James Coley is a caseworker for Integrated Recovery Network. With public… (Irfan Khan / Los Angeles…)
James Coley can't save all his clients. He can't slay their demons or change the world they live in.
But he goes to work every day and gives it a shot.
On a recent morning in a downtown Los Angeles courtroom, his to-do list was growing fast, the day's challenges lined up bumper to bumper.
The client he was supposed to meet was running late, and he needed to get over to County Jail to check on another client who had threatened to drink Clorox. Then there was a third client he was supposed to take from jail to a housing and treatment program in Pasadena. And he also had to deal with the call he'd just gotten about a fourth client who drank vodka for breakfast and was in trouble at a board-and-care facility.
I had hooked up with Coley because of something the father of Kelly Thomas said to me a few weeks ago. Ron Thomas had said that his 37-year-old son, who died violently in July after a run-in with Fullerton police, was in and out of treatment facilities after being diagnosed with schizophrenia 15 years earlier.
I hear that all the time — in and out of treatment. Thousands of people who fit that description wander the streets of Southern California.
But Marsha Temple, who runs the nonprofit Integrated Recovery Network, says it doesn't have to be that way. A few years ago, Temple, an attorney who once represented hospitals, zeroed in on what she calls the "revolving door between Twin Towers and skid row."
People would land in Los Angeles County Jail because of a crime committed due in large part to a mental illness, hang there for a while, then go back on the street, get into trouble again and land back in jail or prison. There was little chance of breaking the cycle because they were pretty much on their own, with no treatment plan and no one looking after them.
"It was shameful," Temple said.
With public and private funding, her agency began connecting with clients while they were still in jail, steering them into therapy, medication and housing and then assigning caseworkers like Coley to check in with them regularly.
Temple's staff now handles nearly 100 clients at a time. Since she began, she said, only 20% have gone back to jail — a success rate three or four times greater than estimates for those who get no such monitoring. The cost works out to roughly $10,000 per client per year, which is far less than the cost of churning people through hospitals and the criminal justice system.
Los Angeles County Supervisor Mark Ridley-Thomas called recovery network a model program.
"It provides intensive wraparound services, helping with substance abuse issues, mental illness, employment and social skills training, walking people through the system and seeing to it that they do not fail. And they don't let go. They don't cut their clients loose once a program is complete or a problem appears to be solved," Ridley-Thomas said.
No one can say whether Kelly Thomas might be alive if he were a client in such a program. As his father told me, Thomas often resisted help, and it can be difficult for family or even professionals to break through to someone who doesn't want treatment, medication or even housing.
But you just keep going back to people like that, Coley told me, and try to develop a trust that will pay off eventually.
The Orange County Board of Supervisors should take note. They responded to the Kelly Thomas tragedy by vowing to look into implementing a controversial state provision, known as Laura's Law, that allows for forced outpatient treatment.
There's no doubt some people need to be ordered by the courts into treatment for their own health and safety, and Los Angeles County makes some use of Laura's Law. But there wouldn't be as great a need for forced treatment — which is no sure-fire approach, and can be as traumatic as it is helpful — if there were adequate intervention, supportive housing and other services to keep people from deteriorating in the first place.
The supervisors would be better off investigating why, despite having the second-highest population of chronically homeless people in California, Orange County has fallen way behind on its 2009 plan to use available Proposition 63 funds for the construction of 185 supportive housing units by 2012. Or they could take a close look at Temple's program and try the same thing in Orange County.
The day I spent with Coley was typical for him. He was so busy that the transfer of the woman from jail to housing would have to wait. And after a long delay at the County Jail, it turned out that Coley's desperately ill client had been moved to another facility.
In the courtroom where the day began, his 19-year-old client, a woman with bipolar disorder, showed up and was congratulated by Coley, the city attorney and the commissioner. She had completed a 120-day stretch in transitional housing and therapy, rather than jail, for a minor crime.
Coley did not let her leave until she told him her plans, and he promised to make a follow-up visit within a week.
The guy who had been drunk was still tipsy when we arrived at the board-and-care home where he lives.
"Why were you drinking?" Coley asked the man, who has multiple mental disorders and has made several suicide attempts.
"Because I'm alone and my life is sad," said the client, who wrapped his arms around Coley and thanked his caseworker for being his savior.