mental illness

Why is the mentally ill walking the streets?

The temperature last night was below freezing 18 or 20 degrees with wind chill making it 8 degrees below zero.
About 8pm a gentleman whom I have seen a few times walked into a location where I was at. He was wearing three coats, blue jeans and boots two sizes to big. He wore a dark colored ski hat pulled down his forehead shading his eyes. His hands were glove bare.
He quietly sat in a chair.
When we all stood to leave I noticed he had difficulty walking, his gate was off though he didn’t appear intoxicated.
I asked him if he was ill.
He didn’t respond.
I asked him if he was having trouble with his feet, thinking surely if he has been out in this he might have frostbite.
He pointed to his legs.
I asked him if he wanted to go to the hospital and he indicated yes.
I didn’t have my car that night and had driven over with my friend Karen, whom trained me in homeless outreach in 1998.
We put him in her car with great difficulty. He couldn’t figure out how to get his legs in first or sit and pull his legs in after. He turned his face away as he winced in pain.
I asked him if he was a veteran. He said yes, I asked if he wanted to go to VAMC, he shook his head NO. I asked if he wanted to go to CMC or Elliot hospital. He said Elliot Hospital so we drove to ER.

During the ride across the city he was non-verbal though Karen and I tried to engage him in conversation.
At the hospital he couldn’t or wouldn’t speak. Karen asked for his ID and it took a few minutes for him to process what was required, he began digging in his pocket. We explained to admissions staff why we brought him there.
He was so unsteady walking that they put him in a wheel chair and set him in the waiting room.

The wait was long as the room was full of folks suffering flu symptoms, the man next to us had been waiting 4 hours already. We settled in for a long night.
C sat in his chair hunched over shading his eyes from the light and stares of curious others.
Karen was going to walk over to Dunkin’s. She asked C if he wanted coffee. He nodded. She asked how he takes it, “Black” he answered softly.
She asked did he want a donut, “Chocolate” he said.
I went to the vending machines and got diet coke; caffeine being my friend late a night when I had to keep going.

Another man who I recognized from the street came in and sat down in the chairs across from us. I asked him if he had the flu. He said, “No, I’m just going to sit here and read for the night and stay warm. I can’t sleep at the shelter I saw fleas on the mats.” I explained to him that lice look like fleas in the adult stage and that he needed to check the seams of his clothing for larva stage white bugs. He was certainly scratching enough to indicate he might be infected. I suggested he check in for treatment while he was here.

C was called into nurse for preliminary medical assessment. She helped him take off his boots; again he winced and turned his face away.
She took his pulse in his feet. Then she took his blood pressure and temperature. She estimated his weight as 125 lbs. She held a picture chart of smiling faces to frowns and asked him his pain level. He pointed to a picture indicating 1-2 level pain.
She said “this doesn’t really help because these guys have such a high tolerance to pain they walk around with it all day and night and I can tell he is in pain.”
She rolled up his pant legs and looked at his legs.
Then we went back into waiting room.

At 11pm he was called into the back. The nurse told him that he needed to remove his lower clothing so they could look at his legs. She gave him a Johnny and I helped him pull his coats off. I was amazed of how heavy they were and couldn’t imagine the same weight across my shoulders all day and night.

The nurse pulled the curtain across. I was sitting in a chair on the other side of the curtain wondering how he was doing. I saw only his feet and then his hands beginning to struggle with his boot laces. I asked him if he needed help and he grunted.

I on one side of the curtain and he on the other; I reached underneath and unlaced his boots and he lifted his leg slightly so that I could also remove his socks. It was a humbling experience and my heart filled with compassion. This is someone’s loved one, but too whom does he belong? He is my neighbor, my brother.

I thought of a time when I found a wounded dog on the side of the road and when I touched his paws he whined. How I rushed him into the local vet and he was immediately treated and the police were called to help identify the owners. This doesn’t happen with people. They don’t call looking for whom they belong only to local homeless shelters to see if there is room.

The doctor came in to examine him. She said he had pulse in his feet and while he was cold there was no frostbite. He lifted his legs up when she asked and therefore she saw nothing wrong with him. She did not do any further tests. She asked where he had been sleeping and Karen told her that he has been outside. Check in for the shelter had already passed and C has no concept of time. The doctor then asked for the number to the shelter and asked one of the nurses to call.

