A HOME Team Helping the Homeless who Struggle with Mental Illness

A Los Angeles County Department of Mental Health (DMH) Outreach Team member walks the streets with colleagues from the Los Angeles Homeless Services Authority (LAHSA), seeking to help people experiencing homelessness while struggling with mental illness.

Determined to help those with severe mental illness break the cycle of homelessness, incarceration and hospitalization, the Board of Supervisors unanimously approved a motion by Supervisors Kathryn Barger and Mark Ridley-Thomas to launch a pilot program that would enhance the Los Angeles County Department of Mental Health (DMH)’s ability to care for and treat people living on the streets.

“Even before the pandemic, three of our homeless neighbors have been dying every day. It is all the more urgent that we intervene humanely to prevent people from passively decaying on the streets as a result of severe and untreated mental illness,” Supervisor Ridley-Thomas said. “This motion will allow LA County’s Department of Mental Health to immediately deploy their Homeless Outreach Mobile Engagement (HOME) teams to pilot street-based treatment and clinical oversight to help our most vulnerable residents get on the path to recovery.”

“This is another important tool in our ongoing effort to serve those suffering with mental health issues who fall into chronic homelessness,” Supervisor Barger said. “We remain dedicated to address the needs of these vulnerable individuals and must work together to find new solutions that improve and enhance the treatment options we provide for people experiencing homelessness.”

HOME teams include mental health psychiatrists and counselors, psychiatric nurses and social workers, substance abuse counselors, medical caseworkers, and people who have experienced homelessness. These teams go out into the streets to provide intensive outreach and engagement as well as access to essential resources including mental health treatment and service-enriched housing.

Currently, the HOME teams engage and  assess  homeless individuals who have such severe mental health issues that they are gravely disabled and cannot care for themselves. They conduct voluntary evaluations, provide voluntary crisis intervention services and, when necessary, place individuals on a 72-hour hold for involuntary evaluation and treatment if they are in imminent danger.

LA County Department of Mental Health Director Dr. Jonathan Sherin (in a blue “We Rise” shirt) out in the field with DMH Outreach Teams.

In the proposed pilot, HOME teams have the ability to apply for an outpatient conservatorship for homeless individuals who are not in imminent danger but are gravely disabled and refusing voluntary mental health services. If an individual is awaiting a conservatorship hearing while in the hospital, the HOME team will work, as needed, with the hospital treatment team to determine if on-going hospitalization is necessary.

Concurrent with any conservatorship recommendation, DMH will identify appropriate housing or a mental health treatment bed as well as a dedicated treatment team for the prospective conservatee.

“Our department’s countywide, multidisciplinary HOME teams interact on a daily basis with individuals whose lives have been shattered by serious mental illness,” said Dr. Jonathan Sherin, Director of the Department of Mental Health, who has laid out a series of proposals for disrupting the cycle of chronic homeless in the County. “These clients are unable to make good decisions about their care. It is unjust and inhumane to allow our clients to be exposed to the streets or jails when help is available. This pilot program would provide our HOME teams additional engagement tools, including ‘outpatient conservatorship’ to ensure a client receives treatment, without having to rely on hospitalization.”