MELISSA BLOCK, HOST:
This is ALL THINGS CONSIDERED from NPR News. I'm Melissa Block.
GUY RAZ, HOST:
And I'm Guy Raz. In the decade since states started to empty their mental hospitals, they've struggled to find housing for the mentally ill. In Florida, assisted-living facilities have become a solution. To work in one, the state offers a special license that takes just a high school diploma and 26 hours of training. That's lower than the state requirements for a beautician.
As Kenny Malone, of member station WLRN, reports now, this solution has created a serious problem for at least one south Florida neighborhood and the cop who patrols it.
TOM MERENDA: There was a stale doughnut in front of me in roll call.
KENNY MALONE, BYLINE: It's about 6 in the morning in Lauderhill, a working-class, south Florida city of 70,000 people. The sun's not up yet.
MERENDA: No. it's still dark out.
MALONE: This is about the time you'd find Officer Tom Merenda, with the Lauderhill P.D., patrolling the Cannon Point neighborhood. Even though the morning is dark and drizzly, Merenda's wearing short shorts with his uniform. His mom says he has nice legs. His colleagues make fun of his chicken legs, but they also make fun of his affection for the characters of Cannon Point.
A figure shuffles up to us in the dark. Merenda smiles.
MERENDA: Top of the morning to you.
UNIDENTIFIED MAN #1: Morning. I like to see the police out here. I've been a police for...
MERENDA: Watch out for the car. Are you retired now?
UNIDENTIFIED MAN #1: I've been working for them for 50 years.
MERENDA: Well, it's about time to take a retirement.
UNIDENTIFIED MAN #1: I've been an inspector for 45 years.
MERENDA: One of our mental-health consumers.
MALONE: It might sound like condescension in Merenda's voice. It's actually compassion derived from some very personal experiences. We'll get to that part of the story later.
First, to understand Tom Merenda, you need to understand this neighborhood. Cannon Point is a one-block stretch packed with the highest concentration of mental health assisted-living facilities in the state. The eight privately run ALFs here try to help the mentally ill keep up with daily medications, get access to regular services and live comfortably. That's the theory, at least.
UNIDENTIFIED WOMAN #1: Nine-one-one, what is your emergency?
MALONE: Police average a call from Cannon Point once every four hours.
UNIDENTIFIED MAN #2: We have a client here...
MALONE: That's 14,000 calls in the past eight years.
UNIDENTIFIED MAN #2: ...a mental health client...
MALONE: Fourteen thousand calls from one city block.
UNIDENTIFIED MAN #2: ...that's threatening to kill herself.
UNIDENTIFIED WOMAN #2: Did he leave on foot?
UNIDENTIFIED WOMAN #3: You said you slit your wrists?
UNIDENTIFIED WOMAN #4: Is he on his medication right now?
MALONE: To make matters worse, a drug-dealing culture has cropped up. Merenda says dealers call the neighborhood U Street. U Street has its own YouTube channel featuring videos of street fights.
(SOUNDBITE OF PEOPLE SHOUTING)
MERENDA: Yes. It all comes with the territory.
MALONE: Tom Merenda polices Cannon Point more than almost anyone else in the Lauderhill P.D. In fact, Merenda's really the only one who wants to patrol it. He points off to a beige, stucco building, the most heavily fined ALF in Florida.
MERENDA: This facility here, Briarwood Manor, has one of our more prominent residents. His name is Steven King. He's not the famous book writer, but he's a famous panhandler. But he's the nicest guy you'll ever meet, except for when he's on crack.
MALONE: To understand just how out of control Cannon Point has become, consider that the following is just one of those 14,000 calls. It's two years ago. Merenda responds to a call that Steven King is holed up in his room.
MERENDA: And a knock on the door. He knows me, I know him. And I say, Steven, Steven, and...
MALONE: Steven lets it fly.
MERENDA: (Beep) you. Get the (beep) out of here. Dirty (beep) pigs. He liked to use the F word a lot.
MALONE: Steven was on a crack binge. He'd stabbed another resident, punched through his television, and was bleeding everywhere.
