LAYMAN'S GUIDE TO PRACTICAL WAYS TO HELP HOMELESS* PEOPLE WHO HAVE A MENTAL ILLNESS
*and anyone else — especially Those Who May Have No Relatives, Friends, or Anyone Else to Help Them
The goal of this work is to inspire you to befriend just one person who has a mental illness, whether homeless or not, and offer him or her hope. You don’t have to fully understand mental illness, be an expert in anything, or know exactly what to say to be able to help someone. Just showing you care and be willing to learn as you go will go a long way toward making a real difference in someone’s life – and perhaps yours, too.
In the book “Transforming Madness” by Jay Neugeboren, a man named Moe when he asked people with a mental illness what made the difference in their lives, said,
They tell me it was a relationship, meeting a particular individual at a particular time, someone who believed in them, and who promised to work with them and stand by them for the long run, no matter what, and through all the ups and downs of their lives.
What made the difference, they all say, was having someone believe in them so that they learned to believe in themselves enough to begin to do the work of bringing them back to this world.
Many people with a mental illness, especially those who are homeless, have no one to care about them, to speak up for them, to make known their plight, to help them help themselves connect to all the services they need. If you don’t reach out to that person in need maybe no will!
Guiding Principles
♦ Always do what is in the best interest of the person you are helping.
♦ V oluntary assistance is always the aim, and is almost always the only approach that needs to be taken. Just about every homeless person with a mental illness is willing, if properly approached, to be helped voluntarily.
♦ There are rare occasions when involuntary assistance is appropriate because of the
failure of our mental health laws, and mental health system, to help people who are truly mentally incapacitated and unable to care for themselves. Tread very, very, very carefully in the area of involuntary treatment, but understand there are times when involuntary assistance is the right course of action—the only course of action— that will provide the urgent help for critically incapacitated homeless adults. Involuntary treatment is allowed in Georgia and every state in the nation. There are elaborate legal and medical safeguards to prevent people, once evaluated, from being improperly detained against their will. That the issue of involuntary action is controversial should not deter one from reaching out to help someone. There are several ways an ordinary, caring citizen can help an incapacitated woman or man who has essentially been abandoned on our city streets.
All information in this guide is legally allowed in Georgia. All options discussed,
however inappropriate for some, may meet the needs of others and are therefore included.
Prepared by Alan Harris, April 2007
18 Ways to Help Contents
I. In An Emergency call 911
2 When help is needed right away but it is not an emergency
3. Be A Friend
4. Be A "Linker"
5. Getting mental health services for the first time or reconnecting to mental health services
6. Help Someone Go To Court, Contact Public Defender, Get Meds When In jail, etc.
7. Assist Someone In Obtaining SSI, SSDI, Food Stamps, General Assistance 8 Help With Housing
9. Representative Payee For SSI and SSDI
10. Advocate For the Rights Of People in Mental Hospitals and Local Jails
II. Help A Homeless Person With A Mental Illness AND a Substance Abuse Problem
12. Placement in Personal Care Homes and Nursing Homes
13. How To Help An Incapacitated Person Get Involuntary Treatment of Mental Illness or Drug Addiction
14. Order To Apprehend
15. Anyone may file an application under oath with the local community mental health center
16. Anyone May File A Petition With The County Probate Court
17.What To Do When A Person Is So Severely Mentally Incapacitated He Or She Refuses To Sign SSI Application
18. Guardianship
18 Ways You Can Help a Homeless Man or Woman Who Has a Mental Illness
1. In an Emergency call 911
In an emergency call 911 if the person is suicidal or homicidal or in a physical health crisis that is
life-threatening. An emergency is an immediate situation which require an immediate response. Emergencies are limited to suicide threats, homicidal threats, acute psychosis (sudden or extreme change from normal behavior), if there is a life-threatening crisis, and in some instances, a family breakup.
2. When help is needed right away but it is not an emergency
One of the best ways to help someone get mental health services for the first time or to reconnect to mental health services, is to call the statewide, 24/7 service called Single Point of Entry at 1-800-715-4225. A "live", experienced counselor will provide expert counseling on both mental health and substance abuse. Many homeless people have both an addiction to drugs and alcohol and a mental illness which is called a dual diagnosis. If after assessing the person's situation, the counselor determines the person needs immediate help, he or she can arrange for immediate emergency help. The counselors can provide the telephone numbers and addresses of local mental health and substance abuse treatment facilities and help set up appointments. As a person's advocate, you can call Single Point of Entry and get information about how to help if the person you are helping is not available or refuses to talk to the counselor.
Another way is to go Grady Hospital's Psychiatric Emergency Services clinic on the 13th floor of the hospital where anyone in an emergency can be seen 24 hours a day, 7 days a week. Counseling and medicines can be provided if needed.
3. Be a Friend
You can make a difference in the life of a homeless person with a mental illness. Start with one person. Whether it is a single or frequent encounter, just showing love and kindness can help someone get through the day—and perhaps through the spark you create—through the rest of life, knowing in his or her heart and soul that someone really cares. Be a friend. Be patient. Have a relationship with someone. When possible, stand by and believe in this person no matter what, through ups and downs, so he or she learns to believe in himself or herself. Love, hope, and trust are perhaps chemicals whose effects may be as profound, wonderful and abiding as the effects of medications. Recovery is about relationships, about support, perseverance, encouragement and friendship. Though helpful, it is not necessary for you to know about mental illness, homelessness, where to refer someone, or give money. Just show you care and treat each person with respect and dignity but avoid coddling. It may lead to the point where you can help them in some of the ways mentioned below. When talking to someone who may be suffering from paranoia, making steady eye contact could be perceived as a threat, so making brief intermittent eye contact is advisable. Some people do not want to get too close or be touched. If you offer help, follow through as soon as possible in order to build trust (See Attachment A, "A Message To Those Who Want To Help People With A Mental Illness" which is being made available courtesy of United Way.)
