Two Flew Over the Cuckoo's Nest

Solange Lambert and Cosmo Salerno can't wait to take their love outside the walls of an adult home on Coney Island. But for now, they have to wait.

Solange has been watching all of this unfold from one side, listening politely with her hands folded and her head cocked, looking a little uncertain. As Shalom speaks to the young man, she gets up quietly and opens the back door to the parking lot, where she looks around for Cosmo. He is sitting on a wooden bench just outside the rec-room window, smoking a pipe. She sits down beside him; he cups her face in his hands and gives her a long kiss, then lights a cigarette for her. She leans her head against his and closes her eyes for a moment. Framed by the window, their heads together, they could be anywhere.

Living in Limbo

Like Solange and Cosmo, Surf Manor and the other adult homes exist in a sort of limbo, both because they're businesses, not hospitals, and because their residents are neither profoundly sick nor wholly well. Originally meant to house elderly or disabled people who could no longer live on their own, in the past three decades, adult homes in New York and many other states have largely replaced psychiatric hospitals as primary residences for the moderately mentally ill.

According to one census, there are about 7,200 psychiatric inpatients in New York at any given time, while 28,000 people are living in adult homes. An estimated 40 percent of all adult-home residents have been diagnosed with a psychiatric illness; at Surf Manor, the number is more like 100 percent. In the mid-1990s, the last time a large federal study was conducted, well over a million people in the United States lived in these facilities, about 25,000 of them in New York State.

"An adult home by definition is really not a bad place," says Davin Robinson of the CQC, the state agency that oversees services for the disabled. For some people who will likely always need a lot of help with basic things like taking their medications on time and even just washing their clothes, she says, adult homes are probably the best option for long-term care.

But for others, Robinson says, especially younger people like Solange, adult homes should function more like halfway houses, a stop between the psychiatric hospital and a return to independent living. "[An adult home] isn't meant to support someone to get a job or have any meaningful life in the community," she says. "For a temporary place, it's certainly better than being in the hospital. But it's just that, a temporary stop-gap." For many fragile people with little money or family support, places like Surf Manor become home for much longer than they might prefer. While there's no good data on the average length of stay in an adult home, some residents say they've ended up stranded in these facilities for months, years, and even decades longer than they had intended.

Technically, though, Solange and Cosmo are free to leave whenever they like, notes Matt Schatzel of the state Office of Mental Health, an agency that is one of the defendants in the DAI suit. "Nothing's preventing the adult-home residents from moving out right now if they want to," he says. "That's really their choice."

Attorney Sherrin, who since 1981 has represented Surf Manor and numerous other adult homes, says, "None of the adult homes are against the idea that people should move into the least restrictive setting that's most appropriate and safe for them. But what they do oppose is just taking people out under the theory that anybody living in an adult home who has mental illness would be better off in the community."

State law currently requires adult-home case managers to help residents who want to move out to do so. But that doesn't seem to be happening in many homes, including Surf Manor, says Jota Borgmann, a staff attorney for MFY Legal Services, which provided co-counsel for the disability advocates. "Adult homes are for-profit businesses, for the most part," she says. "So they are trying to make a profit. It's as if I said to my landlord, 'I want to move out, and you need to find me other housing.' What would be my landlord's motivation to do that?"

Most of Surf Manor's revenue comes from the rent residents pay out of their monthly Supplemental Security Income (SSI) checks, which is usual at for-profit homes; Surf Manor also generates additional money by renting a basement office space to New York Psychotherapy, which provides psychiatric services to many of the residents. Solange and Cosmo each receive $1,368 a month from SSI, and pay $1,190 of it—almost 90 percent—back to the home for room and board, the legal amount set for so-called Level 3 care facilities, the designation that covers virtually all adult homes.

They wind up with only $178 each, which isn't even enough to pay for all the other things—medical co-pays, clothing, and toiletries, for example—that the home isn't obligated to cover.

And it certainly isn't enough to save up to move out, Solange adds. "Most regular apartments want you to give a down payment, first month's rent, security," she explains. "We don't have the money to do that at all." At least they have each other.

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15 comments
Succlo
Succlo

These people need to get a job and move on from their personal problems. It's too easy to drug oneself and sit in a flophouse on SSI.