The nurse came back to report “he could not go to the New Horizons shelter until he could come in and talk to his case manager.” The man can barely talk he has gone so far inside himself.


The streets are a mean place. People walk by the homeless and act as if they are invisible and finally one begins to believe that they are indeed invisible. I have seen many who want to shrink so far inside that no one can touch them. Like one of the Four Noble Truths on suffering “if you remove desire, you remove suffering”

But there is still suffering and too much of it. People are not animals and because of the reasoning mind one thinks that “there must be something wrong with me” If one is strong enough and get the right supports they can believe they are worth more, that they deserve care and help that they can move out of homelessness. But when the support is absent the victim has nothing else but to fend for him/herself the best way they know how and in this case to protect themselves by giving up; Stop asking, stop expecting, stop wanting, stop waiting, stop believing.

The doctor asked where C could go for the night if he couldn’t go into shelter. Karen and I responded in chorus, “nowhere but into the street.”
Doctor said, “Its freezing temps out there!”
I said, “Yes it is, but the shelter can ban people for life even if the behavior that got them kicked out is related to their disabilities. They have to make all the ducks fit in a row to maintain control.
She said, “C is not a duck! I will allow him to sleep in the waiting room for the night but he must leave in the morning with no trouble. And she explained to C that if there was any trouble that the nurse would call the police on him. I thought what possible trouble could a very cold non-verbal man in a wheelchair really cause?

She had him sign discharge papers.
They stated “Transient feet pain-Homeless” Dr. Nicola Dirito Herbert

History of medications - none
(Though he has receipts in his pocket from rite-aid pharmacy dated from December from Concord State hospital)

Additional instructions: GET TO THE SHELTER BEFORE THEY CLOSE FOR THE EVENING IN THE FUTURE

I noted that on his prescriptions he had NH Medicare program number which means that he may also have social security. As Medicare program typically comes when SSA has been approved. He may have a guardian who receives his disability checks but for some reason he is left in the streets.


We tucked him into a chair, got him some blankets and prayed for the best in the morning. It was 2AM when I got home.

The next morning I began calling social services about C. (how much money would I have to use if I were the client calling from a payphone?)

The first place I called was Manchester Mental Health Homeless outreach. I was told that the outreach position is currently empty. I asked if there was anyone else I could talk with and was passed to emergency services.

After explaining the night’s events, I was told that they knew him and that C must contact the office himself.

I called NH Dept of Behavioral Health and left a message for M. Young because the NH DHHS shelter rules that we advocates put so much into writing and getting passed in the law 2000, state that when a person is asked to leave a shelter it can only be for violence or a danger to themselves or others. The shelter must file a report with dept of Behavioral Health regarding whom and why a banning takes place. And they must provide help with alternative housing options including calling police for protective custody if need be.


I called the Homeless Hotline 1-800-852-3388 and the recording said “if you are experiencing homelessness or this is a homeless related issue please press one”.
I did and received another recording that said, “There is no one to take your call please leave your name and a call back number and we will get back to you as soon as we can.”

Since there is an outreach worker for Southern NH Services, whom I know I called his office. I was told that Pat Carney is no longer in SNHS and the gal gave me a different number.

I called the number and it was not valid.

I heard rumor last week that Pat moved to Latin American Center and called there. I was told yes, but he is not here please leave a message. I asked if she could page him and she said no but he periodically picks up his messages.

It is now midnight; I have no idea where C. is and I answering machine at home and I have no gotten any calls from Pat.

I sent this post out as email to every continuim of care homeless provider in manchester. Its been over a week and I still havent heard from the official outreach person, but I did get email back from the executive director of the NH Coalition to end Homelessness (nhceh.org)

"Cindy, I don't know what to say. The system is so broken. Its like calling 911 and being put on hold. Marriane Savarese said that the fact that we have chronically homless is basically society saying that we don't care about those with mental illness. I sadly agree. Keith"

In Memorial -Steven Aliberti

Homeless man loses battle with alcoholism
Family says he was devoted to his son
By SARAH LIEBOWITZMonitor staff
Feb 9, 2008