4. Be a "Linker"
.Be a "linker" by knowing who to call, where to look for the hundreds of places where a disabled person can go to get mental health services, SSI, housing, shelter, meals etc. You don't have to be an expert in any area, just have the desire and be willing to learn whom to call for the services needed. See Attachment B for a list of excellent resources available on line and in print form for help with mental health treatment, access to government benefits including SSI, housing, etc. However, the best single, easiest to obtain source for information that is available 24/7 is United Way's 211 First Call For Help. You can call 211 (or 404-614-1000) 24 hours a day, 7 days a week.
5. Getting mental health services for the first time or reconnecting to
mental health services
One of the most important actions you can take to help someone who has a mental problem is to help them connect—or reconnect—to regular mental health services. The simplest way to do this is to call 1-800-715-4225 Single Point of Entry (see item 2 above.) Then, once an appointment is made with a mental health outpatient center, you can help by encouraging the person to keep all appointments, take medicines if prescribed. Sometimes you may need to help with transportation so appointments are not missed for lack of a way to get to the appointment.
6. Help Someone Go to Court, Contact Public Defender, Help Get Meds When in jail, etc.
Many homeless people with a serious mental impairment are frequently arrested for petty "crimes" like public urination, "loitering", and MARTA fare evasion, and have no one to speak to their public defender and/or go to court with them to make it known that they are homeless, that they have a mental illness, and to provide any other information that helps the public defender better understand this person's circumstances. Your intervention might help have the case dismissed or result in a more lenient sentence. You do not have to be a lawyer or expert in anything to help. The public defender can be a big help. Going to court is not always necessary but if time permits, doing so can be a big help. If you do go to court, arrive early and speak to public defender to see what you can do or say that may help the individual.
From 25 to 40% of America's mentally ill (thought to be much higher among homeless people) will have contact with the criminal justice system, estimates the National Alliance for the Mentally {Monitor on Psychology, July/August 2000).
Sometimes, perhaps often, when a homeless person with a mental illness goes to jail, he or she is not given their medicines, perhaps because the jail or prison is not aware of his or her mental illness. If someone you know is in jail, you can call the mental health staff at the jail to request they consider the need to provide mental health services for the person you are helping.
7*. Assist Someone In Obtaining SSI, SSDI, Food Stamps, General
Assistance
Food stamps: Almost all homeless people are eligible for food stamps of $152 (as of 2006). Food stamps are one government benefit easily But, some are not aware they are eligible or how to get them. Fulton County's DFACS's office at 84 Walton Street (404-657-8000) in downtown Atlanta is the closest place to apply for food stamps for those who live in central Atlanta as most homeless people do. .An address is needed and this is where you can help the homeless person find a convenient, safe place where his or her food stamps can be sent You may also help anyone who does not have a birth certificate obtain one since this is a new requirement
General assistance is a payment for people who have applied for SSI or Social Security benefits and are waiting for a decision on their claim or if they have been denied, they are waiting for a decision on their appeal.. Applicants for general assistance must prove they have applied for SSI or Social Security disability benefits and obtain a medical statement that they are disabled People apply for general assistance at the DFACS offices. It takes up to 10 weeks or longer (in Fulton County) for general assistance checks to start if approved. In Fulton County an eligible homeless person gets $80 a month and not paying rent. This amount goes up to $225 if paying rent There are two main requirements for general assistance: prove to DFACS that a claim or an appeal is pending with Social Security office and provide a doctor's statement of inability to work.
SSI and SSDL Many homeless people are eligible for SSI benefits but have no one to help them negotiate a lengthy, difficult application process that takes 4 months or longer. Attachment C explains the SSI and SSDI disability programs. Without knowing anything about the SSI or SSDI programs you can help a person negotiate the difficult process of applying for benefits and obtaining information. You can officially represent the person by completing a form, SSA-1696, that Social Security can provide you. When this form is received by Social Security, it allows you to speak directly to Social Security in behalf of the person you are helping.
Many homeless people applying for food stamps, general assistance, and SSI/SSDI need assistance ranging from having a stable mailing address to help getting an appointment to apply, completing forms, tokens, and help keeping doctors' appointments arranged by Social Security, etc.
Some people who refuse mental health services are willing to accept help in applying for SSI and other benefits such as food stamps, general assistance, etc. In the process of applying for SSI it is often, almost always possible to get them to then agree to accept mental health services in order to document their SSI disability claims. Social Security has a great toll free number—1-800-772-1213 available 7 AM to 7 PM Monday-Friday. You can ask general questions and with the person you are helping present, Social Security can talk directly to you once the person you are helping authorizes them to do so. This allows you to resolve lots of problems without having to go to the Social Security office. See attachment C for information on how to represent someone in order to help them with their disability claim.
