If someone comes into a county mental health facility needing to be treated for drug addiction, caregivers assume she is also struggling with mental illness. If someone else comes in showing signs of a serious mental illness, it is assumed that he is probably addicted to an illegal drug. According to Zenith Hall-Tibbs, who supervises adult residential services provided by the Fairfax County/Falls Church Community Services Board (CSB), “dual diagnosis” clients have been accepted by social service workers as the norm, not the exception. It is all too easy to miss a medication and turn to drugs and alcohol instead, or to succumb to an addiction and abandon medication. “It’s a ‘chicken or the egg’ problem,” Tibbs said, one issue encourages the other, and a misstep with either can catalyze a self-destructive chain reaction.
Because of plans to expand a treatment facility on Route 1, dual-diagnosis has become a topic of interest among residents of several Mount Vernon neighborhoods, including Mount Zephyr, Mount Vernon Manor and, in particular, houses on Gregory Drive.
In 2004, county voters approved a bond referendum that included $3.8 million for renovating a small residential treatment facility for dual diagnosis clients on Gregory Drive, across Richmond Highway from the Saudi Academy. It currently houses six women and supports three more women who live in nearby apartments and come to the facility for treatment. The county plans to raze the building, a former police barracks built in 1960, and build a larger structure that will allow the CSB to add 10 residents, eight of whom will be men, and five outpatients, four of them men, more than doubling the number of people in the facility to 16 and increasing its total client-base to 24. The expansion will allow the CSB to close a treatment facility for eight men in a leased home on Franconia Road.
The nature of the three most common serious mental illnesses — schizophrenia, bipolar disorder and major depressive disorder — all encourage people who suffer their effects to “self-medicate” with illegal substances. For instance, someone with bipolar illness may drink alcohol to depress his high-energy, manic states, then use amphetamines to raise himself out of the depression that will surely follow his mania. As they do now in the two independent facilities, New Horizons’ 15 staff members, including mental health counselors and therapists, will help residents overcome their addictions, manage the symptoms of their illnesses and work towards “the highest level of independent housing that they are able to sustain and maintain,” Hall-Tibbs said. The new facility, named New Horizons, will be staffed 24-hours a day. Residents will not be compelled to remain on the property, but they will be supervised within the building and staff will be aware if they leave. Responsible behavior will be a prerequisite for completing the 18-month program, said Hall-Tibbs.
BUT THE FACILITY’S neighbors are concerned about its expansion. “The word ‘serious’ frightens people,” said Dan Burrier, president of the Mount Zephyr Citizens Association, a neighborhood that lies across the highway from the facility. “People begin to have fears of, ‘What’s going to happen in our neighborhood? I don’t want this in my neighborhood. We have children in our neighborhood.’” Burrier said he and his association’s board had extensively researched the issue in order to present facts about the facility to the “very, very vocal group from Mount Zephyr and other neighborhoods who apparently opposed this.”
“I think everyone’s first concern is going to be the safety issue,” said Robin Gardiner, a mother in Mount Vernon Manor, which lies south of the facility on the opposite side of the highway. She said the county could spend its money more wisely by building a larger facility that was “a little more remotely placed,” than beside Route 1, which she believed would provide too much opportunity for temptation.
But according to Hall-Tibbs, the facility needs to be located within communities so that residents learn how to navigate the real world. As they advance in the program, they earn more independence, including possibly their own apartment. “That’s what makes it work,” she explained.
The CSB held two public information meetings on its plans, one in February and another in May. Paul Whitridge, who lives on Gregory Drive across from the facility attended the meetings. “Most people here aren’t crazy about it,” he said, particularly neighbors with young children. He said he was concerned about men in the program walking around in the neighborhood and possibly coming onto his property. “If I lived alone, single, I probably wouldn’t care too much,” he explained. “But I’m here with my family. I have two small children.”
Whitridge said there have been no problems with the current facility. He said he would feel better if he knew the county was listening to the neighborhood’s concerns, that New Horizons’ staff emphasized to its residents that they were not to trespass in neighboring homes and that every resident was there willingly. “If they’re putting in people who are really trying to help themselves,” he added, “I don’t have a problem with that.”
Hall-Tibbs said there are more than 25 people on the waiting list for spots in the treatment facility, with residents allowed to stay up to 18 months, this means anyone who has been admitted has steadfastly persisted in his or her application for over a year.
She added that most residents are usually incapable of activity that would upset their neighbors. Most schizophrenics in the program, she explained, suffer “99.9 percent of the time” from the poorly-publicized, “negative” effects of the disease. They “feel nothing,” she explained, their inner experience mirroring the blank face they present to the world. The struggle for program staff is not how to prevent residents from leaving the building to trespass in the neighborhood, it’s how to give their clients a reason to care whether they get out of bed and attend to basic hygiene.
BURRIER SUGGESTED communication will be the key to finding common ground on the Gregory Drive facility. “If we don’t have an open dialogue with those people in control of the program, and they don’t give us answers, then that only exacerbates the fear that people have.” With this in mind, he helped arrange a meeting on Sept. 11 between the CSB, county officials, district supervisor Gerry Hyland and several community representatives. The idea of a “community advisory board” emerged from this meeting. This board would be a conduit for dialogue between the New Horizons and its neighbors. “We feel this will go a long way in mitigating the fears that neighborhoods have,” Burrier said.
It would be the first such body created for a facility the size of New Horizons, said Bill Branner, the CSB’s site development manager. “We don’t have anything else like it right now. If it can increase communication between staff and neighbors then that can be a good thing.”
Louise Cleveland, the chairman of the Health and Human Services Committee of the Mount Vernon Council of Citizen’s Associations, an umbrella group for the district’s associations, praised the idea. “We obviously need a facility like [New Horizons],” she said. “The only issue is whether the concerns of the surrounding area are met as far as how it’s operated. That’s why I think communication between the community and the CSB through a community advisory board would be a very good thing.”
Hall-Tibbs said that no concrete plans for such a board had been made, but added, “I envision the sharing of information and concerns so that we offer the best service possible to the consumers and the community.”
The next step in the process for the building of a new facility will take place Nov. 30, when the County Planning Commission is scheduled to hold a public hearing on the matter. One issue will be whether the facility’s location near the Saudi Academy violates county “drug-free school zone” ordinances. If the facility is approved, New Horizon’s project manager Frank Roberts said construction is scheduled to start in the spring of 2008 and be completed in spring 2009.