Mental health troubles dog the chronically homeless

Darrell Sefeldt flashes a black, toothless grin as he explains how the planet Mars has taken root in his big toe. He sits bundled in plastic on a sunny fall morning along the bank of Fountain Creek. The red planet, the 47-year-old homeless man says in all seriousness, has caused him years of throbbing pain and sprouting vegetation in his foot.

By his account, he's drifted for a decade, avoiding people and "noise" and listening to "conversations" while alone in the woods.

He balks at mental health treatment, dismissing his delusions as something to be solved with a diet of double cheeseburgers, breakfast burritos and pecan snacks.

Up the litter-strewn creek, Chris Cannoles sits in a lawn chair and touts the virtues of marijuana for medicating his bipolar disorder and other mental problems.

"I used to go to Pikes Peak Mental Health," he said. "When my Medicaid ran out, I couldn't go back."

As many as two-thirds of the 400 chronically homeless people wandering the streets of Colorado Springs are said to suffer severe mental illnesses, said Bob Holmes of Homeward Pikes Peak. Many of them turn to drugs and alcohol to cope.

Yet, as Cannoles discovered, access to free or subsidized mental health treatment is difficult. Without it, however, even the best of efforts to eradicate homelessness will leave plenty of cases in the cold, homeless advocates say.

Pikes Peak Mental Health, which provides the bulk of the region's mental health services, has watched state funding for the uninsured and homeless fall sharply over the years, said Kelly Phillips-Henry, chief operating officer for Pikes Peak Behavioral Health Group, the parent organization for the group. In 2008, the group received funding to treat 876 uninsured patients.

Fundraising helps them see more, but the need severely outpaces demand. Help is left for those who meet stringent criteria, such as a suicide attempt.

Dee Drake is project director for The Collaborative, a group that coordinates the region's mental health resources for the homeless and uninsured. She estimates there is a capacity among all local organizations to give about 100 of the chronically homeless comprehensive mental health care. That doesn't include the long and usually exhaustive efforts to seek them out, get to know them and earn enough trust to persuade them to get care.

For those who want treatment, the system is fragmented, and services are often hard to find or limited. Open Bible, a Christian charity, provides a part-time psychiatrist, for example, but the group is ill-equipped for severe cases, Drake said. Other agencies, such as the Harbor House, provide substance abuse services but no plan for the mental health problems that substance abuse has been masking.

Dan Molner is a social worker at The Lighthouse, a detox center and acute mental illness inpatient facility. A 30-year veteran in mental health, he recalls a time when the mentally ill could access weeks of inpatient therapy.

Now the usual course is a 72-hour window to stabilize a person with extreme episodes before releasing them.

For the homeless, that usually means a return to the streets as soon as the shouting or ranting stops. In rare cases, people have returned to The Lighthouse three times in a 24-hour period.

As advocates and care providers wrestle with the complexities of the mind and its impact on homelessness, people such as Sefeldt are left to deal with their demons.

From his perch by Fountain Creek, he keeps his eye on a pie pan filled with eggnog next to his bed under a leafless Russian olive, a lure for the mice that live in a patch of brambles nearby. He looks on silently and smiles as one ventures out to feed.