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Mental health rollback : Community program one of few options for many 

click to enlarge Jerry Holmes
  • Jerry Holmes

The lines between staff and members at Our House, a local nonprofit for those with a history of mental illness, often blur. Inside the welcoming two-story house, program staff and community members — not patients — work side-by-side answering phones, cleaning, and cooking meals.

Our House isn’t a treatment center but is designed to give those recovering from mental illness a dose of normalcy and community, said Mark Stoeltje, the program’s executive director. “We’re not mental health professionals, we don’t do mental health treatment … But we do think community, in a sense, is necessary treatment for mental illness.”

Members at Our House, many of whom have been hospitalized or even incarcerated in their battle with mental illness, come and go as they please and take an active role in how the program operates, Stoeltje said. Last month, as the program sought to hire a new staffer, Stoeltje said members were part of the interview and selection process.

Programs for the mentally ill are historically underfunded in Texas, and though the Legislature is now trying to avoid the deep cuts anticipated for community mental health services, per-capita funding for the mentally ill in Texas already ranks last among states. The $50 million lawmakers have voted to restore to community mental health services would keep funding flat with previous years, something advocates say is still woefully inadequate and fails to address massive caseload and population growth in crucial programs.

Medicaid rate cuts and inadequate state funding have forced the Center for Health Care Services, Bexar County’s main channel for mental healthcare services for low-income and indigent patients recently started only seeing those with full Medicaid coverage, said Leon Evans, Center CEO. Those with Medicare or other insurance plans are being bumped to a waiting list.

Unfortunately, this has been long in coming … Texas has basically forced us to ration mental health care,” Evans said. The Center estimates that it can only handle about 10 percent of San Antonio’s mental health needs. Evans estimated the Center’s waiting list is already “a couple hundred” patients long — still much lower, he said, than in other Texas counties. Advocates fear that those without care are will likely flood hospital emergency rooms and jails — a troubling and expensive solution.

Stoeltje said Our House, which operates solely on donations, has become one of just a few private community options left to fill the gap where state services fall short.

And members from Our House regularly volunteer at the San Antonio State Hospital, helping lead peer group sessions with the goal of ensuring that hospital patients land on their feet after their discharge.

Dianne Robinson, a psychologist who runs the Family and Patient Education Program at the state hospital, said Our House has been a crucial partner in helping direct state-hospital patients toward good local services once they’re released. Our House and its involvement at the State Hospital, she said, also helps battle the stigma of mental illness by putting patients in a comfortable, natural community setting.

Pete Dunn

With a long history of mental illness, Pete Dunn battled chronic schizophrenia and had multiple stints in psychiatric hospitals throughout his 20s. With medication and substance abuse treatment, Dunn brought his condition under control, he said, and stayed out of psychiatric hospitals for roughly three decades.

But when Dunn was in his 60s, both of his parents died and his condition rapidly worsened. “I started to become upset and eventually I had a major, major episode,” he said. After being hospitalized, Dunn was then ordered into group therapy.

About three years ago, Dunn’s psychiatrist suggested he try Our House, he said. “I was shocked when I got here. I’d been in these community programs before and you’re used to seeing people being like zombies. … These folks right away were engaged, they said hello, shook my hand, and treated me like anybody else. That’s something I never had before,” he said.

Coming here is good for us,” he said. “I think of it as if we’re making a transition from hospitalization and these day-treatment programs to getting out in the working world.”

“We’re no longer tied to the hospital. We’re not behind locked doors.”

Jerry Holmes

Three years ago, Jerry Holmes left his life in Illinois and moved to San Antonio, seeking warmer weather in retirement. But soon after his move, he began to suffer from severe depression and isolate himself.

 It got bad. I was so depressed that suicide was on my mind quite frequently,” he said.

Eventually, Holmes was committed to the San Antonio State Hospital for treatment. Soon after he was discharged, he sought help and community at Our House.

Holmes now helps run the makeshift resource library on the house’s second floor, keeping forms and files on local housing and treatment programs. “I started volunteering a lot after [hospitalization]. … It helps keep me where I need to be,” he said.

Twice a month, Holmes visits the state hospital, where he himself was once a patient, helping lead peer group sessions with patients. “[The state hospital] helped me when I couldn’t help myself … volunteering there helps in [other patients’] recovery, I hope, because it sure helps in mine.”


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