8. Help with Housing
Many homeless people with a mental illness get an SSI check ($603 in 2006) but still live on the street or in shelters because of the high rental costs and partly because there are so few places that offer meaningful help.. Some of them have no one to help them find housing that they can afford. There is no one place they can go to get housing information, referrals, placement However, United Way has an exhaustive housing list that can be used to help someone find low-income housing that might be suitable. Included in United Way 211 's housing directory are shelters, transitional shelters, inexpensive hotel and motels, special needs housing for people with a mental illness, HTV/AIDs, the elderly, personal care homes, public subsidized housing, and private affordable housing. It is a very helpful, underused directory. To access the United Way web site, go to www.nnitPidwavatlanta.org and click on find help then and the second screen will list the housing directory. Also, you can go to www.atlantahousingsearch.com. If you don't have access to a computer you can simply call United Way at 211 (or 404-614-1000) and ask the 211 agent for help. This service is available 24/7.
9. Representative Payee
About 20 to 25% of people who get a SSI or Social Security check are required to have someone help them manage their money. This person or organization is called a representative payee. The duties of a payee are basically to pay for housing first then divide the remaining money for food, transportation, etc. and give it to the person each week. The payee can be an organization or an individual. Many homeless people who need a payee find it very difficult to find anyone to be their payee whom they can trust and who will not misuse or abuse them. There is a great need for reliable people to serve as rep payees for people with a mental illness. Serving as a person's rep payee is very simple and easy to do. To become a person's payee requires a one-time visit to the Social Security Office. To stop being the rep payee when the need arises requires only a telephone call to Social Security. Social Security's 1-800-772-1213 teleservice center can answer questions from 7 AM to 7 PM Monday through Friday.
If you meet someone whose payee is taking their money or charging them exorbitant fees, you can assist the homeless person by reporting this to the Social Security Office by calling 1-800-772-1213 and an investigation will be made
There are official representative payee organizations approved by Social Security in metro Atlanta. They are allowed to charge a small fee. No one else who serves as a representative payee is allowed to charge a fee, any fee, for their services. If you cannot serve as a payee, then you can still assist a person by referring them to one of the SSA approved payee organizations. To get the names of these organizations, you can call your nearest Social Security office or the teleservice center at 1-800-772-1213. One of these organizations is Help Group Services at 404-766-3628. Ask for Betty Huffman.
10. Advocate for the Rights Of People in Mental Hospitals and
Local Jails
Help stop inappropriate discharges from Grady's Psychiatric Emergency Services (13th floor clinic) or from state-operated mental hospitals. It is considered inappropriate, if not illegal, according to the Atlanta Legal Aid Society, for inmates or patients with mental illnesses to be discharged to the streets or to emergency shelters from mental hospitals. If you know someone who is to be discharged who has no place to go, and they want help in making sure they are not discharged to a shelter or the streets, you can help by calling the Atlanta Legal Aid Society at 404-377-0705 x225 and ask for Sue Jamieson or Toni Pastore who will let you know if they might be able to help.
11. Help a Homeless Person with a Mental Illness AND a
Substance Abuse Problem
At least half of all homeless people with a mental illness are estimated to have an addiction to drugs and/or alcohol. These two problems combined greatly complicate their efforts to recover. There are very few places that help these dually-diagnosed individuals. One of the best ways for you to assist them, whether you are experienced or not, is to call the excellent Single Point of Entry toll-free, 24/7 helpline number, 1-800-715-4225 (statewide). A "live", experienced counselor will assess both the person's mental health and substance abuse issues and offer information.
12. Placement in Personal Care Homes and Nursing Homes
Placement in a personal care home or nursing home often can be accomplished without a guardian, as long as the resident is either (a) cooperative or (b) incapable of objecting. A competent adult has the right to determine his owi residence, and a facility is without authority to restrain an adult absent consent, unless the authority to determine residence has been placed in another (a guardian). At times it may be difficult to gauge whether a new resident will ultimately "object," since he may be resistant at first but may adjust after a period of time. Basically, it comes dowi to whether the administrator of the facility feels it can safely keep the resident and prevent him from harming hims Of course, it is also necessary to make the financial arrangements for the care of the resident, which may be done b the resident (if competent), an attorney-in-fact, or by anyone accepting the obligation and guaranteeing payment Ii 1999, the Georgia Legislature passed the "Temporary Health Care Placement Decision Maker for an Adult Act." Under the Act, upon certification by an attending physician that an adult in a hospital, institution, medical center, o other health care institution is incapable of giving consent to a discharge from such facility and a transfer or admission to an alternative facility or placement, including nursing facilities, personal care homes, rehabilitation facilities and home and community based programs, considered to be in the adult's best interest, authority to grant such limited consent is given to a list of persons similar to the Georgia Medical Consent Law. If no one authorized such law is available or if all who are available waive authority to consent or dissent to the discharge, transfer, or admission, a petition may be filed in the probate court seeking an order solely authorizing such discharge, transfer admission. The order will be limited in time to those purposes and does NOT result in the appointment of a guardit (Source: Bibb County Georgia Probate Court)
Items 13 through 18 are rarely needed (and even more rarely employed when needed) to help mentally ill people. They are included so you may know they exist in the event the need arises.
13. How To Help An Incapacitated Person Get Involuntary Treatment of Mental Illness or Drug Addiction
One of the guiding principles of this guide is that there are rare occasions when involuntary assistance is appropriate because of the failure of our mental health laws, and mental health system, to help people who are truly mentally incapacitated and unable to care for themselves. Tread very, very, very carefully in the area of involuntary treatment, but understand there are times when involuntary assistance is the right course of action—the only course of action— that will provide the urgent help for critically incapacitated homeless adults. Involuntary treatment is allowed in Georgia and every state in the nation. There are elaborate legal and medical safeguards to prevent people, once evaluated, from being improperly detained against their will. That the issue of involuntary action is controversial should not deter one from reaching out to help someone. There are several ways an ordinary, caring citizen can help an incapacitated woman or man who has essentially been abandoned on our city streets who are not a danger to themselves or others. Under Georgia law, a judge of the county probate court or superior court can authorize involuntary treatment of persons proved to be suffering from mental illness or drug or alcohol addiction. As an advocate for homeless people with a mental illness, it is helpful to know about these conditions even if you never have occasion to use them. Helping an incapacitated homeless person can be the most humane, caring course of action you can take. The elaborate safeguards in place prohibit abuse of any involuntary commitment efforts.
