Mental health resources dwindle as the APOLLO Resource Center closes its doors
On a recent morning in St. Paul's Summit-University neighborhood, in the basement of a tall brick apartment building, a few people lounge in the worn leather chairs at the APOLLO Resource Center. The center doesn't have the sterile white aesthetic of a treatment hospital. Billed as a "drop-in center," it's more like a fraternity house for the mentally ill. It's the only mental health drop-in center in all of Ramsey County, and acts as a second home for many of its regulars.
"Hey, you got that 50 bucks you owe me?" asks one, a slender man with graying hair, grinning slyly. "I'm practicing for the carnival."
Around the corner from the lounge area, there's a kitchen where clients take cooking classes and regularly prepare feasts together. Down the hall is a session room where they participate in group therapy and community classes. Next door is a laundry room with space for group meetings and bingo night.
Unlike at an inpatient hospital, attendance at the APOLLO is voluntary, and the dozens of people who come through its doors daily run the spectrum of mental illnesses. Some come to attend group sessions for chemical dependency, anger management, or job training classes. Others come simply to socialize with someone experiencing similar inner pain.
"It's some place where you can be that's not home," explains Taz Korlath, a regular. "Some place where you can sit down and talk to people, like a coffee shop."
But the APOLLO center won't be around much longer. In January, Ramsey County announced it would redirect the center's funding to other resources. After more than 36 years, the APOLLO will forever close its doors on May 1. And in these final weeks, the regulars are trying to figure out what they will do when it's gone.
"It's breaking my heart," says Shelly Clater, a client for more than 15 years. "I'm still coming to grips with it."
In the aftermath of mass shootings in Tucson, Newtown, and Accent Signage in Minneapolis, the subject of mental illness has been thrust to the forefront of the political debate, both statewide and nationally. Yet in Minnesota, mental health funds continue to get the axe.
Most recently, DFL lawmakers in the House proposed $150 million in cuts to the Health and Human Services Budget — which funds the state's health care programs, including mental health — a surprising move that has spurred behind-the-scenes turmoil at the Capitol.
"My jaw was on the floor for a whole day after I heard the House target," says Rep. Jim Abeler, R-Anoka. "Nobody saw it coming. None of the advocates. None of the long-term providers."
Surprising as it was, these cuts are nothing new. In 2011, when Republicans ran the show, legislators eliminated $1.2 billion from health and human services, draining millions from mental health resources. Over the past four years, legislators have cut nearly $60 million to programs designed to help people with mental illness, according to data tracked by the National Alliance on Mental Illness.
"I'm sure we'll see more money cut in the mental health system," says Sue Abderholden, executive director of NAMI. "They do it every year."
As a result of these cuts, providers have been forced to sacrifice crucial mental health resources, including the Community Behavioral Health Hospital-Cold Spring and the adult mental health residential facility in Eveleth.
But mentally ill clients don't just disappear when the programs do. They end up entering the system in other ways, such as hospitals and jails, which means losing these facilities ends up costing the state more money in the long term, says Philip Krasowski, a nurse at the psychiatric wing of Hennepin County Medical Center who works as a liaison to civil commitment court.
"You have to be careful where you're headed, because it might drive people to more expensive alternatives, and not be very effective," says Krasowski.
On top of downsizing or eliminating resources, these ongoing budget cuts make it hard to keep on staff for the long haul, says Tom Huntley, D-Duluth, who chairs the Health and Human Services Finance committee in the House.
"Basically, the people that work in nursing homes and long-term care facilities are getting 10 to 11 bucks an hour," says Huntley. "They haven't had raises for a long time, and the result is they can go make more money at McDonald's."
During a monthly group meeting in January, the APOLLO staff broke the news to clients: The facility will continue its independent-living skills program, but funding for the center will be redirected toward a new job placement service.
The move is representative of a trend in mental health funding, says Tim Burkett, CEO of People Inc., the nonprofit that runs APOLLO. As public funds continue to diminish, money frequently goes to programs with "measurable objectives." As a result, organizations like People Inc. are forced to spend more money on accountants to keep the books, and programs with harder-to-quantify success like the APOLLO are disappearing.
"This is the wave of the future, so I can't resist it," says Burkett.
