I am climbing the stairs to the Green Door, and quite frankly I am nervous. The Green Door is a community mental health program, which has been hailed by just about everyone-Joseph Califano, the National Institute of Mental Health, Rosalynn Carter-as an answer to the dilemma of what to do with mental patients when they are released from hospitals. "The Green Door," said the First Lady, "is a model that shows how services can be tailored to help these people help themselves."
Still, I am apprehensive. Five years ago, the 14-year-old daughter of friends of mine was brutally murdered on the grounds of Madeira girls' school by a patient shorlty after he was released from the Psychiatric Institute of Washington.
I have come to do a story on the Green Door. This is the first of many visits I will make over the next 12 months. Will the patients be hostile, I wonder, or will they be sitting around like drugged zombies? What do you say to someone who is crazy anyway?
The Green Door opened two years ago in the cavernous basement of All Souls' Unitarian Church at the corner of 16th and Harvard Streets, NW. It was started with six patients recruited from St. Elizabeths by three young women who believed the patients could lead dignified and productive lives if given love and responsibility in a family-type community setting rather than being treated like children in a large institution. Institutions, they maintained, need patients more than patients need institutions.
The idea that mental hospitals are bad for patients is not new, however. Fifteen years ago the United States began emptying mental institutions with the goal of reintegrating patients into the community. Indeed, with the help of psychotropic drugs, the wards have been reduced by two-thirds.In theory, there is little disagreement. "Deinstitutionalization," as it is called, is an effective and humane mental health policy. In practice, however, most experts view it as a national scandal.
The problem is that mental institution, under pressure to cut budgets and empty wards, have dumped people on a society with inadequate aftercare provisions.Victims of chronic mental illness simply cannot provide for their own needs-food, shelter, work, medicine, friends, recreation-without strong community backing.
Without support many of them end up in a sleazy flophouse or a single occupancy hotel, or they may live in foster or group homes, many of which are unlicensed. Others exchange life in one bleak institution for existence in an equally depressing nursing home. More often than not they are forced back to the shelter of the hospital. Almost 70 percent of discharged patients from state and county mental hospitals return within a year, according to NIMH (even patients for whom hospitalization is one-timed event-an estimated one-third of those admitted-are fragile and need help readjusting to the community).
In addition to poor after-care services, released mental patients also have to face public prejudice, which, largely due to "dumping" is increasing. With the staggering escalation of health care costs, and the country in the grips of Proposition 13, experts fear discrimination against the mentally ill will continue.
The Greeks believed emotional derangement was a divine blessing to be treated with awe. In the Middle Ages, it was symptomatic of demonic possession to be cured with exorcism or death. Today, we believe mental illness is caused by childhood environment or chemical imbalance, and we treat it with drugs and or psychotherapy. Insanity is no longer thought to be the work of God or the devil, but prejudice persists. We fear, sometimes justifiedly, that someone who is mentally disturbed will suddenly go berserk and turn our well-ordered world into a chaotic nightmare.
But the idea that the mentally disabled are crime prone is fanciful according to most experts, including Dr. Saleem Shah, director of the Center for the Studies of Crime and Delinquency at the National Institute of Mental Health. "The key factor in crime rates," says Shah, "is not mental illness but prior arrests." He points to a NIMH study published last October comparing the arrest rates for violent crimes of ex-offenders, ex-mental patients and the general public. It showed that an ex-mental patient is no more likely to commit a violent crime than anyone else. The arrest rate for ex-offenders, however, was 29 times higher than the other categories.
For the mentally ill who cannot afford private treatment, Washington is a particularly dismal city. It's too early to know if Mayor Marion Barry's administration's record on mental health will be any better than his predecessors. Many believe the Department of Human Resources is paralyzed in bureaucratic red tape, a paralysis Barry has vowed to relieve. But the main problem of mental health services in the District, says DHR director Albert P. Russo, is lack of funds and dual jurisdiction.
"The District ought to have total control over its own destiny in terms of funds and budget," says Russo, "and also to have a reasonably equal voice along with other states with respect to representation in Congress."