Steven Aliberti seemed to know he didn't have long to live.
His body was deteriorating, damaged by a decades-long battle with alcoholism and other illnesses. Homelessness was a further strain: For about seven years, Aliberti spent his days and nights outside, punctuated by occasional stays in jail and, when the temperature dipped, visits to First Congregational Church's emergency cold weather shelter. "He must have known he was really bad off," said Brenda Aliberti, Aliberti's ex-wife.
The morning of Jan. 26, Aliberti was found lying in the snow near a site frequented by Concord's homeless. Suffering from severe hypothermia, Aliberti, 52, spent several days in Concord Hospital's intensive care unit before dying Jan. 30, said David Keller, the pastor of First Congregational Church, where Aliberti had been sleeping.
Several days after arriving at the hospital, Aliberti's body seemed to begin shutting down, and he was placed on life support, Keller said. It's unclear how long Aliberti was lying in the snow before he was discovered.
Since First Congregational Church began opening its doors to Concord's homeless during the coldest months, Keller has presided over several funerals for shelter guests. Like Aliberti, there have been other men who died in middle age, often after years without a stable home. Aliberti's memorial service will take place this afternoon, at the church where he spent so many nights.
"We're just not ready," Brenda Aliberti said. "He kept making it through the winters, so we had hope."
Aliberti's years of homelessness belied his family ties. Unlike other shelter guests, Aliberti had a network of relatives and friends, several of whom lived in Concord. He doted on his and Brenda Aliberti's 10-year-old son; before becoming too ill, he took his son swimming and bike riding. After Brenda Aliberti helped her former husband purchase a cell phone, he called almost daily, she said. She repeatedly attempted to find him an apartment, making calls to landlords. When he went too long without checking in, she went searching.
"He had a family that continuously reached out to him," Keller said. "It's not a lost person. It's a person with a family and with connections and with love." Shortly before Aliberti's death, he spent time with his father and stepmother, who visited from Vermont, Keller said. Shelter volunteers and hospital workers also attempted to help.
Despite those links, Aliberti never managed to break free of his addiction. He drank heavily, imperiling his health, those who knew him said. Living without a home in Concord, he was surrounded by other drinkers.
"It's very hard for people to understand how overwhelming this illness is, especially if you're homeless and you have no hope," Keller said. "It's your coping mechanism."
Attempts to recover
But Aliberti's is also a story of attempted recovery, and the hurdles facing those seeking treatment. Just before his death, Aliberti made two attempts to enter a treatment facility, only to find that there were no open beds, Keller said.
On one occasion, employees at Concord Hospital helped Aliberti search for a treatment center opening - before they found one, however, Aliberti was discharged from the hospital, and he started drinking again shortly after, Keller said. After that first attempt, shelter workers helped Aliberti make more calls.
"I really believe that Steve was making as best of an attempt that he could to get sober, but (there was) no doubt that his addiction had gotten the best of him," Keller said. "But that's not to say he didn't want it," Keller added, referring to treatment.
The state contracts with six crisis sites in the state, where those addicted to alcohol or drugs can go for residential non-medical detoxification and counseling. The six sites provide a total of 54 beds, according to the state Department of Health and Human Services. Waiting lists are common, according to those who work with the homeless. To find an open bed, those seeking treatment need to call the crisis sites daily. Unlike private facilities, these centers admit patients regardless of their ability to pay.
"I know there aren't enough beds," said Keith Kuenning, executive director of the New Hampshire Coalition to End Homelessness. "Here you are, a homeless individual with no internet access, no phone, and you're supposed to make a daily phone call.
"The thing that's upsetting about this is that we know how to help these people," added Kuenning, who advocates the creation of permanent housing for the homeless, which make counseling and other support services available.
Stay-at-home dad
Alcohol didn't always hold such sway over Aliberti, who was born in New Haven, Conn.
He worked off and on as a mechanic before injuring himself, his former wife said. When he and Brenda Aliberti met a dozen years ago, he was a recovering alcoholic devoted to his treatment program. The first year of their son's life, it was Steven Aliberti - who had recently undergone a knee replacement - who stayed home to care for him. When Brenda Aliberti returned home at the end of the day, Aliberti would have the whole house clean, she said.
But when their son, Robert, was a toddler, Aliberti relapsed. His former wife suspects that a medication he was taking for Hepatitis C, which he likely contracted during a blood transfusion decades ago, may have harmed him. Depression is one possible side effect of the drug, called interferon.
Aliberti's drinking occasionally led to violence. Several years later, the couple divorced.
After Aliberti moved out of their Concord home, "he was never able to really get himself up again," Brenda Aliberti said.
Although Brenda Aliberti said that, "we begged him to get an apartment," Aliberti remained on the streets. He loved the outdoors; as long as the weather wasn't too cold, "it didn't really bother him," she said. From time to time, he was picked up for small thefts, including a 30-pack of Coors Light on one occasion and $60 worth of beer and wine on another, according to news reports. He spent time in jail.
When Brenda Aliberti tried to find him a room or an apartment, Aliberti told her that he was scared of the responsibility. He began frequenting the shelter at First Church several years ago, and became a regular guest again this winter, after spending time at the Red Roof Inn in Loudon, Keller said.
There were sober stretches - he spent time in a treatment program, and he couldn't drink while in jail. Brenda Aliberti wouldn't allow drinking in her home. Illness would send him to the hospital, and Aliberti would be temporarily sober.
"He was always trying to change through the years," Brenda Aliberti said.
But as Aliberti aged, his health declined. Apart from alcoholism, he had trouble with his blood pressure and other ailments, such as frostbite, according to his former wife. After being released from jail this winter, Aliberti was beginning to say that, "I'm too sick; I don't see a way out for myself," Keller said. "People were imploring him to believe that there really was a future for him."
Even as Aliberti felt increasingly ill, he helped family and friends, sharing money from his Social Security checks and, when he had it, alcohol, Brenda Aliberti said. "He would rather give and have everyone be happy," she said. Keller also knew Aliberti to have a reputation for buying things for others, even though he had little money for himself.
"He was very grateful and very respectful," Keller said. Aliberti was also a "person of profound faith," the sort of man who carried a Bible, Keller said.
Throughout, Aliberti's family and friends knew that, "Robert was who Steve lived for," Keller said.
Aliberti "really thought highly of his boy," said Charles, a friend of Aliberti's who is also homeless, and didn't want to give his last name. "He had some really nice sides to him."
For Aliberti, this winter brought frequent visits to the hospital; Keller estimates he was admitted three or four times in January. On one occasion, hospital employees helped refer him to a detoxification site, but there were no available beds. On another occasion, shelter workers took Aliberti to the hospital.
Aliberti didn't show up at the shelter the night of Jan. 25. The next morning, another shelter guest found Aliberti in the snow, Keller said. According to several people, Aliberti was discovered near Stickney Avenue. He was rushed to Concord Hospital.
"He was just a very caring, loving person," Brenda Aliberti said. "And it's very sad that he has to have this disease of alcoholism."
A memorial service will take place today at 2:30 p.m. at the First Congregational Church in Concord. Memorial donations may be made to the church, which is located at 177 North Main St., Concord, New Hampshire.
------ End of article
By SARAH LIEBOWITZ