Many of the regulars didn't take the news well, says Katie O'Brien, community support services division head for People Inc. "It's almost like a grieving process," O'Brien says. "There was a whole range of emotions of anger, sadness, frustration, disbelief."
Clients talk about the APOLLO center as if it's a life preserver keeping them from drowning in isolation. Some fear inpatient hospitalization or adult foster care will be their only alternative once the center closes.
Says Clater: "We have no backup plan."
Lynne Nerenberg is a regular at the APOLLO, one of a few dozen who inhabit the center every weekday, frequently for up to eight hours.
A bespectacled 62-year-old with dark, thin hair, Nerenberg suffers from schizophrenia. Before finding the APOLLO seven years ago, she was in and out of hospitals and treatment centers, lost and unwilling to cope with her illness.
"They definitely helped me stay on medication," Nerenberg says. "I was afraid of the stigma and paranoid of the effects of the medication ... and they helped me work through it so I could stay on medication and improve."
A native of St. Paul, Nerenberg was diagnosed with schizophrenia late in life. She attended Macalester College in the '70s, and after earning a B.A. in political science, took jobs freelancing for newspapers around the Twin Cities, including the St. Paul Dispatch and the Entertainer (which would later be rebranded as the Twin Cities Reader).
By the mid-'80s, Nerenberg had become deeply religious, and moved to New York City to live in a Hasidic neighborhood of Brooklyn, she says. She worked odd jobs to pay rent — once as a temp in the accounting department of the New York Times — and started taking night classes at the New School, graduating with a master's degree in media studies.
In the mid-'90s, after her father died, Nerenberg moved to California to take care of her mother. Within a few years, her mom suffered a stroke and died. That began Nerenberg's downward spiral.
"I couldn't handle the stress," she says.
Before long, Nerenberg was homeless and living on the streets of Fargo. She found a shelter that would let her stay if she agreed to see a psychiatrist, who diagnosed her with schizophrenia.
Nerenberg brought her illness under control with Risperdal and moved into a supportive house. After a year, she came back to Minnesota and found an apartment in a building on Dale Street in St. Paul.
It was the same building that houses the APOLLO, though at the time, Nerenberg was apprehensive about the treatment center.
"I was paranoid," she recalls. "I thought that they would commit me if I joined APOLLO."
After moving into the apartment, Nerenberg quit her medication and quickly began to decompensate. She rarely left the apartment, and stopped taking care of herself, even when she developed a debilitating case of arthritis.
One day in 2005, the apartment's manager came into her unit to tell her she was being evicted, and found Nerenberg crawling around on the carpet. She was committed to the psychiatric wing of Regions Hospital, and spent the next year in treatment centers and halfway houses.
Discovering the APOLLO in 2006 gave her new life. She started attending group sessions for stress management and self-esteem building. She took current events classes, and was even able to practice writing again in a creative literature class.
Unlike at hospitals and other treatment facilities, she didn't feel judged at APOLLO. Though staff still charted her behavior, she didn't feel like they were out to get her.
Nerenberg has been going to the APOLLO almost every weekday since she first arrived seven years ago. So when a staff member told her the center was closing, she was devastated.
"I felt like I had been punched in the stomach," Nerenberg says. "It was very visceral."
Only a year ago, Darren Beckom was living on the streets of St. Paul, spending most nights at shelters around the Twin Cities.
Beckom has struggled with schizoaffective disorder his entire life, and in addition to antipsychotics and other prescriptions, was self-medicating with a cocaine habit. Beckom's case manager first urged him to check out the APOLLO in 2011, but he wasn't interested.
"I didn't know nothing about it," says Beckom. "I thought it was just a homeless shelter."
Beckom eventually came around and decided to try APOLLO, hoping it could help him get clean. He attended group therapy for chemical dependence, and later stress and anger management. He kicked the coke habit, and the staff helped him find an apartment.
Beckom comes to the center almost every day now, often just to hang out with other clients. But now that APOLLO is closing, he worries about relapsing.
"I've been clean for 11 months now, and that's only by APOLLO being here helping me," he says. "Getting involved in these meetings and these groups is what's been keeping me along the way. Now if that leaves, I don't know what I'm gonna do."
