adeline St. between Fairview and Harmon streets, and concerns from city monitors that the center wasn’t providing services to clients, city officials recommended eliminating the program’s $88,000 grant—just over half of its total budget.
The City Council gave the center a year’s reprieve after it agreed to install a new management team, and in November, California voters may have given it a new lease on life.
By passing Proposition 63, an initiative forecasted to raise over $600 million a year for mental health programs, having a peer-based program like the drop-in center within its borders might give Berkeley an advantage as it competes for the new stream of funding.
The initiative establishes client self-help services like the drop-in center as a top state mental health priority, said Berkeley Health Department Director Fred Madrano. Having a well-run drop-in center, he added, could help the city win state grants.
Winning the state’s stamp of approval is a giant leap for client self-help services, which began in the 1970s as an alternative to mainstream mental health programs.
Unlike traditional programs, which are run by a professional staff and require patients to actively seek services, peer-based centers are staffed nearly entirely with former patients. They offer services like job training and transitional housing to clients who choose to seek them.
Because they require fewer trained staff, client-self programs typically cost less than traditional services.
The model is also coming into vogue nationally. Last year, the president’s Freedom Commission on Mental Health made the expansion of client self-help services one of its six primary recommendations.
The commission’s findings didn’t include federal funding for programs, but Sara Thompson, director of adult mental health for the National Mental Health Association, expects peer-based programs to multiply in the coming years.
“Washington is telling states that this is what we want you to do,” she said. The recommendation, she added, comes after several studies have shown that patients in peer-based programs report that staff members are more empathetic and better able to engage them in mental health services.
A lack of funding has kept the programs from expanding in California, said Ann Arneill-Py, executive director of the California Mental Health Planning Council. Because client self-help programs don’t offer medical services that qualify for Medi-Cal reimbursements, the primary funding source for state mental health programs, they haven’t taken root in many counties that are strapped for cash.
“Now with Proposition 63, I think we’re going to see a big increase,” she said.
Whether the Berkeley center sticks around long enough to benefit from the expected windfall remains unclear.
The drop-in center suffered from an inattentive board of directors and an overworked staff that failed to keep adequate records of the services it provided, said Nancy Thomas, executive director of the Alameda County Network of Mental Health Patients, an umbrella organization for self-help groups that, at the city’s urging, took administrative control of the center.
As part of its agreement with the city to preserve funding this year, the center must document whether its services are meeting city quotas for providing clients with counseling, shelter beds, transitional housing and referrals to professional mental health programs.
The requirements were not what the founders of the client self-help movement envisioned, Thomas said. “Originally, the goal was to be an alternative outside the system, but now that we’ve been absorbed into the system and take public money, we have to be more accountable.”
Thomas oversees the center’s $165,000 budget, which pays for five employees and ten volunteers. She said Proposition 63 funds could pay for improved administration and services, but she acknowledged the center would remain on shaky footing until it resolved the growing antagonism with its neighbors.
Under orders from the city, the drop-in center has to reinstitute a long dormant neighborhood advisory board comprised of several of the neighboring residents who earlier this year called for the city to end the program.
“There have been far too many problems for too long,” said Ozzie Vincent at a city-sponsored meeting about the center last month. At the meeting eight neighbors complained that the drop-in center had violated its use permit by not posting contact numbers for complaints or maintaining the advisory committee. The neighbors also complained that clients urinated in their yards, loitered in the streets and attracted drug dealers and violent crime to the area.
From January through November, police received 91 calls from the center’s vicinity at Adeline and Harmon streets and 29 separate calls specifically mentioning the drop-in center, Berkeley Police Officer Spencer Fomby told participants at the city-sponsored meeting. Ten of those calls were for disturbing the peace.
“By its very nature self-help centers attract the toughest clients,” said James Sweeney, former executive director of the Oakland Independence Support Center, also a member of the Alameda County Network of Mental Health Clients. “There will always be some people who won’t behave. You can’t expect [the clients] to act like middle class suburbanites.”