Washington has the highest concentration of mental health professionals in the world, according to the National Institute of Mental Health. Yet, as Dr. E. Fuller Torrey, formerly of NIMH and now working at St. Elizabeths, says: "In the shadow of the White House and the Capitol live half a million people who have available to them fewer mental health services than exists in probably any major city in the United States."
Despite this critical shortage of services, the annual per capita expenditure for public mental health services in the District is approximately $138, a far higher figure than that of any state. New York spends $34.38 per person annually, according to statistics published by the National Association of State Mental Health Directors. Maryland spends $19.67 and Virginia $13.11.
St. Elizabeths is the only hospital administered by the prestigious National Institute of Mental Health. Istead of being a federal showplace, it lost its accreditation in 1975 when the Joint Commission on the Accreditation of Hospitals cited various deficiencies including poor treatment, rundown facilities and mismanagement.
St. Elizabeths' 1979 operating budget is a whopping $102 million. That is more than 35 states with larger populations spend on their entire public mental health services. In fact, says Harry Schnibbe, executive director of the National Association of Mental Health Directors, St. Elizabeths is probably the best-funded mental health facility in the world. "In Georgia, for example, mental health professionals run-eight hospitals and about 500 community programs on a $75 million budget, and virtually all their facilities are accredited."
St. Elizabeths has been extremely poorly managed, acknowledges Robert Schonfeld, who has a year's leave of absence as the deputy executive officer of NIMH to oversee the reorganization of the hospital. St. Lizabeths is unique. It's been around since before the Civil War. Everything is out of date, as far as management is concerned. It hasn't been run as a business. It's been run like most federal agencies, which is not the way if you want to save money."
Schonfeld is confident that St. Elizabeths will be reaccredited within six months and that, with improved administration, costs can be cut.
In Washington, according to the D.C.. Mental Health Association, some 6,000 people need community-based after care services. Half of them have been discharged from the hospital, the rest are on what is called "convalescent leave," that is, well enough to leave the hospital yet sick enough to require treatment. In addition, there are approximately 2,300 patients resident at St. Elizabeths, half of whom, according to a number of doctors treating them, could be released if there where anywhere for them to go.
"It's a real mess," explained one disillusioned young social worker there."St. Elizabeths is under pressure to discharge people, but if there is nowhere for them to go they are better off in the hospital and then St. Es is criticized."
As it happened, Gail Marker, Ellen McPeake and Judy Tolmach started the Green Door as the result of a class-action suit to give patients at St. Elizabeths the right to treatment in the community under the 1964 Community Mental Health Centers Act. At the time, they were working for the Mental Health Law Project, the Washington public interest firm that brought the 1975 case to court.
"We won the case," recalls Gail Marker, a small, highly charged 33-year-old social worker who is now executive director of the Green Door. "But there weren't any community-based after-care facilities for ex-mental patients in the District, so we decided to start one ourselves."
It may be politically embarrassing for President Carter, who promised to improve life for the mentally handicapped in this country, to have this "mess" in his own backyard. "All this talk about the federal government suing the hell out of the states to accomplish what they haven't been able to accomplish in their own facilities is a big farce," says Harry Schnibbe. Upon coming to office, HEW Secretary Joseph Califano pledged to get accreditation for St. Elizabeths and hand it over to the District of Columbia to administer. But when he recently asked Congress for $55 million to revamp the ill-fated institution, a cry went up. It makes no sense, say his critics, to pour money into new beds at St. Elizabeths when at least one official study indicates that half the patients shouldn't be there.
Meanwhile, the Mental Health Law Project is reintroducing its suit against HEW for failing to comply with the 1975 court ruling to establish aftercare facilities in the District. The administration's action is seen as a betrayal of deinstitutionalization. What if really needed, many people insist, are more Green Doors.
An oasis in a desert, the Green Door itself is hard to criticize. Out of 108 members enrolled in the program last year, only 23 were rehospitalized. Out of that 23, nine dropped out of the program altogether, and 14 returned to the Green Door. Some psychiatrists who believe that only physicians are qualified to supervise the mentally ill, suggest that the staff is young, naive and inexperienced.
