Reintegration & Recovery >> Community Center

When both employers and employees involved in Project Renewal's innovative Job Links program were honored August 14th at the Holland House in midtown, the point was crystal clear: people with psychiatric issues and histories of homelessness not only can work, they make extraordinary employees.

Victoria Shire, Business Manager of New Horizon Courier Service, a Job Links employer for two years said, "Job Links does a great job preparing clients not only for the resume and interview process, but for the actual workplace." New Horizon, run by Lenox Hill Neighborhood House, has employed 75 people with histories of homelessness over the last five years. "When we hire from Job Links I know it will be a successful employee."

Another employer, RDS Delivery's David Zogby, said, "Working with employees like (Job Links participant) Michael makes my job much more meaningful. It's no longer just about delivering packages. I look forward to employing other Job Links clients in the future." And Nancy Young, who runs Common Ground's Ben & Jerry's Partnershop in Times Square enthused: "The people at Job Links were supportive and ready to help. They are always totally there for us. We would be happy to hire from them again, especially because the caliber of their clients is so high. We are thankful for good employees."

But, the real stars of the event were the eleven clients honored for long-term employment; having successfully celebrated six months or a year of employment at their jobs. As Job Links' Director, Michele Fontaine put it, "Ultimately, it is their courage and tenacity that we celebrate today…and every day."

The Job Links program 'links' individuals who cope with mental illness and have been homeless, to competitive employment in the community. It is an extension of Project Renewal's highly successful employment division, Next Step, which provides vulnerable men and women with what they need to get, and then keep a job. Through Next Step and Job Links, clients get help with assessment, education, training, and then placement and post-placement support.

Job Links won the 2001 Excellence in Service Achievement Award from the New York State Office of Mental Health. For more information about Project Renewal's Job Links, contact Michele Fontaine at 212-620-0340.

Victoria Shire of New Horizon Courier Service and employee Deborah W. Deborah has worked at New Horizon for more than a year.

Q&A with Jim Mutton Director of Project Renewal

Project Renewal is a social service agency founded in 1967 to care for and help renew the lives of the homeless and mentally ill in New York City. This is where Robert Neugeboren, who is profiled in the documentary film Imagining Robert: My Brother, Madness, and Survival, has lived for the past 3 years. Reintegration.com spoke with Jim Mutton, Director of Project Renewal, about his organization and what it offers to consumers such as Robert.

Q. How typical is Robert's experience compared to some of the other people who come to Project Renewal?

Jim Mutton: Very typical. When we first opened the residence, those were all of the folks we were serving-people who had spent nearly all of their lives in state institutions. These days, he tends to represent about a third of the population we work with. There are folks we're seeing now that have lived in the community for a while but haven't done as well in other settings. There are those who have been referred to us from other housing - people who have been homeless for many, many years. Virtually everybody we work with has either schizophrenia or schizoaffective disorder. About two-thirds of the folks also have substance abuse problems. Virtually everybody has a major medical problem. So I think Robert is fairly typical of those who come through the residence and go out into the community.

Q: You mentioned at the Imaging Robert panel discussion that it's not necessarily the medication, but the team. How does the team help in the reintegration process?

Jim Mutton: Our team is probably the most comprehensive team I've seen in a housing setting. We're talking about having a medical staff that is obviously state-of-the-art. They know their stuff inside and out. We also have case managers, often paraprofessionals, who have a much more direct role with the resident. They're with residents 24/7. This is their home. They work shifts at all hours of the day and night, 7 days a week. So they get to know the person inside and out. They're in the residents' rooms, they go on appointments with folks, they're the eyes and ears of the program.

Our philosophy is that everybody-whether it's somebody who works in the kitchen, all the way up to the psychiatrist-is very much an active part of that team. They're the ones that ultimately allow someone to flourish. I think it's a model that works at this level of care for people who need it. Ultimately, when a resident moves into the community, the team is still out there in different ways - and that makes a big difference. Folks who are moving out with some complexity of illness need contact with a medical staff person on an ongoing basis.

Q: How does Project Renewal differ from the typical Clubhouse setting, such as Fountain House?

Jim Mutton: We have different philosophies when it comes to treatment and approach. The word "treatment" doesn't really come into the vocabulary of a Clubhouse. There are no psychiatrists and no case managers at a typical Clubhouse. Everybody's a member, whether they're a staff person or a consumer. But we do work hand-in-hand with Fountain House in many ways.

About 95% of our residents are also Fountain House members. They go to the Clubhouse during the day for vocational support, to meet friends, to try out a job, to learn a new skill. The Clubhouse gives them a greater sense of empowerment, another flavor of what life is like out in the community. At the same time, Fountain House relies on us in many ways, to provide extra support and structure for those folks when and where they need it. So there will be a lot of people Fountain House will want to talk to us about.

Our Clinical Director has a very close relationship with the Fountain House Housing Director, and we're often trading consumers into different levels of support. Someone from our facility may move into a Fountain House apartment when they're ready for it. On the other hand, Fountain House may have someone who's really not ready to be out in the community by themselves, so they come and live with us. It's a very reciprocal relationship. We set a lot more limits with folks where we believe it comes to that. If somebody is in danger of decompensating and ending up back in the hospital, we want to avoid that. We want to keep people in the community. Fountain House may not push that issue as much.

Q: How does Project Renewal differ from Fountain House in terms of being a residential facility?