The wisest course of action for most advocates to take when vou see someone who is incapacitated
and unable to care for himself or herself is to call the statewide 24/7 Single Point of Entry 1-800-
715-4225. and speak to a live, experienced counselor who can give you helpful advice on how to
help.
14. Order to Apprehend - "OTA"
Upon the affidavits of at least two persons who attest that, within the preceding 48 hours, they have seen the person to be taken into custody and that, based upon observations contained in their affidavit, they have reason to believe such person is a mentally ill person (or drug dependent or alcoholic individual) requiring involuntary treatment, the appropriate court of the county in which a person may be found may issue an order commanding any peace officer to take such person into custody and deliver him forthwith for examination, either to the nearest available emergency receiving facility... .where such person shall be receive for examination (Such an order can also be issued upon an unexpired physician's certificate.) See Official Code Annotated, Section 37-3-41 (b) Formerly, the facts on which such an order or certificate was based had to meet the standards for inpatient treatment as denned by the OCGA. Essentially, these demand a finding that the person is a danger to himself or others. A change in the law, i.e. in the definitions of "involuntary treatment" and "mentally ill person requiring involuntary treatment" allows a doctor's certificate, police delivery or a Probate Court emergency order to apprehend to be based on a person's meeting inpatient or outpatient treatment standards See OCGA Section 37-3-1 (9.3) and 37-3-1 (12). The court order expires 7 days after it is executed.
15. Anyone may file an application under oath with the local community mental health center.
Anyone may file an application under oath with the community mental health center for a court ordered evaluation of a person located within that county who is alleged by such application to be a mentally ill person requiring involuntary treatment.. Upon filing of such application, the community mental health center shall make a preliminary investigation and if the investigation shows that there is probable cause to believe that such allegation is true, it shall file a petition with the court in the county where the patient is located seeking an involuntary admission for evaluation. OCGA Mental Health Law 37 3 61 (1)
16. Anyone may file a petition with the County Probate Court
Any person may file with the county probate court a petition executed under oath alleging that a person within the county is a mentally ill person requiring involuntary treatment The petition must be accompanied by the certificate of a physician or psychologist stating that he has examined the patient within the preceding five days and has found that the patient may be a mentally ill person requiring involuntary treatment and that a full evaluation of the patient is necessary. OCG 37 3 61 (2)
17. When a Person Is So Severely Mentally Incapacitated He or She
Refuses To Sign SSI Application
this is rarely needed, rarely used even when needed, approach to be considered when certain
conditions exist. Under Social Security rules, when an adult person with a mental illness refuses to sign an SSI or SSDI application for benefits, AND in the judgment of a physician is unable to understand the meaning of applying for SSI or SSDI benefits and needs a payee to help manage his or her money, AND is being "cared" for, the person who is caring for this adult can file an SSI or SSDI application without the disabled person's permission and without being the legal guardian. The person doing the "caring" can be an agency, an organization, or even an individual citizen. For example a volunteer who sees a homeless person with a mental illness on the streets or in a shelter and is the principal contact with that person, that would most likely qualify as "caring" for that person. If all other conditions mentioned above are met, then the person doing the "caring" can apply in behalf of this person for SSI or Social Security benefits. That such an unusual national provision exists is proof of its acceptance as an appropriate and as a legal means of insuring the right of the disabled person to receive disability benefits is protected rather than viewing it, as some do, as an invasion of the person's rights. If any questions regarding this procedure, e-mail Alan Harris has successfully used this approach and is available to answer questions from anyone who may have a question about it. Contact him at [email protected].
18. Guardianship
Is the formal appointment of a guardian by the Probate Court necessary to care for or conduct the affairs of an adult who has become incapacitated or disabled? The answer to this very important question, asked often by not only the family and friends of the adult but also by the adult, depends on the circumstances of each individual case. Posing the question is both appropriate and prudent, because adult guardianship proceedings are fairly complicated and time-consuming, as well as relatively expensive, primarily as a result of the due process protections afforded the proposed ward in such proceedings. This is not to say that guardianship proceedings are overly complex. The court must receive clear and convincing evidence of incapacity before removing the rights of an adult citizen and the order issued in every case is "fashioned" to the particular circumstances. However, there are often alternatives to guardianship which may accomplish the needed ends in any particular case. These alternatives should be considered, where applicable, and should be utilized in every case where doing so will accomplish the underlying purpose AND provide any needed protection for the adult Legal guardianship is obtained by going to the probate court in the local county. An attorney is not required but it is highly desirable to have one, or at least advice from an attorney. Legal guardianship is a very serious step to take and should be considered a last resort. There are times when legal guardianship is needed and necessary. In those cases, the law provides appropriate protections for the adult, and guardians appointed by the Court are monitored and must file written, periodic reports on the condition of the ward and the ward's property with the probate court establishing the guardianship. (Part of the above information was adapted from the Bibb County Probate Court web site.)
