When patients are discharged from a psychiatric hospital, their transition to the community can be a daunting task. Housing, employment, entitlements—how can one person attend to all this?

People with serious and persistent mental illness who live in New York City can receive help at the peer-run Brooklyn Peer Advocacy Center (BPAC). The staff offers assistance on three fronts: housing, employment, and peer advocacy, which includes assistance with entitlements, legal difficulties, and housing concerns.

One-on-one assistance and self-help groups—some of which are run by the consumers themselves—are offered at all of the center’s nine offices, including those at Kingsboro and South Beach Psychiatric Centers (SBPC).

The common thread in all programs is to empower people with mental illnesses. This means that the center’s clients participate in the staff’s efforts to assist them—even if they make only a single phone call. This focus on empowerment is not surprising considering that the employees know firsthand that it works. Almost all the employees, as well as most of the staff of the center’s parent agency, the Baltic Street Mental Health Board, are diagnosed with a psychiatric illness, explained Dana Anthony, the board’s executive director.

Using this "empowerment approach," the staff has assisted 80 former long-term patients from Kingsboro Psychiatric Center to live in the community again. And if one considers that a hospital bed costs $120,000 a year, this is an annual savings of $9.6 million, said Isaac Brown, BPAC’s director of advocacy services and housing. "[To do this,] we work to have clients trust us, and we give them a whole picture of what life can be like in the community if they wish it," explained Brown.

Last year alone, the 40 employees of the center and its parent agency helped 2,200 individuals.

In addition, BPAC’s accomplishments have surpassed the performance goals set by the Brooklyn Office of the New York City Department of Mental Health, Mental Retardation, and Alcoholism Services (DMHMRAS), which funds BPAC.

How does BPAC achieve so much? Besides working to empower consumers, the center has strong linkages with Social Security offices, housing agencies, Human Resources Administration, vocational rehabilitation agencies, and other organizations and agencies.

Another reason for its success is the leadership of its directors: Brown himself is diagnosed with paranoid schizophrenia and used to live on the streets, talking to statues and rummaging through garbage cans, he said. Now married and the father of a young daughter, Brown is a well-known artist whose work is purchased by collectors throughout the world.

"I cannot praise the center enough, and a large part of its success is due to Isaac. He is an outstanding leader who is respected by city leaders, providers, and his staff," commented Dimitra Risueno, Ph.D., the assistant commissioner of the Brooklyn Office of DMHMRAS.

Despite his success, Brown relates well to his clients’ struggles. "I remember when—after 10 years of unemployment—I was first hired by a counseling center to work as a customer-service representative for mental health consumers. When I put on the suit and tie I hadn’t worn in 10 years, it was a great feeling. It gave me renewal of hope in life. And I want to help others to have the same feeling. . . . My success can be a blueprint for other people’s success."

And the clients Brown and his staff help do achieve success: Last year 30 clients found competitive employment, 50 secured housing, and 1,500 received help with personal advocacy issues. Moreover, 60 clients live in center-supported housing.

"Isaac and his staff are like a noble army—an army of recovered consumers—who want to make sure everything is right for other consumers. They treat consumers with dignity and respect, and the consumers in turn think of themselves as being truly empowered," said Risueno.

Although the staff don’t get involved in clinical issues unless a client’s ability to function is affected, they do work closely with many health care professionals. In fact, BPAC has offices at three locations of South Beach Psychiatric Center’s outpatient service, as well as at the inpatient facilities of South Beach and Kingsboro psychiatric centers.

At the hospitals, part of their initiative is to educate the hospital employees: "Some employees only see patients who have been admitted over and over again, and they don’t believe that these patients can live independently. So a lot of what we do is explain that recovery is possible," said Brown, who has been a director since the center started.

To ensure that providers, consumers, and others know about BPAC’s offerings, the staff gives numerous presentations at events, conferences, and hospitals. "With their empathy and their experience being mental health consumers, Brown and his staff have done an exemplary job of reaching out and bringing people into their program," said Risueno.

Although BPAC’s staff and clients advocate on mental health issues such as insurance parity, the main focus of their peer advocacy efforts is assisting consumers with entitlements, legal issues, housing, and other concerns. The center offers three peer advocacy programs: a general self-help program, one geared specifically for older adults, and one that helps clients transition from the hospital to the community.

In the peer advocacy programs, "we listen to the clients’ problems, then we give them hope and tell them we can work as a team to solve their issue. Finally, we take action by calling government officials, accompanying them in court, filling out forms, and so on. And the client helps too," said Brown, noting that BPAC’s motto is "We care, serious and persistent, about finding solutions to your problems."

Besides providing supported housing for 60 clients, the center’s housing program helps consumers apply for city-subsidized housing. In doing so, Brown created a checklist of 30 tasks. The list is divided into the steps the peer advocate completes and those that the client completes. The clients attend weekly group meetings to discuss their progress and problems.

There are two employment programs for the clients, most of whom are not working. One is a supported-employment program in which the staff helps clients find competitive (not sheltered) full- and part-time employment. The other program, a very unusual one, takes place at the center’s fabric store, the Baltic Bazaar. Here, clients receive training in a wide variety of retail positions, and qualified individuals can participate in advanced sewing apprenticeships, explained Anthony, who facilitated the opening of the store.

One client who takes advantage of BPACs offerings is Mildred Thompson, 49, of Brooklyn. Thompson spends her weekday mornings at the Center, where she learns computer and sewing skills and where she participates in groups on peer advocacy and job skills.

"They [the peer advocates] helped me get SSI. They assigned me a peer advocate who helped me fill out the paperwork and explained SSI to me. I feel a lot better now that I understand about SSI," said Thompson.