job wahoo

one of our guys that has been living in a tent all winter with his wife, got himself a job as a mechanic for the cab company. looks like the might be housed by spring, god willing.

I went to the drop-in center as I found it was open for football today. There in the back corner of the room was S. He was sitting at a table all by himself. I asked him how he was feeling and he said he has been a bit sick. I know there is a little bug going around so I asked him if he went in to see the nurse to get some medication. He said, " the only thing that is wrong with me is I drink too much."
Okay, we finally got to the place that he needed to reach. Admitting.
I told him there is another way.
He said he knows all about AA his father had many years sober.
Good that hurdle passed.
I asked him if he was willing to go to any lengths to stop drinking and he said yes.
We drove to the hospital and brought him to ER for accessment.
Before I left him I told him I was an alcoholic in recovery and that as he sits there waiting and his alcohol levels drop he will have physical cravings. It is at the point that he needs to decide if he is sick and tired of being sick and tired.
I also told him that if he left the hospital that it wouldnt mean that I wouldn't stop talking to him, because I am an alcoholic and I understand.
Now I am not saying these things to boast I am telling you that outreach works when it is done by peers rather than professionals. Preofessional counselors have learned to keep their distance, bounderies in tact so they dont talk about their lives or how similar they are to other people.
But by developing relationships with people, through mutual interests and likes just like you would with an acquaintence, we break down the barrier between us and them.