The Breakthrough: Hopelessness and Exploitation Inside Homes for Mentally Ill

In the 1960s, New York began to clear out its scandal-ridden psychiatric hospitals. In their place, a new system emerged. Thousands of mentally ill New Yorkers moved into “adult homes,” large apartment complexes concentrated mostly in New York City and its surrounding suburbs. The homes were meant to provide a safer, more humane alternative to the hospitals; they were closer to where many of the patients lived, and promised modest psychiatric care and other services.

But decades later, that grand vision had devolved into something that looked more like a nightmare.

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In 2001, New York Times metro reporter Cliff Levy spent a year investigating conditions of the homes. He found that more than 1,000 people died in a six-year period. Some threw themselves off of rooftops. Others succumbed to extreme heat, only to be found days later, decomposing in fetid rooms. He found that the homes were often staffed by unqualified workers paid a pittance to look after a population in desperate need.

Today, Cliff is a deputy managing editor at the Times. He has joined us on this episode of The Breakthrough to discuss the 2001 series, “Broken Homes.”

He describes how he developed his own novel way of obtaining records of deaths in the facilities, and how he tracked down former workers who detailed schemes invented by the home’s operators to maximize profits. He tells us how he made cold call after cold call to reach the relatives of dead residents.

“It’s exhausting, and it’s really depressing,” Levy said in describing the effort. “And you ask yourself, like, ‘Maybe I’m just wasting my time.’ But then, at some point, you reach someone.”

The stories helped prompt a class-action lawsuit, which led to a federal court order requiring New York state’s Department of Health to move as many as 4,000 mentally ill residents into their own apartments, where they can live more independently with individualized services.

ProPublica is now examining that transition and the effort to improve conditions at the homes. Thus far, the state’s progress has been slow and controversial:

Earlier this summer, we reported that the Department of Health is behind in its deadlines to move the residents. We learned that a federal judge has accused the state of trying to evade the regulations at the heart of his order by colluding with industry. We spent parts of several weeks at a home called Oceanview Manor in Coney Island, where residents wander around outside the facility drinking malt liquor, begging for change and eating from garbage cans, looking ill and unkempt. Workers seemed outmatched, and the home’s owners declined to be interviewed.

We are looking to continue our reporting on this subject.

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