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Connecting With Reality : Program Helps the Mentally Ill Cope, but It Doesn't Coddle Them


SANTA MONICA — It's Wednesday morning. Lisa Mansouri plops down in the wagon-train circle of chairs in a halfheartedly partitioned section of Step Up on Second, Santa Monica's day center for adults with a history of mental illness.

More than a dozen members--they are never called "patients"--wait. Half of them wisecrack; half stare, their faces so blank they capture the madness of a Van Gogh self-portrait.

Mansouri, Step Up's program director, lays it on the line.

"There have been an awful lot of people in this building asking for cigarettes or money. That's panhandling. Believe it or not," she says.

"I'll put you out (of Step Up) for a whole day if I catch you." Her voice is stony.

Shopping carts are taboo, too, Susan Dempsay, founder and director of Step Up on Second, reminds the members, most of whom are homeless.

"They're the private property of the stores, and besides, they're an excuse for not getting a real home," Dempsay explains.

Members wail that their prized possessions will be stolen if left unattended in the alley, as Step Up requires. Dempsay's face erupts in a devilish smile. A missing shopping cart might be just what it takes for the whining member to be forced into living life the way most do. That's what Step Up is about, Dempsay says.

For almost a decade now, Step Up on Second has been trying to provide the mentally ill with the basics to reconnect with the world. It offers an untraditional mix of services, refined over the years by trial and error, that focus not just on treating the mental disturbances, but also on vocational training, grooming, money management and even employment opportunities.

Santa Monica is noted for its extensive array of social service programs, and particularly for the help it offers the homeless, but few programs are held in as high regard as Step Up on Second. Police and city officials have nothing but praise for it, and Dempsay has been showered with awards on the national, state and local level.

The acclaim is not without a price, however. A vocal segment in Santa Monica contends that the homeless services have made the city a magnet for transients, and a far more dangerous and less pleasant place for everyone else. As the embodiment of what is good about Santa Monica social services, Step Up is thus also a target; it provides genuine help to the homeless, therefore it is part of the problem.

While the political debate rages on, there is upheaval of a different sort these days at Step Up on Second. This month, it moved from its longtime home, an aging warehouse-type structure on 2nd Street, to temporary headquarters on Lincoln Boulevard. The 2nd Street building will be gutted to make way for a four-story complex with greater space, comfort, cheer and, most important, 36 apartments to house mentally ill adults.

Step Up is the creation of Susan Dempsay, and it is also her personal therapy. In 1978, her son, Mark, changed almost overnight from a college-bound 18-year-old into a schizophrenic whose torment was expressed in wordless screams.

Four years later, Dempsay had put Mark through the conventional treatments, but he was not healed. Doctors couldn't cure him, nor could they tell Dempsay how to provide the support he would need just to get by. Frustrated, Dempsay designed her own safety net for people whose mental illnesses weren't so severe as to require hospitalization, but who were not well enough to function like most people. That was Step Up on Second.

The center doesn't force members to see doctors or even require that they take their prescribed medication. Staffers, however, do give treatment and medication a hard sell as they constantly remind people to take care of themselves, whether that means getting a job or taking a shower. There are no locks or bars, and nothing that smells or looks like a hospital. Step Up never worked for Mark. Unable to cope even in the special environment his mother built, he has gone to New York in search of mental peace. Yet, Step Up is there for more than 800 people a year whose illnesses make it difficult for them to hold a job, apply for Social Security or, in some cases, even buy a bus pass.

What Step Up isn't is a place to vegetate, a place to be baby-sat, to wallow in self-pity or to be coddled by do-gooders. In fact, Dempsay and Mansouri say the rules are tougher than when Step Up opened in 1984. The cots for napping have vanished, for example; members were using them to recover from boozing and drugging all night. Dempsay's bottom line with members is "take responsibility for yourself." When they do, Step Up gives them job training by working at the center, cooking, cleaning or selling in the thrift shop at the entrance.

The ones really making it help set up for the city's farmers market on Wednesdays and work for the Santa Monica Sanitation Department. Some sell hot dogs on the Third Street Promenade. Dempsay dreams of opening a restaurant staffed by Step Up.

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