"But then, who but the young, the inexperienced and maybe naive would get into a business like the Green Door," jokes Dr. E. Fuller Torrey, who wishes there were more places like it to send his patients. "If they were more worldly, they would be more concerned about making their $50,000 or $75,000 a year."
But if the Green Door itself is not criticized, there is some disagreement as to the role of such places in future mental health care in this country. At one end of the spectrum of medical opinion is someone like Dr. Loren Mosher, chief of the Center for the Study of Schizophrenia at the National Institute of Mental Health and consultant to the Green Door. He believes that all mental institutions, and in particular St. Elizabeths, should be pulled down and replaced with small, less restrictive community-based facilities. Dr. Sigmon Lebestrohn, head of psychiatry at Sibley Memorial Hospital, offers a more conservative view. Deinstitutionalization is a good idea which has gone too far, he believes. The problem lies with zealous young civil rights lawyers who pay more attention to getting people out of hospitals than to their medical needs. "State mental hospitals have been the targets of undue criticism," he says. "There is no doubt in my mind whatsoever that certain types of mental illness require long-term institutional care."
It took $60,000 worth of grants from private foundations to get the Green Door going. Unlike many aftercare programs for the mentally ill, it is nonprofit. Last October, in recognition of its success, St. Elizabeths gave the Green Door a $250,000 service contract, that will allow it to enroll more people. "What we really need is a new building for our clubhouse," says Gail Marker. "We are bursting out of the church." The Green Door is negotiating to buy the old Werlich mansion at 16th and Corcoran Streets, NW, but its prospects are not good. Money is always a problem.
Gail Marker recalls the pioneer days when the founders were trying to make the dream of the Green Door a reality. "We knocked on the doors of 24 churches before we found one that would rent to us. They didn't want crazy people running around upsetting the congregation." She shrugs her shoulders and asks with a bitter laugh: "How would you like to have an ex-mental patient living next door?"
The 90 Green Door members-they are called members rather than patients-are no ordinary middle class neurotics. Ninety percent of them have been diagnosed as schizophrenics, a loose term that covers a range of symptoms including inability to distinguish between reality and fantasy, paranoia and a tendecy to hallucinate. With the exception of four patients recently referred by private psychiatrists, the members are all from St. Elizabeths. Their lives until now have been spent in and out of hospitals.
A third of the group live in six apartments, which are leased by the Green Door and rented to their members. Most of the rest live in foster homes, in a group home or with their families. A few still sleep at St. Elizabeths. This month the Green Door opened its first traditional housing unit on Lamont Street NW, for six members who are well enough to leave the hospital but not ready to cope with apartment living.
I am greeted at the top of the stairs by a large, pleasant-looking woman who smiles and asks me to sign in. Is she a staff member of a crazy person? I don't know, and I am afraid to ask. To my surprise, the atmoshpere is cheery, informal; no closed doors. People are laughing-even joking!
It is 9 a.m. and the members are assembling to organize the day's chores. It's the members' clubhouse, insist the staff; they are responsible for running it.
"To begin with there are three letters which need answering for tax-deductible contributions. Someone should call the trustees and remind them about the meeting next week, and we should go to the bank," says Beverly Russau, a social worker with the clerical unit who sometimes wears her hair in a demure braid and sometimes in an afro.
It is hard to tell who is staff and who isn't, a feature which distinguishes a good therapeutic atmosphere from a bad one, according to Dr. Maxwell Jones, a British experth on the subject. He maintains that authority figures, like doctors in white coats, are not the best people to help schizophrenics. Jones developed his theories while running an English mental institution during World War II that had no staff. He discovered that not only could the patients help run the hospital, they thrived under the responsibility.
"I'll do the letters," volunteers Laura Donovan, whose name, as well as several others in this article, has been changed. She is a neatly dressed middle-aged Irish woman with sad eyes and bitten fingernails. Of all the members I was to meet there, she appeared the most normal. But as the Green Door was to teach me, appearances can be deceptive. She openly described the terrifying postpartum depression that struck her after the birth of her last baby, causing her out-of-work alcoholic husband to put their other childredn in the care of his mother and commit her to a mental institution. "We also have a visitor," says Beverly, introducing me. "Would anyone like to show her around?"
