Monday, May 20

The man in room 117

Sam and Olga had come to the conclusion that only involuntary treatment could break the cycle for Andrey: something indefinite, combining long-term injectable medication with intensive therapy and counseling.

They are part of a much larger ideological shift underway as communities look for ways to manage growing homeless populations. California, one of the first states to abandon involuntary treatment, has passed new laws expanding it. New York has invested $1 billion in residential housing, psychiatric beds and wraparound services.

Sam had pinned his hopes on Washington’s new involuntary treatment law and found it infuriating that this fall, when Andrey was released, the new system was not yet in place. His frustration was often directed toward civil rights advocates who opposed forced treatment.

“They have an agenda, but the agenda is not to help him,” he said. “Their goal is to just let him go crazy. Whether this includes violence, assault, living in degradation, living in your own filth, starving, eating moldy food. This is his right.”

One day, while making his rounds, Sam found himself arguing with Kimberly Mosolf, director of the treatment facilities program at the nonprofit Disability Rights Washington.

He laid out his case: Forcing someone like Andrey to take drugs again would backfire, leaving him more resistant to treatment, not less.

He cited Seattle-area data showing that nearly a quarter of people forced to take drugs had been forced to do so more than three times previously. Seven percent of them had been forced 10 times or more.

“We’re seeing a churn effect,” he said. “These periods of short incarceration, of short civil commitment, are destabilizing. This is what the data tells us.”

He recommended a gentler, slower way forward. If Andrey obtained permanent housing, with no strings attached, outreach workers could build a relationship and gradually broach the topic of medications. This approach, known in the political world as “housing first,” has emerged as the leading strategy for addressing homelessness in American cities, allowing officials to demolish tent encampments without encroaching on civil liberties.

This was the path that opened up to Andrey.

He received the call on a cold, gray day in late November. She was in his room and recorded a torrent of new ideas: that his mother had been inseminated with Joseph Stalin’s sperm, that the government had planted a bomb in his brain and detonated it. The front desk called to say that his social worker had come to visit him. He had excellent news.

The local housing authority had offered him a studio apartment in Central Park Place, a low-income apartment building on the grounds of Vancouver’s Veterans Affairs hospital. The residents were mostly veterans, but the rooms were also reserved for people with mental illnesses. The rent was $590 a month and could be covered by his disability check.

This placement solved several problems at once. He would no longer run the risk of freezing to death, clogging up fields or scaring pedestrians. For social workers it was a rare triumph. And for Andrey, it meant the pressure was off: he had a safe place to live that wasn’t dependent on taking drugs.

On the December morning, when she arrived at the hotel to help him move, Olga was surprised to find him awake, with his things packed in six bags, he couldn’t wait to go. All that morning he seemed like a different person: alert, motivated, funny. She charmed the apartment building manager, who was clean and bright, decorated with Christmas decorations.

He signed forms promising not to punch walls, start fires or smoke in the unit. The condominium manager asked him, in an apologetic tone, to indicate what should be done with his belongings “if something were to happen”.

He blinked. “You mean if I were dead?”

She nodded. There was a small, awkward silence.

“Damn, man!” he said, and everyone in the room burst out laughing.

“Bury me with my stuff!” she exclaimed jubilantly.

They laughed again. Then the palace administrator, ceremonially, gave him a bunch of keys on a blue key ring.

Unlike the other residents, men in their 60s and 70s, Andrey seemed vigorous and charismatic, overloaded with the natural gifts of youth. His apartment was small but immaculate, with a window overlooking a sun-drenched street. He accompanied his social worker to the elevator bank and posed for a commemorative photo.

Then the door closed and he found himself in the small room with his mother.