Attachment A A Message to Those Who Want to Help People With Mental Illness
Attachment B List of Homeless Resource Guides
Attachment C SSI & Social Security Disability Benefits
Attachment D How A Homeless Person Gets Services At Grady Hospital
Attachment E Myths About Mental Illness
*and anyone else — especially Those Who May Have No Relatives, Friends, or Anyone Else to Help Them
The goal of this work is to inspire you to befriend just one person who has a mental illness, whether homeless or not, and offer him or her hope. You don’t have to fully understand mental illness, be an expert in anything, or know exactly what to say to be able to help someone. Just showing you care and be willing to learn as you go will go a long way toward making a real difference in someone’s life – and perhaps yours, too.
In the book “Transforming Madness” by Jay Neugeboren, a man named Moe when he asked people with a mental illness what made the difference in their lives, said,
They tell me it was a relationship, meeting a particular individual at a particular time, someone who believed in them, and who promised to work with them and stand by them for the long run, no matter what, and through all the ups and downs of their lives.
What made the difference, they all say, was having someone believe in them so that they learned to believe in themselves enough to begin to do the work of bringing them back to this world.
Many people with a mental illness, especially those who are homeless, have no one to care about them, to speak up for them, to make known their plight, to help them help themselves connect to all the services they need. If you don’t reach out to that person in need maybe no will!
Guiding Principles
♦ Always do what is in the best interest of the person you are helping.
♦ V oluntary assistance is always the aim, and is almost always the only approach that needs to be taken. Just about every homeless person with a mental illness is willing, if properly approached, to be helped voluntarily.
♦ There are rare occasions when involuntary assistance is appropriate because of the
failure of our mental health laws, and mental health system, to help people who are truly mentally incapacitated and unable to care for themselves. Tread very, very, very carefully in the area of involuntary treatment, but understand there are times when involuntary assistance is the right course of action—the only course of action— that will provide the urgent help for critically incapacitated homeless adults. Involuntary treatment is allowed in Georgia and every state in the nation. There are elaborate legal and medical safeguards to prevent people, once evaluated, from being improperly detained against their will. That the issue of involuntary action is controversial should not deter one from reaching out to help someone. There are several ways an ordinary, caring citizen can help an incapacitated woman or man who has essentially been abandoned on our city streets.
All information in this guide is legally allowed in Georgia. All options discussed,
however inappropriate for some, may meet the needs of others and are therefore included.
Prepared by Alan Harris, April 2007
18 Ways to Help Contents
I. In An Emergency call 911
2 When help is needed right away but it is not an emergency
3. Be A Friend
4. Be A "Linker"
5. Getting mental health services for the first time or reconnecting to mental health services
6. Help Someone Go To Court, Contact Public Defender, Get Meds When In jail, etc.
7. Assist Someone In Obtaining SSI, SSDI, Food Stamps, General Assistance 8 Help With Housing
9. Representative Payee For SSI and SSDI
10. Advocate For the Rights Of People in Mental Hospitals and Local Jails
II. Help A Homeless Person With A Mental Illness AND a Substance Abuse Problem
12. Placement in Personal Care Homes and Nursing Homes
13. How To Help An Incapacitated Person Get Involuntary Treatment of Mental Illness or Drug Addiction
14. Order To Apprehend
15. Anyone may file an application under oath with the local community mental health center
16. Anyone May File A Petition With The County Probate Court
17.What To Do When A Person Is So Severely Mentally Incapacitated He Or She Refuses To Sign SSI Application
18. Guardianship
18 Ways You Can Help a Homeless Man or Woman Who Has a Mental Illness
1. In an Emergency call 911
In an emergency call 911 if the person is suicidal or homicidal or in a physical health crisis that is
life-threatening. An emergency is an immediate situation which require an immediate response. Emergencies are limited to suicide threats, homicidal threats, acute psychosis (sudden or extreme change from normal behavior), if there is a life-threatening crisis, and in some instances, a family breakup.
2. When help is needed right away but it is not an emergency
One of the best ways to help someone get mental health services for the first time or to reconnect to mental health services, is to call the statewide, 24/7 service called Single Point of Entry at 1-800-715-4225. A "live", experienced counselor will provide expert counseling on both mental health and substance abuse. Many homeless people have both an addiction to drugs and alcohol and a mental illness which is called a dual diagnosis. If after assessing the person's situation, the counselor determines the person needs immediate help, he or she can arrange for immediate emergency help. The counselors can provide the telephone numbers and addresses of local mental health and substance abuse treatment facilities and help set up appointments. As a person's advocate, you can call Single Point of Entry and get information about how to help if the person you are helping is not available or refuses to talk to the counselor.
Another way is to go Grady Hospital's Psychiatric Emergency Services clinic on the 13th floor of the hospital where anyone in an emergency can be seen 24 hours a day, 7 days a week. Counseling and medicines can be provided if needed.
3. Be a Friend
You can make a difference in the life of a homeless person with a mental illness. Start with one person. Whether it is a single or frequent encounter, just showing love and kindness can help someone get through the day—and perhaps through the spark you create—through the rest of life, knowing in his or her heart and soul that someone really cares. Be a friend. Be patient. Have a relationship with someone. When possible, stand by and believe in this person no matter what, through ups and downs, so he or she learns to believe in himself or herself. Love, hope, and trust are perhaps chemicals whose effects may be as profound, wonderful and abiding as the effects of medications. Recovery is about relationships, about support, perseverance, encouragement and friendship. Though helpful, it is not necessary for you to know about mental illness, homelessness, where to refer someone, or give money. Just show you care and treat each person with respect and dignity but avoid coddling. It may lead to the point where you can help them in some of the ways mentioned below. When talking to someone who may be suffering from paranoia, making steady eye contact could be perceived as a threat, so making brief intermittent eye contact is advisable. Some people do not want to get too close or be touched. If you offer help, follow through as soon as possible in order to build trust (See Attachment A, "A Message To Those Who Want To Help People With A Mental Illness" which is being made available courtesy of United Way.)
