November 7, 2010; Source: Baltimore Sun | A Baltimore Sun investigation has found serious problems with Baltimore Behavioral Health, Inc., a nonprofit that provides housing and psychiatric and drug treatment programs.

BBH patients are given housing along with drug and psychiatric treatment. BBH’s contention is that it is much harder to treat someone living on the street than someone who is safely housed. Vans pick up BBH patients every morning for treatment from the rowhouse, situated in one of the roughest neighborhoods in Baltimore. According to the Sun, “city Health Department data show that more people die of overdoses than in almost any other part of Baltimore.”

Despite its admirable mission, the group’s operations have come into question in recent months. Among the issues the Sun investigation found were, no state oversight, questionable business partnerships, deficient sanitary conditions in BBH apartments, and the decision by BBH to use “patient-managers” with as little as 60 days sobriety the keys to medicine cabinets in the apartments.

One of those patient-managers is Stephen Brown. Three months into his third stint at Baltimore Behavioral Health, Inc. for drug and psychiatric treatment, he was offered a job at the nonprofit treatment center. According to the Baltimore Sun Brown managed a rented rowhouse where he would live with seven other patients. His duties included “enforcing curfew, hunting for hidden drugs and unlocking a cabinet so residents could take their psychiatric medicine.”

Brown said that he wasn’t interested in the position and that it was “stressful”. He added, “I accepted it because that’s what they gave me.”

Some in the field find the practice questionable. “We wouldn’t give someone with 60 days’ sobriety access to someone else’s medication,” said Gale Saler, director Gaudenzia of the Chesapeake region, a mental health and addiction treatment organization. She told the Sun that at two-months sobriety some patients are still “white-knuckled, holding on by the skin of their teeth. Recovery is hard.”

Providing housing for recovering addicts and adults with mental illness is integral to successful treatment. Even under the best circumstances though, it’s a messy business. Addiction is a disease and relapse is an expected part of the recovery process. Living with mental illness can have cyclical setbacks as well. Despite sometimes-impossible budget constraints, it is incumbent upon providers to provide a safe haven for their clients. It seems BBH could benefit from rethinking its hiring practices and the state could provide much needed oversight.—Aaron Lester