Lakotawinter
Lakotawinter

OFF OUR MEDS ON PARK AVENUE (True Story) Walked past a tall homeless man near Park Avenue one afternoon. Barefoot, hair like a porcupine, three inches of dirt on clothes. Took a closer look. He was yelling into his CELL PHONE! I stopped a few feet away in shock. HE has a CELL PHONE?! "Oh, hell yeah. Haven't seen my brother in three years. Right. Still lives in the Bronx. Yeah. What do I care about that?" He paced up and down yelling into the phone to the person on the other line. As I passed him I looked carefully at the cell phone. Put my hand over my mouth so he wouldn't see me laugh. It was a hair brush! Damn. It was a life lesson for me. Don't judge people by the way they appear! He was really hurting and obviously alone and scared. I was pissed 'cause he had a cell phone! He turned the mirror on me and made me look at myself. I love NYC! If you stay here long enough you can get a Masters in Life!

Lucy
Lucy

Wow! What a compelling angle on the situation of adult homes. It's hard to consider what's best for the patient while also considering the humanity of the issue. Very illuminating piece.

JK
JK

Holy crap, are these people insane?!??!

Missboo42
Missboo42

True love is so hard to come by these days, it is refreshing to read a story about two people who love each other. I hate the term 'mental illness.' We are all mentally ill to one degree or another. Please don't reply, "Speak for yourself!" The people who think there is nothing wrong with them are the people who have the most problems in life. I do not know one person here in NYC who isn't fighting some sort of emotional trauma on a daily basis. 99% of them would be so much happier with someone in their life. Half their problem is not having someone to share things with. We can go to the Moon (?), build skyscrapers through the clouds, and create the Internet, but we haven't a clue how to make people better without tons of meds. There has to be a cure. If you calculated on a yearly basis how much money was spent on disability and mental health in this country and eliminated 80% of it, we wouldn't have the financial woes we currently suffer from. 'Mental illness' is a crutch for a lot of people. I've seen it my entire adult life. Come back to this couple 5 years from now and give us an update.

HaroldAMaio
HaroldAMaio

Since 2003, they have been in the middle of a huge legal battle between New York State, which supervises privately owned adult homes like Surf Manor, and advocates who say the adult-home system unfairly isolates "the mentally ill" from society

As entertaining as is your "the" mentally ill, it is inaccurate, imprecise. Please say what you mean, those words do not do it.

Harold A. Maiokhmaio@earthlink.net

Solange
Solange

My name is Solange Lambert and this article was about my boyfriend Cosmoand myself. Your comments are extremely hurtful. You say we should get a joband move on with our lives. You have no idea how hard this is to do with no oneto help us in our lives. We both have no family and support.You cant talk about other peoples lives unless you have walked inthere shoes. Also someone who was abused in every way possible from the agesof two to seventeen like myself and just move on.Try living my life for 1 day and see how it feels

Spook
Spook

Why is it that people love New York for shit like this? A Masters in Life? Give me a f'en break. You get insights from mentally ill people on the streets so you love New York?WTF?

Boston2lalaland
Boston2lalaland

We never really do know a persons road. Thanks for sharing this. More so, thank you for having the compassion

JK
JK

It appears you are getting your wish to severely cut federal spending on the mentally ill (http://www.nami.org/Template.c... however, it's not clear to me that cutting some single-digit number of billions is going to cure the financial woes we currently suffer from.

Furthermore, speak for yourself.

JK
JK

I didn't find that entertaining at all, you insensitive clod!

Kristin Wolke
Kristin Wolke

Solange - I just wanted to say that I think you + Cosmo are brave to have someone write a story about your lives... Have you looked into the federal program HPRP (Homelessness Prevention Rapid Rehousing)? I work at the Rescue Mission upstate but still have contacts in the Brooklyn area (I moved up here 3 years ago). Please feel free to contact me via facebook; I may have some info that you could use to get out of that place. The HPRP is a federal program that (once you find an apartment + show that you can afford it after they help you) will pay for your security deposit and up to 3 months rent in advance to your landlord. That will give you and Cosmo additional time to save a little nest egg for future rent, etc. The contact person in NYC is the Assistant Commissioner of the Department of Homeless Services, City of NY. Her name is Eileen Lynch and her email is elynch@dhs.nyc.gov (212-361-7957). I hope this helps you to get out of that "adult home" ASAP. best wishes!!!

HaroldAMaio
HaroldAMaio

"The" mentally ill is not entertaining, no resepectable journalist ought entertain it. As I wrote: "it is inaccurate, imprecise. Please say what you mean, those words do not do it."

Harold

HaroldAMaio
HaroldAMaio

Writers and editors are entertained by the form, or they wouuld not employ it, I am not.

JK
JK

You called it entertaining. I feel like you've stepped over a line here.

 
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