The next closest drop-in center is in Minneapolis, but Beckom says it's hard to make the trip every day. Beckom is also concerned for some of the patients he's become close with throughout the past year, some in far worse condition than him.
"Right now, there's no other option on the table," says Beckom. "We still hoping and praying and wishing for the best, that this could stay open."
For Shelly Clater, the struggle with severe mental illness began more than 30 years ago, when she was a 19-year-old single mother of two infant girls.
Clater began to slowly recede into her head, and one day her sister's boyfriend found Clater riding around on a Metro Transit bus, noticeably disoriented. The boyfriend brought Clater to her mom, who called 911 immediately upon seeing her.
"I lost touch with reality," Clater recalls.
Clater was admitted to the psychiatric wing of Hennepin County Medical Center, where she was diagnosed with schizophrenia — later reassessed as schizoaffective disorder. She went on antipsychotic meds and spent the next year at inpatient hospitals.
When she was released, Clater found it difficult to move forward with her life, she says. She took odd jobs at places like Kmart, Target, and a daycare center, but was quick to quit as soon as she felt a co-worker didn't like her.
In 2001, Clater was living in an apartment in Little Canada, completely isolated from the world other than her 15-year-old son. She was still on the antipsychotics, but again began to drift slowly away from reality, spending her days watching TV and arguing with the radio.
"I was so deep inside of my head," she says. "I was in a really bad, bad, bad place."
In a moment of clarity, Clater realized she needed help and called United Way's 2-1-1, at the time known as "First call for help." An operator told her to get out of the house, and recommended the APOLLO.
The APOLLO saved Clater from isolation. She began attending group sessions, and volunteered to answer phones at the center. She took an interest in politics after going to a current events class, and became involved in activism. She helped others register to vote, and contacted politicians to lobby for better services for mentally ill people.
Clater has been going to the APOLLO since 2001. She's now a co-facilitator of her own group with the National Alliance for Mental Illness, and attending workforce training with Vocational Rehab Services, a state-run service that helps Minnesotans with disabilities build skills to get jobs.
She's still trying to imagine what life will be like when the center closes.
"Without APOLLO, none of this would have happened," she says.
On a Tuesday evening in March, APOLLO clients are shooting free throws in the Merriam Park Community Recreation Center gym in St. Paul. They are all dressed in royal blue jerseys labeled "Apollo Eagles," save for one muscular guy in a do-rag who is sporting a Timberwolves jersey.
It's the championship game in St. Paul's Adaptive League, an all-ages league for people who are mentally or physically disabled. It's not exactly March Madness, but a few of these guys can shoot, and the stakes are high. APOLLO lost only one game during the regular season, and it was to Southside, the team they're playing tonight.
"Basketball is Southside's forte," says Mike Kane, the APOLLO team's coach. "I've been doing this for 10 years. Southside dominates basketball. We tend to dominate softball."
The game comes down to a nail biter. With two minutes left, APOLLO has lost its early lead, and Southside is ahead by four points. APOLLO makes a valiant effort to come back, but ultimately loses by six points.
"We had that, man!" screams the guy in the do-rag. "We had that. This is some bullshit, man."
The two teams shake hands, and the APOLLO players are presented with a consolation red ribbon.
Sports have been a major part of therapy at the APOLLO, but with the center closing in a few weeks, they are trying to figure out a way to keep the team going under a different organization's brand.
As the APOLLO prepares to close for good, everyone is scrambling to figure out what to do next. For a couple of months, a group of clients banded together and tried to save the APOLLO with letters and phone calls to politicians. But their cries went unanswered, and they've resigned themselves to their fate. Most staff members will stay on and work for other programs run by People Inc. In the meantime they are helping create transition plans for their clients.
For the more well-adjusted clients like Nerenberg, the APOLLO closing could have an upside. She feels ready to move on, she says, and plans to spend her newly freed up time trying get more involved in the Jewish community. She's also excited to go back to work, and will look into finding a job through the new program funded with the APOLLO money, possibly doing clerical work or customer service.
Not everyone is in quite such a hurry to move forward, however. Among staff and other clients, there is fear for what will happen to those who have come to depend so much on APOLLO.
"For some people," says O'Brien, "this is their only connection."
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