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Deborah De Santis

Deborah De Santis

Posted April 21, 2009 | 12:26 AM (EST)

What The Soloist Tells Us About Homelessness and Mental Illness in America


Imagine being in the prime of your life, possessing an incredible musical ability, so gifted you are accepted at one the most prestigious performing arts schools in the world. You are in an orchestra with Yo Yo Ma. You could be the next Beethoven or Mozart.

Then picture your life unraveling at lightening speed, your confidence eroding, your grasp on reality slipping away. One day you're at the Juilliard School of Music with a promising future and then, in just a few years, you're homeless, living on the sidewalks of Los Angeles, serenading passers-by with rambling attempts at classical music.

These are the two lives of Nathaniel Ayers, who at 20 was playing before audiences at New York City's Lincoln Center and at 21 was diagnosed with paranoid schizophrenia.

I just left a special Congressional briefing on the best-selling book and upcoming movie, The Soloist, which tells the story of Ayers and LA Times columnist, Steve Lopez, who discovers the musician languishing on Skid Row. (The movie, slated for release on April 24, stars Jamie Foxx and Robert Downey Jr. as Ayers and Lopez respectively.)

Lopez attended the briefing this afternoon and his message to members of Congress and the rest of us in the Capitol's visitors center was moving and compelling on several fronts. In many ways a call to action that will recommit and re-energize us to battle homelessness, and for better programs and policies to assist those dealing with mental and behavioral illnesses.

When Lopez met Ayers on a busy downtown Los Angeles corner, remnants of a shattered life were all that remained -- a shopping cart filled with instruments, ragged and dirty clothing and drum sticks (to chase rats while trying to sleep).

The Soloist relays the relationship between the writer and the ex-Juilliard student. Through their interactions, we receive a sobering education on the state of homelessness and mental illness in America and the lack of coverage and medical attention for those suffering. Too frequently, the homeless who are mentally ill fall through huge cracks in our health and housing systems, forcing them to live alone in horrible conditions, in largely forgotten worlds full of paranoia.

For those of us who work to help prevent and end homelessness, The Soloist is an all-too-real reminder of the daily obstacles people who are homeless and their advocates face. Sometimes the cracks in the system become gaping holes.

Not only do we feel for Ayers as he struggles to address his demons, but we ride the roller-coaster of emotion Lopez experiences as he befriends this musical genius and does everything he can to encourage him to realize his full potential.

Working with people who are homeless and experiencing mental illnesses and other health problems is not easy. Society has at times given up on this vulnerable population and incorrectly concluded nothing can be done to address their issues, or to solve the cycle of despair resulting in long-term homelessness.

We at the Corporation for Supportive Housing (CSH) and many other advocates know differently - there are proven solutions that work. Effective, cost-efficient models that move vulnerable people like Ayers off the streets and into affordable, permanent housing where they can receive the support they need to heal and build better lives.

We do have smart strategies to fill the huge cracks in the current health and housing systems if we make the right investments. There are a lot of Nathaniel Ayers in our world (approximately 123,000 just in the U.S.), and they can get the attention and stability they deserve if we are willing to make the choices that really help them.

Study after study concludes that supportive housing is the most effective solution to ending long-term homelessness and it does fill in the cracks, especially when proper care has been lacking. Four recently released evaluations from different sections of the country add to what many have already documented: supportive housing successfully breaks the downward spiral and can actually save tax dollars by reducing the over-reliance on emergency public services, including hospital stays, use of costly mental health facilities, time in nursing homes, and pressure on our criminal justice systems and facilities. When all figures are calculated, it is obvious the amount we are spending on emergency services for the homeless outpaces the funds we would need to bring supportive housing to scale.

CSH has compiled an impressive summary of the four recent studies and many other analyses that clearly show the success and promise of supportive housing. CSH and other organizations are innovating and changing systems to build more effective solutions so that we can end the devastating cycle of long-term homelessness.

Closer to Los Angeles where the tale of The Soloist unfolds, CSH is maximizing a commitment from the Conrad N. Hilton Foundation to create more supportive housing. A little over four years ago, the Hilton Foundation awarded a generous grant to CSH to launch an initiative to reduce the number of long-term homeless people, with a special emphasis on ending homelessness among people with serious mental illness.

As documented by the Urban Institute in a series of reports on the Hilton Foundation's grant to CSH, public agencies and systems in Los Angeles are now cooperating and better aligning to increase the availability of permanent supportive housing. The ability of the housing developers and local agencies has increased substantially. CSH is providing the tools and training, and identifying financing opportunities, to make this happen. Little by little cracks are being filled.

CSH partners with a number of local groups and individuals on the ground in LA, the people who are really making the difference there. Based right in downtown Los Angeles, LAMP Community is outstanding, providing immediate housing and lifelong supportive services for homeless men and women living with severe mental illness. Many officials in Los Angeles and California have also become passionate proponents of supportive housing. California Senate President Darrell Steinberg is a reliable champion for people who are homeless and he fights for mental health reform.

The Soloist is heart-wrenching. One can certainly be forgiven for feeling sadness for what Nathaniel Ayers experienced and his on-going struggles. What we cannot excuse, however, is doing nothing or, just as negligent, relying on failed systems and methods that produce ineffective results for people who are homeless with mental illnesses. This is especially true because there is a proven way to facilitate their recovery, helping them realize their dreams. As emotionally draining as The Soloist can be, we find hope in supportive housing and the good it is doing for so many of our vulnerable neighbors.

Cracks in systems exist, but people like Nathaniel do not have to fall through them. Supportive housing providers, and the thousands of advocates, innovators and policymakers across the country who have embraced this better, proven way, are the mortar filling the holes. They are building a strong foundation to prevent and end homelessness once and for all.