MERENDA: And you just have to put on some latex gloves and just go in there and try to subdue them without getting blood in your mouth or in your eyes or whatever. But he needs help.
MALONE: Residents told police that the on-duty caretaker was asleep during the whole ordeal. The incident was one of hundreds uncovered during a collaborative investigation by the Miami Herald and WLRN, that found sweeping failure within Florida's assisted-living industry, especially within the 1,000 facilities that cater to the mentally ill.
State agents caught employees in nearly 100 homes illegally doping residents, tying them up, or locking them in isolation. Agents then caught each home committing the same violation again. Our investigation found assisted-living facilities that cater to the mentally ill have twice the rate of abuse and neglect, compared to homes specifically for the elderly.
Nowhere are those problems more obvious than in Cannon Point. So I ask Merenda: How did this happen?
MERENDA: I'm not really sure.
EARL HAHN: What's that saying? The road to hell is full of good intentions.
MERENDA: Earl Hahn is the planning director for Lauderhill. He says 20 years ago, the city had a grand plan to turn Cannon Point into a haven for the middle-class elderly. That's the good-intention part. The road to hell bit? That was the special zoning that allowed an exceptional density of assisted-living facilities into the neighborhood.
MALONE: Instead of homes for the elderly, mental-health ALFs poured in. Hahn says someone should have noticed that the city was creating a psychiatric ward.
HAHN: You know, it's hard to establish mental-health facilities, and many people don't want them in their neighborhoods. And once we opened it up and we said welcome, welcome all; of course, places that historically have difficulty locating, they say, here, we can locate without the problems.
MALONE: And here's why Cannon Point isn't just a Florida problem. I talked to legal experts and academics and disability advocates. They say you can pick anywhere in the country and find some version of this: the warehousing of people with mental illness.
In New York, advocates have been fighting adult homes that are bigger, they say, than some of the state institutions people are leaving. In Illinois, it's nursing homes. Fifteen percent of the nursing home population there is people with mental illness. When mixed with elderly residents, there have been problems with rape and even murder.
Advocates say people with mental illness need services to help them integrate into normal society - the exact opposite of clustering people into homes, the exact opposite of Cannon Point.
But from Tom Merenda's perspective, Cannon Point is at least something.
MERENDA: If it wasn't for these ALFs, either somebody would be on the street, or they would be with a relative that can't take care of them.
MALONE: But would you send your grandparent to one of these ALFs?
MERENDA: Well, like I said, sometimes, you don't have a choice.
MALONE: And this is what makes Merenda's story so complicated.
(SOUNDBITE OF KNOCKING)
MALONE: No one knows the problems with mental-health ALFs better than Tom Merenda.
MERENDA: (Whispering) She hasn't seen me in a while so she'll see me and, like, probably freak out.
MALONE: And yet his mother, Christine(ph), is in one. She suffers from paranoid schizophrenia.
MERENDA: Hi, Mom.
CHRISTINE MERENDA: Hi, Tommy, honey. Oh, I love you. I miss you.
MALONE: Her room smells like smoke. The bed has one sheet. The walls are bare except for a single finger-painting by one of Tom's two daughters.
MERENDA: And how is my precious little Abby(ph)?
MERENDA: She's good.
MERENDA: And how is my precious, a little bit bigger - a little bit - Skyler(ph)?
MERENDA: She's good.
MALONE: After the visit, Merenda admits he feels guilty every time he visits his mom in that drab room.
MERENDA: But I know it's the only option I have because I can't afford to keep her where I'm living. And when she is off her meds, I have, you know, kids at home and things like that. I just can't have them grow up in that type of environment.
MALONE: There's a paradox in the way Merenda fights for the neighborhood. Advocates - and quite frankly, commonsense would say Cannon Point is not helping anyone. City leaders even agree. They've just passed a law to remove all ALFs from the neighborhood within five years, leaving Tom Merenda and others to wonder where the residents of Cannon Point will end up next.
For NPR News, I'm Kenny Malone in Miami.
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