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Clubhouse a sanctuary for homeless who are severely mentally ill

San Diego Union-Tribune - 12/6/2021

Editor's Note: This story is part of The San Diego Union-Tribune's ongoing "Crisis in Mental Health" series.

On the street, they are shunned, exploited and feared.

But inside a nondescript red brick building in downtown San Diego, homeless people with severe mental illnesses have found a sanctuary.

"The people here have been very sane and kind," said a woman named Ness, who wore gray pants with a matching sweater as she sat quietly at a table with a Bible marked with highlights.

"This is a neat place to come. It's kind of steady, where you can sit and rest your feet and have coffee. With their compassions for others, you can feel it. It'd be like if your family is around."

Ness was at the Connection 2 Community clubhouse operated by the National Alliance on Mental Illness, where she often spends her days to find respite from the chaotic world outside on 16th Street, a neighborhood dense with sidewalk encampments and drug use.

More commonly known as the C2C, the clubhouse follows the standards of Clubhouse International by providing a place for people with mental illnesses to find friendship and access to employment opportunities, housing, education and medical and psychiatric services.

NAMI contracts with the county to operate the C2C clubhouse along with the Casa del Centro Clubhouse at Imperial Avenue and 28th Street in San Diego and the Plaza Clubhouse in Chula Vista, which opened in November and is holding meetings in a park because it does not yet have an office.

San Diego County Behavioral Health Services also has contracts with Mental Health Systems, Pathways Community Services, Community Research Foundation and other groups to operate clubhouses in other areas of the county.

Cathryn Nacario, CEO of NAMI San Diego, said the C2C clubhouse may be one of only two in the nation that specializes in serving homeless people with severe mental illness. She knows of one other in Seattle, Washington.

"The clubhouses are incredibly inexpensive ways to assist and provide a structured environment, building socialization and employment skills as well as a place to go every day with support, a meal, and many other classes and activities," she said.

NAMI's Casa del Centro and Plaza clubhouses have a $560,000 annual budget from the county, while C2C Clubhouse is more costly because of the population it serves. Nacario said that the clubhouse receives $600,000 from the county and $410,000 from People Assisting the Homeless, which provides outreach.

She said the clubhouse model fits in well with the county's new focus on continuous care for mental illness.

"Along with the county's mission of providing long-term care coordination and support versus treating everybody in crisis, we want to be able to start treating people in a longitudinal manner that will have continuous support for an individual with SMI (serious mental illness)," Nacario said.

"It's a place where individuals can go forever if they like to get the support and skills they need to be reintegrated in a productive way into society," she said, adding that such continuous support will decrease the need for crisis care.

The C2C clubhouse opened in April 2019, and program manager Vanessa Onstad said the building usually is quiet at the start of the month when many people on the street receive benefits, but becomes much more active by the end of each month. In the last quarter from July 1 to Sept. 30, the clubhouse counted 5,238 visits, including people who stop in more than once a week.

The Downtown San Diego Partnership conducts a monthly evening head count of homeless people, and the most recent count conducted in October found 1,026 people sleeping on sidewalks or in cars, with 541 in the clubhouse's neighborhood of East Village. Annual counts conducted by the Regional Task Force on Homelessness find almost 40 percent of homeless peoples say they have a mental condition.

The clubhouse on 16th Street is easy to miss. A single sign painted on the door isn't visible from the street, and a security guard allows people in by sliding a gate at the entrance to the parking lot, where the large and colorful Duwara Consciousness Foundation's mobile shower often is parked.

Inside, the open ceiling is painted black and the vinyl floor is gray, but the atmosphere isn't dreary. Gold and purple beads hang from strings of overhead lights to give the room a Mardi Gras feel, a reference to the days when Onstad and other staff members lived in New Orleans.

Onstad said homeless people learn about the clubhouse through word of mouth and through the NAMI outreach team.

"I think the thing that really differentiates us from other outreach teams is we look through a mental health lens," she said.

The clubhouse staff helps people willing to accept recovery with every step, she said, but they also help people with other needs. The most-sought need is housing, but some people only need help with obtaining an identification card, she said.

Mike Jones works for Family Health Centers of San Diego, a nonprofit that operates clinics and other programs throughout the county, and is stationed at the clubhouse five days a week to help members with a broad range of needs, including obtaining ID cards, benefits, legal aid and disability insurance. He recently helped a homeless man re-enter a shelter after spending three months on the street because he mistakenly thought he was banned.

"His mental health kicked in a little bit and he didn't think he could go back," Jones said.

On Friday mornings, Jones runs a session called Breaking Barriers, which he described as an open discussion to help people overcome things that are holding them back in life.

"It doesn't just click on," he said about how it affects members. "It turns on slowly. But the more effort they put into it, the more they get out of it."

Some members such as Ness enjoy the peacefulness of being in the clubhouse, which has a reading library and serves home-cooked meals.

But clubhouse members also can be volatile and unpredictable. One man who identified himself as an ex-Navy SEAL said he had post traumatic stress disorder and had killed terrorists, including three in the past week. When Ness interrupted a conversation he was having, he exploded in loud profanities and lunged at her. She called for help, but the altercation never became physical.

Another male clubhouse member walked up and talked about how metal discs should be buried in the ground to reverse the rotation of the earth and lessen gravity over 10 years.

"He does it to me all the time," said Russell Niland, a peer support specialist coordinator at the clubhouse. "He's trying to get you to laugh. He knows he's being silly. He's one of the nicest people in here."

As for the man who verbally assaulted Ness, Niland said he has never harmed anyone. In the two and a half years he has been at the clubhouse, Niland said the only physical incident occurred when a woman punched a security guard in the nose at the showers.

"We get cussed out all the time, which is fine," he said while preparing a lunch of chili and baked potatoes from scratch in the kitchen. "I take that as a badge of honor. I've been called every name in the book you can think of, some of them very creative. I'll write them down and say, 'That took some imagination.' You can't take anything to heart. If someone comes up to you , you say, 'I appreciate your feedback. Have a great day.' You've got to have patience working here."

Niland said he'll serve lunch to about 60 people on busy days at the end of the month. He called the clubhouse a safe place for people who otherwise would be on the street, but feel productive while inside where they can work on themselves at their own pace.

"A lot of these people want shelter, they want a sense of community," he said. "They want to sense that they're heard, because out there on the street, nobody's listening to them."

Lawrence Hageman, 51, said he has been homeless half of his life and originally came to the clubhouse because he lost his wallet and needed a new ID. He continues to come as a volunteer to help keep the clubhouse plants healthy and is philosophical about life.

"I noticed they were really busy here, so I decided to lend a hand with the plants, to help them grow and make this place look nicer," he said. "I help out everywhere."

Hageman rejects the term homeless, and prefers to say he is "houseless."

"The way I see the world is way different from most people," he said. "The earth is our home. I believe life is accomplished through movement, and when we get a house somewhere we're stuck and we stop learning."

Back in the kitchen, Niland said he was making chili from scratch because clubhouse members do not often get to have home-cooked meals. The clubhouse feels that much more like a home through the presence of his Chihuahua mix, Bella, who seems to have the run of the place.

"It's always about treating everyone with the same amount of dignity you want to be treated with," he said. "At the end of the day, they're still people. They have challenges for sure, but they're still people."

This story originally appeared in San Diego Union-Tribune.

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