A heavy-set man of about 35 with thick graying hair and a way of not looking at you when he speaks, raises his hand. The alcohol, which John O'Brian now claims he has under control, has taken its toll on his mind and his once handsome looks. He is convinced he looks like TV's Incredible Hulk.
"I'm hurt when people laugh," he says, "expecially when I got on a bus and people stare and teen-agers start making jokes."
Like many at the Green Door, he appears lethargic and slow to take in what is being said. This, I later discover, is partly caused by the tranquilizing drugs he takes three times a day to control depression. His dosage, and that of other members on medication, is supervised by physicians at St. Elizabeths. Many of the members are oversedated, according to some staff people. Consequently, they fall asleep frequently.
"Altogether I was at St. E's six or seven times. It was pretty horrible," John recalls, nervously running reddened hands through his thatch of hair. "The staff was very impersonal. Once I was on the telephone and they snatched it out of my hands and hung up."
At the Green Door, where his skill with an ancient mimeograph machine makes him indispensable to the clerical unit, he finds the attitude of the staff warm and friendly.
"I always try to come on time," he says. "That used to be a big problem on some jobs I had."
On the way to the kitchen, we collide with an emaciated unshaven middle-aged man in grease-stained brown trousers. He is holding an ashtray in front of him at arm's length. Terrified, he flattens himself against the wall, his eyes fixed at a point on the ceiling. This is George Templeton, a newly arrived member. I decide to observe him.
"Hello," I say. He turns, stomps away, muttering: "I'm a beggar and a bum . . . I am going to burn in hell."
I wonder if the Green Door will produce any change in this unhappy creature, who first entered an institution, an orphanage, at age three because nobody wanted him.
The members of the kitchen unit have just returned from the Giant food store on Columbia Road NW where they have been shopping for lunch. They will prepare and serve the meal in the adjacent dining room at noon sharp. An elderly woman wearing a large green apron over her pale orange dress is painstakingly chopping celery for the macaroni salad. An artificial flower matching her dress is tucked into her reddish hair. Ruth Parker is a lesson to everyone who meets her. How, they ask, can a woman who has spent 40 years in a mental institution attain the capacity to enjoy the small things in life when those who haven't been subjected to that dehumanizing experience can't? Ruth's memories of St. Elizabeths are of the flower gardens and the piano she was occasionally allowed to play.
"I was 14 years old," she says, recalling when she was first committed. "I got desperate and shouted out of the window at midnight, "Nobody loves me! Nobody loves me!'" (Her mother died when she was five and her father left for Arizona.) "I woke up the neighbors and they went out and got a petition and put me in an institution."
Ruth writes poetry which is published in the monthly Green Door newspaper and is learning sign language from two volunteers from Madeira School to enable her to communicate with some deaf at St. Elizabeths.
It's fine by us if youd do a story about the Green Door, but you should clear it with Gus, the membership chairman," says Ellen McPeake, the administrative director, who is scraping purple paint off the front of a store on 18th Street that the Green Door is renting with the idea of opening up a thrift store.
The Green Door program stresses decision-making because most patients are conditioned in hospitals to avoid taking responsibility.
As one of the six original members of the Green Door who helped set up and plan the day program in the basement of All Souls' Unitarian Church, Gus Monroe is a respected figure. He is a tall 38-year-old black man who laughs a lot without being embarrassed that one of his front teeth is missing. He has been at St. Elizabeths on and off since becoming ill in 1959. "It was depression-nervousness," he says, leaning back on the couch in the Green Door lounge with his hands behind his head. "I felt nobody cared for me. I felt a total loss."
Now gus works as a utility man at the local Giant, which he likes because everyone is kind to him. "I still get depressed sometimes," he admits, but now he shares a Green Door apartment with three other members who cheer him up.
Gus raises no objections to the story idea.
Eleven days later Beverly and Judy Carter, another social worker, are leaving in the Green Door van for St. Elizabeths to pick up Jeff Haller and Janet Shaw and install them in apartments. They have been coming to the Green Door from the hospital every day by bus. Most members live on SSI (Supplementary Security Income) of $170 a month, which doesn't leave much at the end of the month after rent, utilities, groceries and bus fares.