4. Be a "Linker"
.Be a "linker" by knowing who to call, where to look for the hundreds of places where a disabled person can go to get mental health services, SSI, housing, shelter, meals etc. You don't have to be an expert in any area, just have the desire and be willing to learn whom to call for the services needed. See Attachment B for a list of excellent resources available on line and in print form for help with mental health treatment, access to government benefits including SSI, housing, etc. However, the best single, easiest to obtain source for information that is available 24/7 is United Way's 211 First Call For Help. You can call 211 (or 404-614-1000) 24 hours a day, 7 days a week.
5. Getting mental health services for the first time or reconnecting to
mental health services
One of the most important actions you can take to help someone who has a mental problem is to help them connect—or reconnect—to regular mental health services. The simplest way to do this is to call 1-800-715-4225 Single Point of Entry (see item 2 above.) Then, once an appointment is made with a mental health outpatient center, you can help by encouraging the person to keep all appointments, take medicines if prescribed. Sometimes you may need to help with transportation so appointments are not missed for lack of a way to get to the appointment.
6. Help Someone Go to Court, Contact Public Defender, Help Get Meds When in jail, etc.
Many homeless people with a serious mental impairment are frequently arrested for petty "crimes" like public urination, "loitering", and MARTA fare evasion, and have no one to speak to their public defender and/or go to court with them to make it known that they are homeless, that they have a mental illness, and to provide any other information that helps the public defender better understand this person's circumstances. Your intervention might help have the case dismissed or result in a more lenient sentence. You do not have to be a lawyer or expert in anything to help. The public defender can be a big help. Going to court is not always necessary but if time permits, doing so can be a big help. If you do go to court, arrive early and speak to public defender to see what you can do or say that may help the individual.
From 25 to 40% of America's mentally ill (thought to be much higher among homeless people) will have contact with the criminal justice system, estimates the National Alliance for the Mentally {Monitor on Psychology, July/August 2000).
Sometimes, perhaps often, when a homeless person with a mental illness goes to jail, he or she is not given their medicines, perhaps because the jail or prison is not aware of his or her mental illness. If someone you know is in jail, you can call the mental health staff at the jail to request they consider the need to provide mental health services for the person you are helping.
7*. Assist Someone In Obtaining SSI, SSDI, Food Stamps, General
Assistance
Food stamps: Almost all homeless people are eligible for food stamps of $152 (as of 2006). Food stamps are one government benefit easily But, some are not aware they are eligible or how to get them. Fulton County's DFACS's office at 84 Walton Street (404-657-8000) in downtown Atlanta is the closest place to apply for food stamps for those who live in central Atlanta as most homeless people do. .An address is needed and this is where you can help the homeless person find a convenient, safe place where his or her food stamps can be sent You may also help anyone who does not have a birth certificate obtain one since this is a new requirement
General assistance is a payment for people who have applied for SSI or Social Security benefits and are waiting for a decision on their claim or if they have been denied, they are waiting for a decision on their appeal.. Applicants for general assistance must prove they have applied for SSI or Social Security disability benefits and obtain a medical statement that they are disabled People apply for general assistance at the DFACS offices. It takes up to 10 weeks or longer (in Fulton County) for general assistance checks to start if approved. In Fulton County an eligible homeless person gets $80 a month and not paying rent. This amount goes up to $225 if paying rent There are two main requirements for general assistance: prove to DFACS that a claim or an appeal is pending with Social Security office and provide a doctor's statement of inability to work.
SSI and SSDL Many homeless people are eligible for SSI benefits but have no one to help them negotiate a lengthy, difficult application process that takes 4 months or longer. Attachment C explains the SSI and SSDI disability programs. Without knowing anything about the SSI or SSDI programs you can help a person negotiate the difficult process of applying for benefits and obtaining information. You can officially represent the person by completing a form, SSA-1696, that Social Security can provide you. When this form is received by Social Security, it allows you to speak directly to Social Security in behalf of the person you are helping.
Many homeless people applying for food stamps, general assistance, and SSI/SSDI need assistance ranging from having a stable mailing address to help getting an appointment to apply, completing forms, tokens, and help keeping doctors' appointments arranged by Social Security, etc.
Some people who refuse mental health services are willing to accept help in applying for SSI and other benefits such as food stamps, general assistance, etc. In the process of applying for SSI it is often, almost always possible to get them to then agree to accept mental health services in order to document their SSI disability claims. Social Security has a great toll free number—1-800-772-1213 available 7 AM to 7 PM Monday-Friday. You can ask general questions and with the person you are helping present, Social Security can talk directly to you once the person you are helping authorizes them to do so. This allows you to resolve lots of problems without having to go to the Social Security office. See attachment C for information on how to represent someone in order to help them with their disability claim.
8. Help with Housing
Many homeless people with a mental illness get an SSI check ($603 in 2006) but still live on the street or in shelters because of the high rental costs and partly because there are so few places that offer meaningful help.. Some of them have no one to help them find housing that they can afford. There is no one place they can go to get housing information, referrals, placement However, United Way has an exhaustive housing list that can be used to help someone find low-income housing that might be suitable. Included in United Way 211 's housing directory are shelters, transitional shelters, inexpensive hotel and motels, special needs housing for people with a mental illness, HTV/AIDs, the elderly, personal care homes, public subsidized housing, and private affordable housing. It is a very helpful, underused directory. To access the United Way web site, go to www.nnitPidwavatlanta.org and click on find help then and the second screen will list the housing directory. Also, you can go to www.atlantahousingsearch.com. If you don't have access to a computer you can simply call United Way at 211 (or 404-614-1000) and ask the 211 agent for help. This service is available 24/7.
