Sheltered addicts, strained recovery: Patients put in charge; drug use was common

For much of his adult life he'd been a slave to cocaine, marijuana, prescription pills and alcohol. Twice he had gone through weeks of intensive psychiatric and drug treatment at <a class="taxInlineTagLink" id="ORGHC0000029" title="Baltimore Behavioral Health" href="/topic/health/hospitals-clinics/baltimore-behavioral-health-ORGHC0000029.topic">Baltimore Behavioral Health Inc.</a>, only to go back to using drugs on the streets.By summer 2008, Stephen Brown was three months into his third stint at BBH. That's when the private treatment center in Southwest Baltimore deemed him ready for a new challenge: to manage a rented rowhouse where he would live with seven other patients. His duties included enforcing curfew, hunting for hidden drugs and unlocking a cabinet so residents could take their psychiatric medicine.<br>
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But he says the assignment, which paid him $120 every two weeks, caused serious <a class="taxInlineTagLink" id="HEBEC000014" title="Stress" href="/topic/health/behavioral-conditions/stress-HEBEC000014.topic">stress</a>. Not only did he receive no training, he says, but he was still in <a class="taxInlineTagLink" id="HEBEC000013" title="Mental Health" href="/topic/health/behavioral-conditions/mental-health-HEBEC000013.topic">mental health</a> treatment, still on antidepressants.<br>
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The two-story brick house on South Fulton Avenue that he managed is part of a network of rowhouses that BBH rents in Southwest Baltimore. As of July, 150 of its roughly 800 outpatients were living in the houses, which are clustered in a battered working-class area where prostitutes ply corners before noon and city Health Department data show that more people die of overdoses than in almost any other part of Baltimore.<br>
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For BBH patients, many poor or homeless, the housing has meant not having to worry about finding a place to sleep. For BBH, it has attracted indigent patients whose outpatient care is usually paid for by taxpayers, according to interviews with former patients and staff at the West Pratt Street clinic. To help ensure that they attend treatment, BBH has vans that pick up patients in the morning for daily therapy.<br>
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But some former patients and staff as well as outside doctors say that BBH, which last year grossed $17 million, finds <a class="taxInlineTagLink" id="HEBEC00006" title="Mental Illness" href="/topic/health/behavioral-conditions/mental-illness-HEBEC00006.topic">mental illness</a> in patients whose main affliction is <a class="taxInlineTagLink" id="HEBEC000020" title="Substance Abuse" href="/topic/health/behavioral-conditions/substance-abuse-HEBEC000020.topic">substance abuse</a>. And state records show that drug users are three times more likely to be deemed mentally ill there than at treatment providers across <a class="taxInlineTagLink" id="PLGEO100100600000000" title="Maryland" href="/topic/us/maryland-PLGEO100100600000000.topic">Maryland</a>.

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( Karl Merton Ferron, Baltimore Sun / November 8, 2010 )

For much of his adult life he'd been a slave to cocaine, marijuana, prescription pills and alcohol. Twice he had gone through weeks of intensive psychiatric and drug treatment at Baltimore Behavioral Health Inc., only to go back to using drugs on the streets.By summer 2008, Stephen Brown was three months into his third stint at BBH. That's when the private treatment center in Southwest Baltimore deemed him ready for a new challenge: to manage a rented rowhouse where he would live with seven other patients. His duties included enforcing curfew, hunting for hidden drugs and unlocking a cabinet so residents could take their psychiatric medicine.

But he says the assignment, which paid him $120 every two weeks, caused serious stress. Not only did he receive no training, he says, but he was still in mental health treatment, still on antidepressants.

The two-story brick house on South Fulton Avenue that he managed is part of a network of rowhouses that BBH rents in Southwest Baltimore. As of July, 150 of its roughly 800 outpatients were living in the houses, which are clustered in a battered working-class area where prostitutes ply corners before noon and city Health Department data show that more people die of overdoses than in almost any other part of Baltimore.

For BBH patients, many poor or homeless, the housing has meant not having to worry about finding a place to sleep. For BBH, it has attracted indigent patients whose outpatient care is usually paid for by taxpayers, according to interviews with former patients and staff at the West Pratt Street clinic. To help ensure that they attend treatment, BBH has vans that pick up patients in the morning for daily therapy.

But some former patients and staff as well as outside doctors say that BBH, which last year grossed $17 million, finds mental illness in patients whose main affliction is substance abuse. And state records show that drug users are three times more likely to be deemed mentally ill there than at treatment providers across Maryland.