Lisa Scales smiles shyly as she chops celery sticks for dinner in the mess hall kitchen. But her cautious self-assurance hides an eight-year struggle with severe depression and addiction to cocaine, PCP and alcohol.
The 21-year-old had already been shuttled through eight months of drug and psychiatric programs at various hospitals before she arrived at The River Community recovery center a month ago.
Tucked away in the Angeles National Forest north of Glendora, the 26-bed hillside facility opened two years ago. It was the first residential center in California to serve chronically mentally ill substance abusers.
What makes The River's program different, Scales says, is the sensitivity of the counselors to her dual problem.
Funded through a unique collaboration of Los Angeles County's drug, alcohol and mental health administrations, The River is the only facility in the county providing integrated care for patients suffering from both substance abuse and mental illness, a population referred to as the dually diagnosed.
Programs administered by the county Mental Health Department and the Health Services Department's offices of alcohol and drug abuse provide $500,000 of The River's $750,000 annual budget.
A key figure in The River's creation was Christopher Spencer of Monrovia, a recovering alcoholic whose 23-year-old daughter suffers from schizophrenia.
"These people were falling through the cracks," the 44-year-old developer said. "I know how it hurts."
So in 1986, he bought 70 acres in the Angeles National Forest with the idea of opening a facility for the dually diagnosed. He fixed up the abandoned California Conservation Corps camp which now houses the facility. Together with Bud Hayes, now executive director at The River, Spencer went to the county with the proposal. Spencer, who is a member of The River's board of directors, recently had a satellite dish installed so residents could watch cable television.
"I felt it would be a good place for healing, up in the mountains," he said. "For the mentally ill it's real nice because we don't have to use locked wards. People actually do cooking, go on hikes."
Because of its remote location, residents would have to make a long walk for a beer.
Hayes noted that a major reason the project was launched so smoothly was the site's location.
"There's no community anywhere that's not going to fight this type of project in the neighborhood," he said.
The River is just one of Spencer's many forays into the recovery field.
In 1985, he renovated a dilapidated hotel in downtown Monrovia, transforming it into a 32-bed treatment and extended-care center for alcoholics.
Today, that facility along with a 25-bed facility for men in Covina, a 14-bed women's home in Arcadia, and a 25-bed center in Silver Lake for both men and women make up the Spencer Recovery Centers for recovering alcoholics. The River is the only facility run on a nonprofit basis.
Citizen of the Year
Spencer, who will receive the Monrovia Chamber of Commerce's Citizen of the Year award next month, volunteers at the Weingart Center for the homeless on Los Angeles' Skid Row. And he is the Friday cook at the Union Station Hospitality Center in Pasadena.
Substance abusers have been identified as among the most under served of California's homeless mentally ill in a February, 1988, report by RAND Corp., a Santa Monica-based think tank.
Providing assistance to the dually diagnosed is a growing issue nationwide, said Fred Osher of the University of Maryland School of Medicine. He visited The River last year as part of a national survey of services available to this group, which has been reported to be as large as a million people.
"The River is at the forefront of developing residential facilities" throughout the United States and is a model system within California, said Osher. His study was partially funded by the federal Alcohol, Drug Abuse and Mental Health Administration, an agency of the U.S. Department of Health and Human Services.
An estimated 60% to 90% of mentally ill adults between ages 16 and 40 are believed to have drug or alcohol problems, according to Hayes. Because of the lack of services for the dually diagnosed, he said, many patients have been put through a frustrating revolving-door, referred back and forth between drug abuse and mental health programs.
Hayes said he is thriving on the challenge of designing an integrated program and cross-training a staff that has never tackled the problems of mental illness and substance abuse simultaneously.
"This is the most exciting thing that's ever happened to me," he said. "It's an opportunity that somebody in the nonprofit field hardly ever gets a chance to do."
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