Janet is sitting on her bed in the women's ward with a large white chrysanthemum in her hair. Her bags are half-packed. "I can't believe it. Am I really leaving?" she greets Beverly. A scrawny woman in an unbuttoned washed-out print house dress doesn't want Janet to leave. She babbles angrily, plucking pathetically at her arm.
"I would have thought you would have been ready," jokes Beverly, hugging her as she puts the remaining clothes in the bag. Though Janet has talked about leaving St. Elizabeths since the first of her five commitments six years ago, her half-packed bags suggest a reluctance to leave this enormous red brick institution with bars at the windows and locks on the doors. Insanity, after all, means you don't have to make decisions. You don't have to got to the bank, take a bus, work a pay phone, go shopping, talk to people, or even flush a toilet.
If Jeff has second thoughts about leaving the security of the hospital, he is not saying. A huge grin lights up his face, and his belongings are stuffed into a green plastic leaf bag. He has been ashamed to be here ever since he was caught during an hallucination scaling the Navy Yard fence. At 25, he feels humiliated to be in this ward of lost old men who rock back and forth pulling faces, or pace up and down clutching their crotches.
"I consider being in a hospital a big stumbling block in my life," he says. "I got this girl friend, but I was ashamed to tell her where I was. I didn't call for three months, then I told her I was out of town. I thought if she knew, I would lose her."
Three weeks later, before lunch members gather in the lounge for the work awareness meeting, a discussion of the do's and don'ts of finding a job and keeping it.
A main concern of the Green Door program is employment. Since people who have been in an institution over a long period of time lack skills, references, opportunities and selfconfidence, the Green Door has an ingenious approach.
Felcia Lightfoot, the Green Door job coordinator, knocks on the doors of Washington businesses requesting a three-to-six-month part-time entry level job for a Green Door member-a TEP (Transitional Employment Program) it is called. If the production level isn't met, she tells the employer, who is usually reluctant to hire former mental patients, she guarantees that she, another staffer or a member trained for the work will stand in.
When Felicia first approached Ike Jackson, warehouse manager at Drug Fair, with her pitch, he was reluctant. Ex-mental patients brought their problems to the job and he had enough already with the 200 employes under him. But the personnel manager was anxious to try.
"I was amazed," says Jackson, who has since given 15 TEPs to Green Door members, including Gus Monroe, and has promoted two members to full-time positions. "Their attitude to the job is great because it means so much to them, and absenteeism is practically zero-much lower than average." Problems on the job are ironed out with the social worker. Last year, 30 Green Door members had full-or part-time jobs in more than a dozen participating businesses. They brought in $29,000.
Today apathy pervades the work awarness meeting-the kind of lethargy learned by people who have failed so many times they never want to try again. Some members are sleeping; others stare out of the window vacantly. Three members, including Jeff, are scheduled for job interviews next week. With a staff member playing the role of boss, they rehearse for the group, which offers criticisms, advice, and most important, encouragement.
"Jeff should take off his hat for the interview," suggests Iris Medgers, a pint-sized black woman dressed in blue jeans who loves to hug people.
"Don't flash too much," another member suggests. "You are not supposed to dress better than people doing the interview." Everyone laughs, for some outfits worn by Green Door members are more than "flashy." John Reston, for exmple, a tiny cheery man who is the backbone of the kitchen unit, used to wear an enormous shaggy lion's wig. To my surprise George Templeton raises his hand to speak. He has commandeered the only rocking chair in the lounge and is rocking back and forth, sucking on the stem of his pipe. "Ask questions," he mutters, "that's what you must do."
Members who have jobs are encouraged to tell others about them. With quiet pride, Laura Donovan says that she is beginning work next week at a large department store. Everyone applauds and congratulates her.
Seven Green Door volunteers are gathered at Patty Davidge's house in Northwest Washington to meet Dr. Loren Mosher, who will explain what it takes work with the mentally handicapped. Without volunteers the Green Door would not function, says Patty, a tall middle-aged woman with short cropped graying hair who coordinates the program. Volunteers introduce the community to members, work in the thrift store, teach classes in art, music, dance, language and reading and organize weekend outings.
