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The more grass John Zibbel cuts, the quieter it gets inside his head.
Like his co-workers, he's on medication to fight off mental illness - in his case, schizophrenia. He's heard the “voices” since childhood, telling him to drink or that he's worthless. Medication helps quiet the voices. Cutting grass helps even more.
“When I work, I hear fewer voices,” Mr. Zibbel said.
That's exactly what John Hoover wants to hear.
Three years ago Mr. Hoover was in a meeting at which a top Ohio mental health official said only 5 percent of those in the state with serious mental illness had a job.
That frustrated Mr. Hoover. As executive director of the nonprofit Neighborhood Properties, Inc., he is the landlord for hundreds of subsidized apartment units scattered throughout Lucas County that provide housing for the mentally ill. Sure his tenants weren't homeless, but 80 percent were unemployed and many seldom left their apartments.
“I thought, `There had to be more than watching the Price is Right and smoking cigarettes all day,'” Mr. Hoover recalled.
He started doing some calculations. Getting the grass cut at all of NPI's properties was costing him almost $300,000 a year. Why not see whether some of his tenants were interested in cutting the grass, and making some extra money? And as long as he was at it, why not see whether some of them could handle janitorial and construction jobs fixing up the apartments?
Today, Neighborhood Property Services, an offshoot of NPI, provides jobs for 27 people, all with mental illness and most of whom live in NPI properties. While his workforce is small compared to the 400 tenants at NPI, Mr. Hoover's idea to combine housing with employment opportunities for the mentally ill is unique in Ohio.
Few cities provide as much supportive housing as Toledo. In Ohio, only Columbus has more housing set aside for the mentally ill. And few places have tried to combine both supportive house and stable employment for the mentally ill, said Nancy Nickerson, manager of system development for the Ohio Department of Mental Health.
NPS' efforts are “highly unusual” in the mental health field, she said.
Jacqueline Martin, executive director of the Lucas County Mental Health Board, said Mr. Hoover's efforts are so effective that the state uses NPI as a “model” mental health housing organization.
While she supports going beyond housing and providing employment as NPS does, she warned it can be a difficult and tricky move. Many mentally ill people rely on Medicaid to provide essential drug coverage, but if they make more than $27,000 a year working, they lose their Medicaid benefits.
“One of the things you'll hear from the mentally ill is they'd love to work and be productive citizens, but the risk is just too great,” she said. “John has been able to start an employment opportunity so they don't lose those Medicaid benefits.”
NPS has three branches: a janitorial program employing eight people, a construction program with six people, and a landscaping and grass cutting program that employs 13 people. The construction and landscaping-grass programs are expected to add employees later this summer.
The organization has been so successful taking care of NPI properties that it has begun branching out into the private sector. The landscaping and mowing portion of the business, in addition to caring for 95 NPI apartment complexes, now has contracts to serve Lucas Metropolitan Housing Authority; Unison, a nonprofit mental health agency; three area gas stations, and a local dentist's office.
Donna Lawniczak, office manager for the dental office of Drs. Paul Heinrichs and Jan Bosserman, said when NPS approached her about cutting their grass, they mentioned that the workers had mental illness. She decided to give the program's workers an opportunity to prove themselves.
“It's working out really well. They have us looking better than we have in a long time,” she said.
Mr. Zibbel acknowledged that NPS' formation “was sort of a revolutionary idea. A lot of people didn't think we could do the work.”
Even many NPS workers had doubts. Most had been in and out of countless jobs. Bosses would get frustrated with their performance or fire them as soon as mental illness-related problems surfaced.
Ernest Ball, one of the NPS workers, said his current job is the first job he's had where his boss doesn't yell at him.
“I have to take medication, but they're willing to work with me. I went through a panic attack about six months ago, and when I called in, they said, `Just go to the doctor,'” Mr. Ball said. “Work is my therapy now. I'm finding the more I work, the better I feel.”
Despite success stories like that, Mr. Hoover said some of his greatest skeptics are those within the mental health field.
NPI was formed in 1988 when the Lucas County Mental Health Board was one of nine agencies in the United States to get grant money from the Robert Wood Johnson Foundation to improve housing for the mentally ill.
One stipulation was that instead of just providing housing, “supportive” housing services must be provided. The support could range from helping tenants set up payment schedules for rent or open a checking account to reminding them about appointments.
The work is done by trained employees, like Larry Wanucha, who visit with the tenants.
It's a hot, sunny day when Mr. Wanucha pulls up to his first stop of the afternoon, an apartment unit in North Toledo where a tenant is having problems with a non-NPI tenant in another building. The other tenant is playing loud music, and the NPI tenant is upset and unsure what to do. Mr. Wanucha assures her he'll take care of it and says he'll intercede on her behalf with police and the man's landlord.
His next stop is a unit in East Toledo where an NPI tenant has just moved in. Two other NPI tenants below the man complain to Mr. Wanucha about the man's children making too much noise.
“OK, I'll take care of it,'” he says as he walks up the stairs.
He talks with the man, warns him about the noise. He then reminds him of an upcoming meeting at which the man must show up to get rental assistance forms signed.
“I'll help,” he tells the man, who is worried about getting all the paperwork figured out.
“I sure appreciate your help,” the man says.
On his last visit of the afternoon, an NPI tenant complains to Mr. Wanucha that “people” are harassing him, telling him bad things.
Mr. Wanucha later says the people aren't real. The man, who has schizophrenia, has stopped taking his medication and is hearing voices again.
“There's no shame in taking medicine,” he tells the man quietly. “I've done it, and I'll do it for the rest of my life.”
Mr. Wanucha, who also has schizophrenia, knows how helpful encouragement like that can be. He had a series of frustrating jobs until he began working for NPI in 1993.
“At one point I never knew if I'd have a `normal' life, but I want to succeed and help others succeed. I was born to do this job,” he said.