729A W. Whitehall Rd
State College, PA 16802
August 1, 2010
Mrs. Jones, Director
555 Alden Way
Los Angeles, CA 90020
Dear Mrs. Jones,
This proposal regards the lack of proper treatment centers for homeless people suffering from
mental illnesses. With your approval, I would like to create a community where homeless patients
will receive proper psychological treatment and medication, as well as, job counseling and a place to
sleep to cease their endless cycle leading to chronic homelessness.
The homeless capital of America, Los Angeles, CA, has an estimated 48,000 people homeless any
given night, with 100,000 people having at least a night of homelessness. Their 50 block area called
Skid Row has more homeless people than the whole homeless population of San Francisco. These
alarming statistics are just the tip of the iceberg, 32.7% of people on the streets suffer from a mental
illness, compared to the 15.7% of non-homeless living with mental illness (Audrey). The term
mental illness simply means that a person’s emotions, thoughts, or behavior are so abnormal that it
causes severe suffering. A mental illness can range from depression to psychosis disorders. Many
suffering from severe psychosis will not have the means necessary for help, and without help they
will find themselves battling chronic homelessness. A person with psychosis has a severe disconnect
from reality and can suffer delusions and hallucinations. In fact, 11% of homeless patients suffer
from Schizophrenia, one of the most devastating, depilating mental illnesses(Audrey). A good
portion of these people will quickly begin a seemingly endless cycle of going from the streets, to jail,
to hospitalizations, and back on the streets. The focus for my program will be homeless patients
suffering from severe psychosis in the Los Angeles area. If we understood more about how they got
to this terrible stage of their lives, maybe we would be more inclined to offer help.
Psychotic breakdowns do not usually occur until mid-20s to 30s, a time where many are on their
own and have a job. Once that breakdown hits they could be completely abandoned, lose their job,
and insurance won’t cover the psychiatry bills anymore. Without help the disorder will take over
and life becomes a downward spiral that is nearly impossible to break. Many believe homelessness is
something completely unrelated to them but in fact 14 million Americans have a period of
homelessness throughout their life time (Coldwell). What people often overlook are the deeper
issues that an individual struggles with before homelessness that lead to unemployment or
abandonment from family. We need to place ourselves in their shoes and see their struggle.
Another big issue that started this influx of homelessness was mental asylums shutting down. For
the past century there has been a consistent battle with providing adequate amount of care and
government funding. When the asylum era was truly blooming in the beginning of the 20th
there was a beautiful balance of care for long-term residents but social stigma and government
caused these homes to become dilapidated (Smith). Many asylums ended up having to close which
gave its residents nowhere to go. There has been an effort to open community based care centers
but a lot have failed because of funding and other reasons.
There is an effort, but not a successful, quick enough one because people are still suffering every
day. Since there are no decent care facilities for the mentally ill homeless to turn to, they are not
receiving the therapy they need; 30%-60% of individuals with a serious illness are not taking the
medications they need to. This lack of care entraps the mentally ill homeless into a seemingly
endless cycle of incarceration, homelessness, and emergency hospitalizations. All of these factors
result in a higher rate of health care costs for these people, which trap them even more (Smith). It
has been discovered that 15.3% of jail inmates have been homeless in the past year which is 7.5-11.3
times higher than the general United States population. Among those homeless inmates mental
illness, was 10%-22% more prevalent than non-homeless inmates (Greg). Besides all of this direct
impact, one has to think of the family of these people. They have to try and sleep at night knowing
their psychotic sister, brother, son, daughter, mother, father, is on the streets. All of these factors
combined are reason enough to conclude that a mental health community is needed.
The devastating truth behind many of the homeless we roll our eyes at and ignore is something we
need to face and deal with strongly. Community care can increase patient’s quality of life, decrease
days spent homeless, and decrease government costs (Gilmer). It can give families their children,
siblings, parents back. A mental health community can restore these people’s hopes and dreams
while decreasing government’s cost on jails and emergency hospitalizations. We must be selfless and
remind ourselves how lucky we are and how much we can give to these people.
This program will directly affect the homeless patients we will be treating as well as the families.
Our goal is to help these patients end their cycle and become healthy, active citizens. They will be
able to obtain a job, whether through us or outside employers, and start caring for themselves. This
program will also help the family of these patients by giving them peace of mind. They will no
longer have to worry about where their child, sibling, or parent is sleeping tonight; they will know
they are safe. The family will also be given the opportunity to reconnect with them and be a part of
their recovery process.
The mental health community program has a simple mission statement to get mentally ill people off
the streets and give them the opportunity to have a new life. The program will target those who
have psychosis problems; which, simply put, means they are very disconnected with reality. It
includes extreme forms of mental illness, like schizophrenia, and the patient may be suffering from
delusions. These people will be targeted because without help from others they will be forever stuck
in this cycle. The program will offer these people many things including a place to sleep, therapy,
psychiatry for medications, job counseling, and other amenities. If the program is successful Iplan
to expand it to other cities, this is not something I want to have for only a year. I believe the city of
Los Angeles and the individuals will benefit greatly from this program and will keep it running.
The step up for our mental health community will be a place that will feel like home for our patients
and not a hospital or jail they may be used to. It will be a place where they feel safe and open to
being themselves. They will be delegated responsibilities and as they improve in recovery they will
get more responsibilities. The responsibilities will start with making your bed in the morning to
cooking dinner to group therapy leaders. A group therapy leader means they will lead discussion
during therapy, while a psychologist is still there. The goals of these responsibilities are to connect
the patients with reality, give them work ethic, and make them feel like this is their home that they
should care for. The patients will be sharing a room with another person that they will need to
interact with and socialize.