Mosher, a small man who exudes warmth with a touch of arrogance, introduces himself as "the shrink around town who has the reputation of being anti-psychiatry."
"One of the good things about the Green Door." he assures the assembled volunteers, "is that it is not run by psychiatrists . . .
"Hospitals," he continues, "are terrible places where people are systematically taught not to function." Moreover, "drugs are abused."
Doctors are beginning to see people with an irreversible condition called "tardive dyskinesia," an involuntary twitching of the face and tongue as well as some parts of the body. "Studies show that it can occur in up to 40 percent of people who have been on phenothiazines and other major tranqailizers," he says.
I recalled a work awareness meeting at which Ted Samuels, a gentle soft-spoken man,was telling what he had learned before being ready for a job. "I have to learn to control my face," he said, "because it upsets people."
Tardive dyskinesia, says Mosher, is irreversible. "People should be substituted for pills and places like the Green Doors for hospitals," he says, adding that it is nonsense to believe that people have to be full of tranquilizers before leaving a hospital.
"To be a good volunteer you have to understand where that person is and have the ability to empathize without being judgmental," continues Dr. Mosher, "I know of no worse onslaught to the self-esteem than the process of going crazy and being put in a hospital. Mentally ill people have a different set of rules," he explains, "and working with them can be draining and demanding. You have to be tough and have a lot of ego strength."
A volunteer asks what you say to someone like Bogdan when he says his enemies are dropping poison in his eyes or "I'm going to rape two women next week." "Do you agree, or do you say 'Bull-Bogdan'?'" Bogdan is a mysterious character, committed to St. Elizabeths while demonstrating outside an Eastern European embassy in Washington. A small sandy-haired man with a goatee, he paces restlessly from room to room at the Green Door in a black overcoat, firmly convinced he is commander-in-chief of the U.S. Armed Forces.
"Bogdan's reality is what he believes it is," explains Mosher. "You can sympathize, but point out it's not your reality. To tell the truth," he adds, "I dont relate to what they can't do. Relate to what they can the traditional psychiatirc symptoms. Focus much more on social competence and social disability. You can't relate to what they can't do. Relate to what they can do."
The White House is visiting the Green Door! Rosalynn Carter has just left the local supermarket on Columbia Road where she has been shopping with members and is on her way to the church in the van. Tomorrow she is giving a press conference announcing the results of the President's Commission on Mental Health, of which she is honorary chairman, and needs film footage to illustrate the type of community-based mental health centers the commission is advocating. ABC plans to use it on "Good Morning America." Secret Service agents are everywhere.
An ABC technician makes the mistake of helping himself to coffee from Ralph Lander's coffee machine. As a member of the Green Door's maintenance unit, serving coffee is his job, and he is furious, especially because the coffee slopped on the table.
"Never mind, Ralph. He didn't know," comforts Ellen McPeake.
"She's just coming through the door," someone whispers, "stand back." Suddenly, there is a commotion. Two tall men dressed in raincoats converge on Laura Donovan, where she is sitting at her desk in a newly pressed navy blue and white polka dot dress excitedly waiting to meet the first lady. Without warning, they whisk this sad little woman down the stairs and out of the building.
The Secret Service had done a through security check on everyone at the Green Door. They too suspected that people with a history of mental illness could be violent and didn't want to take any risks. Laura Donovan's name was discovered to have several shoplifting charges pending against it in Massachusetts, New York and Maryland. That morning the Metropolitan Police took out a warrant for her arrest and swept her away a few seconds before Mrs. Carter mounted the stairs. "I wish they could have let us know earlier or waited until after Mrs. Carter's visit," said one shocked staff member. "Laura must have been so humiliated, and it is so upsetting for everyone else."
Apart from this incident, the visit in an enormous success. Rosalynn Carter seems at ease with the Green Door members and they with her. Tactfully she questions them on how long they have been there and where they were before. Turning to Jean Anderson, one of the Three members sitting with her at the lunch table, she gently inquires how Jean happened to find herself at St. Elizabeths. Jean explains that she fell to pieces after her 14-year-old daughter died of Leukemia. "My fater died of leukemia too," Mrs. Carter says, "and I haven't gotten over it either."