Jim Mutton: Project Renewal essentially works with the homeless. We've been doing that since the 1950s. A lot of the services we provide are shelter-based programs. Not all are mental health related; some are for substance abuse treatment. The Clinton Residence where Robert lives is strictly mental health. It's supportive housing for 57 folks. We also have a single room occupancy hotel on 42nd and 9th that we took over in one of the most notorious, crime-ridden, drug and prostitute infested areas in the city. We turned it into what has become an ideal living environment for 309 people. The 48TH

street residence has set the trend for what is needed in terms of housing and rehab in the community and is a model that a lot of other agencies have looked at.

Housing and Rehab are provided for Fountain House members, but are not its mainstay. The Clubhouse model that Fountain House offers allows everyone to come together in a social environment.

Q: I get the feeling that it was not easy to get Robert to transition from an institutional environment and into this program. How do you go about recognizing when people are ready to move into this type of program?

Jim Mutton: We get about 150 referrals a year, for maybe 10 or 15 openings. At the last count, I heard there were about 10,000 mentally ill folks waiting for this type of decent supportive housing. We're obliged to work with a number of folks who come from state institutions. When we were set up in 1990, it was essentially all that we served, with sort of a "stepped transition" into the community. That has changed, so that we're not working with as many from state facilities. We're moving people out at a rate that is extremely limited.

Robert literally spent 35- 40 years of his life in and out of those facilities. The adjustment for him was to learn a whole new set of boundaries and a whole new set of "people" skills. To give you an example, early on he had an altercation with one of the staff members where he had asked for cigarettes and was told that it wasn't time, that he could get them at a certain point - and his reaction was to punch someone in the face. Normally in a hospital, he'd be in restraints and sedated for days. That didn't happen in the community. We were able to give him a time out in a quiet area - going to a respite area in our basement - and come back into the residence without jeopardizing his quality of life. I think over a course of time he started to realize that he needed to relate to people differently. He wasn't going to get his needs met by yelling and screaming and essentially being a nasty piece of work. He had to get to know people and learn a level of respect.

One day Robert was having a bad time and his brother Jay was very concerned that we were going to kick him out. Our Clinical Director said it very well when he said, "This has nothing to do with mental illness. This is about being a pain in the ass and he needs to get over it." And Jay was able to walk away and realize that's what we're about.

Q: If you look back over Robert's life, if a program like this were available 30 years ago, where do you think he'd be today?

Jim Mutton: I think Robert struggled with having a break in his life when he was sort of at his peak. He had won a scholarship to City College; he was on his own and had sort of broken out of the family environment and was living successfully. The struggle for him today is to realize that he lost 35-40 years of his life. I don't know if the kinds of treatments he was put through-the latest fashion, as it were, in mental health treatment-would have made any difference. We've made tremendous strides in the last 5 years in terms of what works. And I think a lot of people have realized that it's all about the community.

There are still people fighting amongst themselves about what's best, about what medication is best, what helps. Thousands and thousands of dollars that used to be funneled into mental health care were stopped last year and there was an outcry: What's going to happen? We need to build more housing. We need to fund these programs. A lot of lobbying has taken place, and finally the State and Assembly have agreed that community reinvestment works and there needs to be legislation passed.

So, whether or not Robert would have come through this any differently, I don't know. I think he went through a lot of life lessons in and out of the hospital.

Q: Compared to someone who's living on the streets and homeless, at least Robert had his brother there. Does that make a big difference?

Jim Mutton: Yes. I think for 2/3 of the folks we work with, they don't have a family member who is that invested. They're often forgotten about. Even the families that are around need so much education and support just to establish a new relationship. A lot of what we do is outreach to siblings-aunts, uncles, cousins-who come in, meet with us, and learn about what life is about in the community.

Q: I suppose for those do show up, it must be a tough job on your part to convince them that you can make a difference.

Jim Mutton: Right. It's not the end of the road in many ways. People can get better and they can lead productive lives. They can achieve goals that any one of us would want to work on, but they've just had a harder road of it. We've had people who have lived with us be reunited with family that they haven't seen in 15 or 20 years. The real success story is when someone can reunite and reclaim a family member and provide them with a place to live again.

We have a woman who is a mother of 6. She raised them all single-handedly without any medication for most of their lives-from childhood on up to early adulthood-before she realized she finally needed to get some help. The family is now back in the picture. Their hope is that they can provide a place for her to live, to embrace her and take her back into their lives.

It's a tough road to re-educate and to battle the stigma that's out there. Most of the families that we work with don't have any clue about the illness and what works.

Q: How do you work with employers to help get consumers jobs outside in the real working world?

Jim Mutton: Employment is probably one of the most central parts of rehab and reintegration. It's our belief that everybody has the potential to get back to work. Work is something that generates the most motivation for most people, and is closely related to housing readiness. We have a supported employment program called Job Links that was set up a couple of years ago with the specific goal of finding competitive jobs for mentally ill consumers. These are real jobs with real wages - not a stipend, but something that can offer benefits.

Job Links goes out scouting for potential employers that are willing to give people a chance. They'll place a consumer into a job almost immediately and they provide the support in the workplace through a method called Job Coaching. The whole emphasis is that we train people to get back to work. They go through "X" number of group interactions and pre-vocational skills training sessions before they can get back to work. It's a very different philosophy from what psychiatric rehabilitation has been over the years.

Supported employment works this way: Find the job, get the person into the job, then provide the support in the workplace. We've had people working at Shea Stadium with the NY Mets; a woman at the Village Voice as a receptionist; a guy who's a superintendent at a non-profit building in Brooklyn; and another guy who helps organize a Laundromat. In cases where the state has basically washed their hands of it, such people will never be back at work. We really want to encourage people to "own" the job, so they can have something to call theirs. These folks have a job that they can work and enjoy, and it pays real wages - and I think that makes the difference. As a result, there's a strong push on for supported employment, and I think it works.

Visit Project Renewal online at www.projectrenewal.org.