9. Representative Payee
About 20 to 25% of people who get a SSI or Social Security check are required to have someone help them manage their money. This person or organization is called a representative payee. The duties of a payee are basically to pay for housing first then divide the remaining money for food, transportation, etc. and give it to the person each week. The payee can be an organization or an individual. Many homeless people who need a payee find it very difficult to find anyone to be their payee whom they can trust and who will not misuse or abuse them. There is a great need for reliable people to serve as rep payees for people with a mental illness. Serving as a person's rep payee is very simple and easy to do. To become a person's payee requires a one-time visit to the Social Security Office. To stop being the rep payee when the need arises requires only a telephone call to Social Security. Social Security's 1-800-772-1213 teleservice center can answer questions from 7 AM to 7 PM Monday through Friday.
If you meet someone whose payee is taking their money or charging them exorbitant fees, you can assist the homeless person by reporting this to the Social Security Office by calling 1-800-772-1213 and an investigation will be made
There are official representative payee organizations approved by Social Security in metro Atlanta. They are allowed to charge a small fee. No one else who serves as a representative payee is allowed to charge a fee, any fee, for their services. If you cannot serve as a payee, then you can still assist a person by referring them to one of the SSA approved payee organizations. To get the names of these organizations, you can call your nearest Social Security office or the teleservice center at 1-800-772-1213. One of these organizations is Help Group Services at 404-766-3628. Ask for Betty Huffman.
10. Advocate for the Rights Of People in Mental Hospitals and
Local Jails
Help stop inappropriate discharges from Grady's Psychiatric Emergency Services (13th floor clinic) or from state-operated mental hospitals. It is considered inappropriate, if not illegal, according to the Atlanta Legal Aid Society, for inmates or patients with mental illnesses to be discharged to the streets or to emergency shelters from mental hospitals. If you know someone who is to be discharged who has no place to go, and they want help in making sure they are not discharged to a shelter or the streets, you can help by calling the Atlanta Legal Aid Society at 404-377-0705 x225 and ask for Sue Jamieson or Toni Pastore who will let you know if they might be able to help.
11. Help a Homeless Person with a Mental Illness AND a
Substance Abuse Problem
At least half of all homeless people with a mental illness are estimated to have an addiction to drugs and/or alcohol. These two problems combined greatly complicate their efforts to recover. There are very few places that help these dually-diagnosed individuals. One of the best ways for you to assist them, whether you are experienced or not, is to call the excellent Single Point of Entry toll-free, 24/7 helpline number, 1-800-715-4225 (statewide). A "live", experienced counselor will assess both the person's mental health and substance abuse issues and offer information.
12. Placement in Personal Care Homes and Nursing Homes
Placement in a personal care home or nursing home often can be accomplished without a guardian, as long as the resident is either (a) cooperative or (b) incapable of objecting. A competent adult has the right to determine his owi residence, and a facility is without authority to restrain an adult absent consent, unless the authority to determine residence has been placed in another (a guardian). At times it may be difficult to gauge whether a new resident will ultimately "object," since he may be resistant at first but may adjust after a period of time. Basically, it comes dowi to whether the administrator of the facility feels it can safely keep the resident and prevent him from harming hims Of course, it is also necessary to make the financial arrangements for the care of the resident, which may be done b the resident (if competent), an attorney-in-fact, or by anyone accepting the obligation and guaranteeing payment Ii 1999, the Georgia Legislature passed the "Temporary Health Care Placement Decision Maker for an Adult Act." Under the Act, upon certification by an attending physician that an adult in a hospital, institution, medical center, o other health care institution is incapable of giving consent to a discharge from such facility and a transfer or admission to an alternative facility or placement, including nursing facilities, personal care homes, rehabilitation facilities and home and community based programs, considered to be in the adult's best interest, authority to grant such limited consent is given to a list of persons similar to the Georgia Medical Consent Law. If no one authorized such law is available or if all who are available waive authority to consent or dissent to the discharge, transfer, or admission, a petition may be filed in the probate court seeking an order solely authorizing such discharge, transfer admission. The order will be limited in time to those purposes and does NOT result in the appointment of a guardit (Source: Bibb County Georgia Probate Court)
Items 13 through 18 are rarely needed (and even more rarely employed when needed) to help mentally ill people. They are included so you may know they exist in the event the need arises.
13. How To Help An Incapacitated Person Get Involuntary Treatment of Mental Illness or Drug Addiction
One of the guiding principles of this guide is that there are rare occasions when involuntary assistance is appropriate because of the failure of our mental health laws, and mental health system, to help people who are truly mentally incapacitated and unable to care for themselves. Tread very, very, very carefully in the area of involuntary treatment, but understand there are times when involuntary assistance is the right course of action—the only course of action— that will provide the urgent help for critically incapacitated homeless adults. Involuntary treatment is allowed in Georgia and every state in the nation. There are elaborate legal and medical safeguards to prevent people, once evaluated, from being improperly detained against their will. That the issue of involuntary action is controversial should not deter one from reaching out to help someone. There are several ways an ordinary, caring citizen can help an incapacitated woman or man who has essentially been abandoned on our city streets who are not a danger to themselves or others. Under Georgia law, a judge of the county probate court or superior court can authorize involuntary treatment of persons proved to be suffering from mental illness or drug or alcohol addiction. As an advocate for homeless people with a mental illness, it is helpful to know about these conditions even if you never have occasion to use them. Helping an incapacitated homeless person can be the most humane, caring course of action you can take. The elaborate safeguards in place prohibit abuse of any involuntary commitment efforts.