As Mrs. Carter receives an honorary membership to the Green Door after lunch, George, dressed in an unusually clean pair of trousers, spontaneously pulls out a harmonica from his pocket and strikes up "For She's a Jolly Good Fellow." Tear well in Rosalynn Carter's eyes. Afterwards, as other members gather round to congratulate George on his number, he beams with pleasure. He is no longer a "beggar and a bum" but a momentary hero in the eyes of his surrogate family.
Only Bogdan is missing. He was purposely kept away. As "commander-in-chief of the U.S. Forces" threatened with imminent extermination by enemies in high places, a visit by the White House threatened to confirm his wildest paranoia.
Jeff has an interview at Giant Food, one of the first companies along with Drug Fair and McDonald's to give Green Door members a break. Leonard, who has shaved his beard to comply with regulations at McDonald's where he was on a TEP with a member last week, accompanies him to the personnel office in Rockville.
The personnel officer greets him kindly as he enters the trailer which serves as an office in the middle of the parking lot. "What kind of work have you done in the past?" she asks.
"My first job was when I was 11 years old delivering papers," he replies, his hands working nervously in his lap. "When I was 16 or 17 I had a summer job with the YMCA, being counselor for little kids. Then in 1974, when I was 24, I worked for them again. I was a clerk and cashier and handled valuables for people coming to YMCA."
"The job we have in mind for you," says the personnel officer after asking Jeff about the Thorazine he takes three times a day, "is bagging groceries at the Van Ness store. It's an important job because you are the last person the customer sees before leaving the store." She adds that under Giant regulations, he will be required to shave his beard and cut his hair.
"That's OK with me," says Jeff. But on the way home in the car he begins to worry. Where exactly is the Van Ness store? How will he get to it from his apartment?
Two weeks later Jeff is sitting in the lounge. He has been barbered but he is not so sure about the job. "I don't feel I'm quite ready for it. Next week I will go for an interview at Drug Fair.I might even go to South Carolina instead."
"Some members like Jeff are so capable and intelligent and yet they don't believe they can do anything," explains Judy Tolmach, "while others have inflated ideas of what they are capable of doing. In order to be ready for a job, you have to be prepared to fail, to accept that your are human."
Like loving parents with ambitions for their children, the Green Door staff expects the members to do better next time. Many do. Others may never be well enough to hold down a job. No one at the Green Door thinks in terms of cure.
"Chronic schizophrenia is a life-long disability, just like any other handicap," explains Gail. "The reason so many of our members have trouble functioning is not because of the schizophrenia per se, but because of environmental factors. We can't do anything about the schizophrenia, but we can alter the environmental factors to reduce disability."
Three weeks later the staff is holding its weekly meeting. The center is open to members four days a week from nine to three, but Tuesdays is the day the staff members try to catch up on administrative matters.
These are no ordinary nine-to-five professionals who leave problems at the office. They are 24-hour-a-day "burn-out" candidates who are on call seven days a week to cope with crisis, which is part of life behind the Green Door.
Gail voices her continual anxiety about money. The greatest threat to the survival of the Green Door, she explains, is the District and federal governments' commitment to short-time financing for people with long-term disabilities. The reason for this, a St. Elizabeths official says, is because Congress appropriates money on an annual basis and they can't plan ahead.
"We have people at the Green Door for whom we have only received payment for three months. They have been with us for two years, and we will probably continue to carry them for another five. It is ridiculous to expect people who have been in and out of hospitals for 15 years to be cured in three months," she says indignantly.
Leonard complains that the morale in the kitchen was bad last week. He attributes this to the time he spent on job-training for members. The Green Door needs more staff. But what really bothers the group today is Laura. What to do about her?
Laura is awaiting trial on the shoplifting charges. Meanwhile the department store where she was working called yesterday to say she has been caught red-handed stealing three watches. Last week Jane Stebbings, one of the Green Door members with whom she is living reported that her checkbook was missing as well as some money.
