District Women Want Mental Health Clinic to Stay Open

The conference room in the D.C. Community Services Agency doesn't offer much -- just some squeaky chairs and mismatched metal filing cabinets -- but every Thursday morning at 10:30, it contains what Sylvia Adegoke calls her "lifeline." This Southeast Washington spot is where Adegoke, 55, has met with her mental health support group every week for three years.

"Anyone have a mirror?" she asks one recent Thursday, elbow-deep in her purse. The ladies are supposed to look in mirrors as they say their affirmations.

"I am a good and beautiful person inside and out, and I deserve the best," Adegoke says to begin her weekly check-in. "I'm still fighting to keep D.C. CSA open."

Adegoke and the three other women in attendance on April 30 -- Cassandra Matthews, Sherri Peters and Angela Reid -- have come here since 2006 to share stories about their mental illnesses, no-good boyfriends, tough financial situations and other challenges. Now they are fighting to keep open the clinic that brought them together.

This branch of CSA, on Alabama Avenue, is set to close July 1 as part of the city's move to privatize mental health services. The D.C. Department of Mental Health, or DMH, is closing six of its clinics and sending about 4,000 clients to 27 private health-care providers by March 31. According to an audit commissioned by the city last year, the transition will save the city about $14 million annually because the private clinics are more efficient. Since the support group members will most likely not end up with the same provider, the women have only a few sessions left together.

To keep the clinic open, Adegoke has rallied on the steps of the John A. Wilson Building and testified in front of a D.C. Council committee.

"You have more programs for dogs and cats than you do for human beings," Adegoke said at a March 30 meeting where the DMH budget was reviewed.

Adegoke gets help at CSA for her bipolar disorder, also known as manic depression, an illness marked by shifts in mood, energy and the ability to carry out daily tasks. She suffered her first breakdown in her 30s, when she refused to leave her bedroom, bathe, eat or do her hair. And now she fears she will also lose a receptionist job that she has held since 2006 through another DMH program.

She refused to attend the five events in March to learn about her treatment options ("a waste of time," she says), instead praying that the clinic will stay open. In addition to hosting "provider fairs" and offering counseling, the CSA staff has offered to help affected clients visit private treatment centers where they might continue their care.

Green Door, a nonprofit organization that serves people with conditions such as schizophrenia and bipolar disorder, will absorb 400 clients. Judith Johnson, Green Door's chief executive, says the year-long transition is proceeding smoothly -- a "textbook case" of open communication among providers. Green Door already runs a support group for about eight women, and the organization is willing to start another one if there is demand.

"I think it's going to work just fine," Johnson says. "We need to think like the outside world. I've changed health-care providers, and it's irritating; nobody likes that. But after a couple of months you're fine. I think they will adjust.

"We don't want to think of people as overly fragile here. They're not that different from you and me."

The six women who regularly attend Adegoke's group are "extremely advanced in their ability to cope and do what they need to do," according to Sean Archie, the social worker and administrator who supervises them. The group's goal is to improve attendees' social functioning.

Peters, 46, was so shy and withdrawn when she started attending the weekly meetings that she didn't speak for the first six months. She eventually opened up and now shares about her housing struggles (she relies on disability payments and says she's "one step from homeless") and her weight and food issues. She's now confident enough to go clubbing.

"We were messed up for real," Matthews says. "All of us were bad off."

Matthews, like the other three women at the April 30 meeting, has bipolar disorder. She looks forward to attending the group, especially on weeks when the women get dressed up and go to the movies or celebrate a birthday. Aromatherapy and nutrition specialists have spoken to the women. One week, they all got free pedicures. Without the group, Matthews says, she would be tempted to stay inside for days at a time.

Because she fears using public transportation, Matthews is worried about how she will get to another clinic. She can force herself to take Metro once in a while, but not every week. None of the treatment centers is as close to her Southeast home as the CSA site, which requires her only to take two short bus rides.

The group's last major transition -- the departure of two caseworkers six months ago -- triggered a depressive episode for Peters, who could not attend the group for four weeks. The women will need to choose new case managers and therapists, but they will be able to retain their psychiatrists, according to a DMH spokeswoman.

The women stay in touch between meetings, and they expect to continue their friendships after their clinic closes. So why not keep the group going on their own?

"Even though we're in recovery, we still need help to run the group," Adegoke says. "We need our case managers, our therapists." (Archie, the group supervisor, will be laid off as a result of the privatization.)

For now, the women come to CSA every Thursday to talk about their faith and their grandchildren, and to spill about recent dates. Peters reports that she has signed up to go to a treatment center in the Fort Lincoln neighborhood in Northeast, "just in case." Her case manager told her a women's support group meets there.

Information about the transition to private providers can be found at http://dmh.dc.gov or 202-673-7440.

Comments: saslowr@washpost.com.