The staff members will be skilled, dedicated individuals who feel strongly towards this cause. We
will need licensed clinical psychologists to run individual and group therapy sessions with the
patients. There will be a therapist in the community 24 hours a day in case of emergencies. We will
also have 1 or 2 psychiatrists who will be able to prescribe the patients the medication they need to
take. The psychiatrists will work with the therapists to make sure the patient’s medications are
working properly. We will also have nurses come in periodically to perform health check-ups on the
patients because their physical health is just as important as their mental health.
Timeline for Project
Find a facility: we will need to find a place that will be perfect for our community. We are
not limited to places that look like your typical mental hospital; for example, an area with a
few close houses will work and one of them will be the ‘common’ house. Ideally the home
will be on the outskirts of the city but, if desperate, it may be in the city.
Assemble a dream team: all we need to begin with is two psychologists and a psychiatrist.
These psychologists will need to have proper qualifications and experience, as well as,
inspiration to do this work.
Creating the facility: once a place is found, it is very important that we set it up like a home
not a hospital. We will take this month to fix up the facility by painting, setting up rooms,
and much more.
Recruitment: now that we have a place and a beginning dream team, we will begin to recruit
other employees we will need. These employees will not all be full-time but they will be
important to the workings of our community. This includes other psychologists (full-time),
nurses for checkups (part-time), cooks (part-time), driver to pick up the patients (part-time),
and job counselors (part-time).
Finding patients: this month will be dedicated to finding our patients. We will have several
techniques in doing this. One will be to post flyers around highly populated homeless areas
like Skid Row, in hopes that by posting a phone number and address they will take the
initiative to come on their own. Second we will create a website so concerned family
members can easily reach us and let us know of their family member. The recruiting
method we think will be most profitable is to let the local emergency psychiatric services,
hospitals and jails know of our services and ask them to refer patients to us.
Introducing the Community: during the first few months of operation we will start the
community how we planned. We will perform assessments on new patients to analyze the
care they will need, get the patients acclimated in their rooms, and start therapy and
Group Staff Meetings: at the end of each month the staff will meet and talk about each
patient individually. We will discuss the patient’s progress and what the next step will be.
Then we will call the patient in and talk to him/her as a group about their progress and
goals for the next month. During these monthly meetings we will decide what
responsibilities the patient will have, if any, based upon their progress. Lastly, we will
discuss job opportunities for the patient, if they are ready, and possibly schedule a meeting
with the job counselor for them.
Business as Usual: therapy and psychiatry sessions
Group Staff Meeting
Quarterly Meeting: every four months the staff will meet and discuss the community as a
whole. We will discuss good things we are doing, and things we might need to change or
Business as Usual
Group Staff Meetings
Business as Usual
Group Staff Meeting
The community will continue to run in the fashion indefinitely.
Through my education at Pennsylvania State UniversityIwill have enough experience and
knowledge base to set up this program. During my past two years of school I have taken
psychology courses that have discussed mental illness in full. With my concentration being in
Abnormal Psychology I have also been lucky enough to have professors that have worked in the
field, with psychosis patients, for many years. In this role I will also need management skills to lead
my fellow employees. For the past 4 ½ years I have been a team leader at a supermarket, in this role
I learned the skills I will need to inspire and lead my employees. I have also been a Teacher’s
Assistant which not only taught me managing skills but organization skills. These skills combined
will make me a great leader for this program.
Psychology is something I love and want to continue in the future. I want to work with patients
battling their psychosis in the future. This program will not only teach me valuable information but
improve the community and lives of others. Thank you for your time and attention. I hope you
find inspiration and meaning in our community, just like I do.
Bibliography: A Mental Health Community
1. Audrey Cougnard, Sabrina Grolleau, Florence Lamarque, Christophe Beitz, Stéphane Brugère, Hélène
Verdoux. "Psychotic disorders among homeless subjects attending a psychiatric emergency
service. " Social Psychiatry and Psychiatric Epidemiology 41.11 (2006): 904-910. Psychology
Module, ProQuest. Web. 14 Jul. 2010.
2. Coldwell, Craig M, and William S Bender. "The Effectiveness of Assertive Community Treatment for
Homeless Populations With Severe Mental Illness: A Meta-Analysis." The American Journal of Psychiatry
164.3 (Mar. 2007): 393-399. ProQuest Psychology Journals. Web. 17 July 2010.
3. Gilmer, T., A. Stefancic, S. Ettner, W. Manning, and S. Tsemberis. "Effect of Full-Service
Partnerships on Homelessness, Use and Costs of Mental Health Services, and Quality of Life Among
Adults With Serious Mental Illness. " Archives of General Psychiatry 67.6 (2010): 645. Health
Module, ProQuest. Web. 14 Jul. 2010.
4. Greg A Greenberg, Robert A Rosenheck. "Jail Incarceration, Homelessness, and Mental Health: A
National Study. " Psychiatric Services 59.2 (2008): 170-7. Psychology Module. ProQuest. 1 Oct.
5. Smith, Thomas E, and Lloyd I Sederer. "A New Kind of Homelessness for Individuals With Serious
Mental Illness? The Need for a 'Mental Health Home.'" Psychiatric Services 60.4 (2009): 528. ProQuest
5000. Web. 14 July 2010.