The staff agree it is impossible for Laura to stay in the Green Door apartment, or even in the program itself, where there are certain ground rules-no active use of drugs or alcohol, no criminal acts and no violent behavior.
But on the matter of what to do with Laura, there is disagreement. Is Laura sick, or is she a criminal? What is the Green Door's responsibility? The staff is clearly shaken, especially since Laura hadn't told St. Elizabeths or the Green Door of her past.
Finally, they decide to pack her belongings and wait until she returns home that eventing and let her decide what she wants to do.
"Guess what!" says Gail, breaking the tension. "I have news for you all. George has bought himself a new suit at the thrift store!" Everyone laughs and applauds.
Sometimes it seems as though the vitality of the Green Door is fueled on crisis and its phenomenal expansion over the last two year. "What happens," I ask Gail, "when you've reached your projected 150 members next year and you've moved out of the church into your own building?"
"Oh, but there are so many things we need to do," she exclaims and starts to list them-a cafe out in the community, an evening program, a pool table, a banquet to hono businessmen who have employes Green Members . . ."If we don't have new ideas, then we have lost everything."
It is a beautiful day. Ruth has taken up jogging. Dressed in the latest fashion in running shorts-navy blue with white piping round the leg-she takes off into the park with Leonard and the other members who are part of an early morning exercise group. Iris throws her arms around me and with her insatiable curiosity wants to know where I have been all week. "Are you staying for lunch today? You have to get a ticket if your are. Only guests go free," she tells me.
Truly, I conclude, I feel at home at the Green Door. Former mental patients are only people after all. I would welcome any one of them as a neighbor.
Last night Laura was informed she could no longer be a member of the Green Door. She cried. She decided to go back to St. Elizabeths where she says she hopes to find out what makes her steal.
Sixteen days later, Gail Marker and I are sitting in the small rough brick yard at the back of the thrift store. "Who is independent anyway?" she asks. "You and I have friends, family and job.We are dependent on them and, if we weren't, we'd be pretty poor sorts of humans beings. Most of our members have never had that."
Inside, John, Iris, George and several other members are unpacking boxes and putting price tags on the items for sale. The thrift store is now making a small profit. True, none of the Green Doors are going to turn into great American success stories and make money. Yet, within the framework of their mental handicap they have traveled further on a rougher road than most people I know.
George, who is now the proud possessor of a key to the thrift store and opens up every morning, approaches Gail with a pair of gray trousers in his hand. "There's a hole here," he says, pointing to a small rip in the seat. "Can you mend it for me, then wash the trousers?" "OK, George" Gail says, "But I can't guarantee my sewing."
When George leaves she turns to me and says: "There's a launderette right next door. Next month we'll get him in there."
P.S. After this article was completed, George Templeton had a job-a three week temporary assignment working in the warehouse of Drug Fair in Springfield, Va. To get there he took two buses and the subway. "I made more than $100," he says proudly. It was the first paycheck of his 49 years . CAPTION: Cover photo, The cover photograph of the Green Door is by Mimi Levine.; Picture 1, Pearl Anderson and Sam Redman, both Green Door members, dance in an informal recreation period.; Pictures 2 through 5, A major concern of the Green Door is helping members toward full-time employment and independent living. Opposite, from top: Assistant job developer Barbara Luther counsels Green Door member Connie Jones on how to fill out a job application. The new thrift store on 18th Street near Columbia Road gets a facelift and cleanup before opening, and once in business Connie Jones sets up a special sales stand outside the shop on a balmy day. Moving into his new Green Door-sponsored apartment, Nel Morrisey puts his bedframe together.; Picture 6, St. Elizabeths recreational therapist Julia Graham, above left, leads a Green Door member in a weekly group dance session on the All Souls' Unitarian Church sundeck.; Pictures 7 and 8, Rosalynn Carter helps out in the Green Door kitchen, top. At the Christmas party are, from left, founder Gail Marker, trustee Gordon Peterson, and member George Templeton.; Picture 9, Job developer Felicia Lightfoot has a surprise for Green Door founding member Gus Monroe: he just landed a job. Photographs by Mimi Levine