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Pathways to housing the homeless

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"I think that's a deeply internalized image for me," he continues, "an inclusive and helpful society where we all live, each with our own gifts to contribute to the pool."

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Wicker chairs and flowers

With at least two staff visits each month – and usually more – Pathways strives for that sense of inclusion, while encouraging the autonomy of independent living. Apartments are scattered throughout Manhattan and Westchester: Congregated sites, says Tsemberis, can breed stigma and an institutional feel.

There's nothing institutional about Jane Whiley's apartment. It is full of wicker chairs and tables painted all shades of green, red, and orange, arranged with astonishing symmetry.

Family pictures, brightly colored plastic fruit, and iced-tea bottles crammed with artificial flowers crowd each surface; homemade collages line the walls. Above the kitchen sink, 18 mugs dangle from hooks on black-and-white checked wallpaper.

Homeless after losing her home of 31 years around the time she was diagnosed with schizophrenia, Ms. Whiley spent eight months in a women's shelter before hearing of Pathways at the Harlem YMCA.

She now works part time as a Pathways receptionist and part time at the Ricco/Maresca Gallery on 20th Street, which features self-taught artists, many of whom are considered to be mentally ill.

'Out of the madness'

When Craig Murray introduces himself over Pepperidge Farm cookies and a beef knish, he sounds as though he's at Alcoholics Anonymous. "My name is Craig," he says earnestly, "and I'm dually diagnosed. That means I have a mental illness and a substance-abuse problem."

A heavy man with wide brown eyes, measured speech, and an easy smile, he speaks eagerly. After six years in a state hospital battling cocaine addiction, he heard of Pathways through a friend, and now lives in Washington Heights.

"Pathways came and scooped me out of the madness," he says, "found that I was articulate, open-minded, civic-minded – a nice person, aside from what was documented in some chart I never saw."

Armando Vasquez has likewise found a haven in Pathways – though as "a street character," he insists it was easy to survive. He met a Pathways worker while visiting homeless friends at Grand Central Station and jumped at the opportunity to obtain permanent housing.

A street kid at 11, Mr. Vasquez was sniffing heroin at 12. "I was a drug addict all my life," he says over lunch. "For 30 or 40 years, all I did was get high." Now he's been clean for 14 years.

As Vasquez talks of his struggle with drugs and "weirdo problems," Tsemberis leans forward. "I don't think it would have been possible for you to deal with your clinical problems if you were homeless," he says.

"Without a doubt," agrees Vasquez. "Without a doubt."

Measures of progress

Not everyone in the Pathways program is happy: Clients push for bigger apartments, or insist their buildings are too noisy, too dangerous, too drug-infested.

"That's always a sign of progress," says Tsemberis, "for them to know that they deserve better, that they can do better."

Darlene Lee, Pathway's East Harlem service coordinator, describes one client who was so used to street life that he'd salvage garbage for decor, cramming seven televisions into a one-bedroom apartment. Tempering that pack-rat instinct, says Ms. Lee, has been "a therapy for him." Now he has four TVs instead of seven – a measure of progress that would count for little in a traditional program, where recovery might be gauged by the number of drinks not taken.

"Especially for people who have been institutionalized," says Tsemberis, "it's a huge conceptual shift to be in a social-service system [that makes] people feel like they're in charge of their lives."

Even enlightened social workers sometimes admit to surprise as they see clients assume the privileges of routine life.