The wisest course of action for most advocates to take when vou see someone who is incapacitated
and unable to care for himself or herself is to call the statewide 24/7 Single Point of Entry 1-800-
715-4225. and speak to a live, experienced counselor who can give you helpful advice on how to
help.
14. Order to Apprehend - "OTA"
Upon the affidavits of at least two persons who attest that, within the preceding 48 hours, they have seen the person to be taken into custody and that, based upon observations contained in their affidavit, they have reason to believe such person is a mentally ill person (or drug dependent or alcoholic individual) requiring involuntary treatment, the appropriate court of the county in which a person may be found may issue an order commanding any peace officer to take such person into custody and deliver him forthwith for examination, either to the nearest available emergency receiving facility... .where such person shall be receive for examination (Such an order can also be issued upon an unexpired physician's certificate.) See Official Code Annotated, Section 37-3-41 (b) Formerly, the facts on which such an order or certificate was based had to meet the standards for inpatient treatment as denned by the OCGA. Essentially, these demand a finding that the person is a danger to himself or others. A change in the law, i.e. in the definitions of "involuntary treatment" and "mentally ill person requiring involuntary treatment" allows a doctor's certificate, police delivery or a Probate Court emergency order to apprehend to be based on a person's meeting inpatient or outpatient treatment standards See OCGA Section 37-3-1 (9.3) and 37-3-1 (12). The court order expires 7 days after it is executed.
15. Anyone may file an application under oath with the local community mental health center.
Anyone may file an application under oath with the community mental health center for a court ordered evaluation of a person located within that county who is alleged by such application to be a mentally ill person requiring involuntary treatment.. Upon filing of such application, the community mental health center shall make a preliminary investigation and if the investigation shows that there is probable cause to believe that such allegation is true, it shall file a petition with the court in the county where the patient is located seeking an involuntary admission for evaluation. OCGA Mental Health Law 37 3 61 (1)
16. Anyone may file a petition with the County Probate Court
Any person may file with the county probate court a petition executed under oath alleging that a person within the county is a mentally ill person requiring involuntary treatment The petition must be accompanied by the certificate of a physician or psychologist stating that he has examined the patient within the preceding five days and has found that the patient may be a mentally ill person requiring involuntary treatment and that a full evaluation of the patient is necessary. OCG 37 3 61 (2)
17. When a Person Is So Severely Mentally Incapacitated He or She
Refuses To Sign SSI Application
this is rarely needed, rarely used even when needed, approach to be considered when certain
conditions exist. Under Social Security rules, when an adult person with a mental illness refuses to sign an SSI or SSDI application for benefits, AND in the judgment of a physician is unable to understand the meaning of applying for SSI or SSDI benefits and needs a payee to help manage his or her money, AND is being "cared" for, the person who is caring for this adult can file an SSI or SSDI application without the disabled person's permission and without being the legal guardian. The person doing the "caring" can be an agency, an organization, or even an individual citizen. For example a volunteer who sees a homeless person with a mental illness on the streets or in a shelter and is the principal contact with that person, that would most likely qualify as "caring" for that person. If all other conditions mentioned above are met, then the person doing the "caring" can apply in behalf of this person for SSI or Social Security benefits. That such an unusual national provision exists is proof of its acceptance as an appropriate and as a legal means of insuring the right of the disabled person to receive disability benefits is protected rather than viewing it, as some do, as an invasion of the person's rights. If any questions regarding this procedure, e-mail Alan Harris has successfully used this approach and is available to answer questions from anyone who may have a question about it. Contact him at [email protected].
18. Guardianship
Is the formal appointment of a guardian by the Probate Court necessary to care for or conduct the affairs of an adult who has become incapacitated or disabled? The answer to this very important question, asked often by not only the family and friends of the adult but also by the adult, depends on the circumstances of each individual case. Posing the question is both appropriate and prudent, because adult guardianship proceedings are fairly complicated and time-consuming, as well as relatively expensive, primarily as a result of the due process protections afforded the proposed ward in such proceedings. This is not to say that guardianship proceedings are overly complex. The court must receive clear and convincing evidence of incapacity before removing the rights of an adult citizen and the order issued in every case is "fashioned" to the particular circumstances. However, there are often alternatives to guardianship which may accomplish the needed ends in any particular case. These alternatives should be considered, where applicable, and should be utilized in every case where doing so will accomplish the underlying purpose AND provide any needed protection for the adult Legal guardianship is obtained by going to the probate court in the local county. An attorney is not required but it is highly desirable to have one, or at least advice from an attorney. Legal guardianship is a very serious step to take and should be considered a last resort. There are times when legal guardianship is needed and necessary. In those cases, the law provides appropriate protections for the adult, and guardians appointed by the Court are monitored and must file written, periodic reports on the condition of the ward and the ward's property with the probate court establishing the guardianship. (Part of the above information was adapted from the Bibb County Probate Court web site.)
Attachment A A Message to Those Who Want to Help People With Mental Illness
Attachment B List of Homeless Resource Guides
Attachment C SSI & Social Security Disability Benefits
Attachment D How A Homeless Person Gets Services At Grady Hospital
Attachment E Myths About Mental Illness
