Shauna Curphey - Writing

Home Safe
Controversial program protects the vulnerable
Real Change, April 15, 2000

By Shauna Curphey

The Lyon Building on Third and James is like no other apartment complex in downtown Seattle. Two candles flicker on an end table in the marble lobby, marking the recent deaths of two former residents. Above the candles is a collage of photos of drag queens, some of the building's current residents. The people who live in the Lyon Building make it unique. Most are HIV-positive and chemically dependent or mentally ill. All were homeless before moving in.

Most housing programs and shelters in King County are not equipped to address the health care needs of HIV-positive clients, according to the 1999 HIV/AIDS Care Services Needs Assessment conducted by Seattle-King County Public Health. High rates of mental illness and substance abuse among people who are homeless and HIV-positive make it even more difficult for them to obtain housing. Many have criminal backgrounds, prior evictions, or drug use problems that disqualify them.

The Lyon Building fills this gap in services. AIDS Housing of Washington opened the building in 1997 in response to an increased demand for supportive housing for people with problems in addition to HIV/AIDS. The Downtown Emergency Service Center oversees the daily operations of the facility. AIDS, mental health and chemical dependency treatment systems throughout Seattle refer clients to the program.

The Lyon Building's staff assesses where residents are in their lives and works with them to make steps and set goals to improve their health and well-being. Gary Friend, the building project manager, explained that the goals reflect the individual capabilities of the client.

"For us, we look at very small increments," says Friend, "that they gain weight, that their case manager works with them to get vouchers so they have new clothes. Those things are part of success."

Part of this pragmatic approach entails providing services to people who are currently addicted to and using drugs.

Friend explained, "We know we house people who use drugs. We have very strict limitations. People cannot deal out of their apartments. They cannot do anything that would increase the level of drug activity in the building."

Instead of demanding abstinence in return for services, the program employs strategies to decrease the negative effects of the user's habit. It's a controversial approach called harm reduction.

Daniel Malone, the Downtown Emergency Service Center housing program manager, prefers to avoid the term harm reduction.

"Some people take it to mean that anything goes," says Malone, "That's been the typical response in our society: to demand compliance or throw them out, throw them away, throw them in jail. That's just unrealistic as we see it in working with the characteristics that our folks have."

The best-known harm reduction programs are needle exchanges. They attempt to minimize the risk associated with intravenous drug use by collecting used needles and distributing new ones. The Seattle King County Department of Public Health oversees five needle-exchange programs.

Professor G. Alan Marlatt, director of the Addictive Behaviors Research Center at the University of Washington, notes that the Puget Sound area is more willing to employ harm reduction strategies than other parts of the country. He attributes this partly to the work of early activists. The first needle-exchange program in the United States began in Tacoma in the 1980s as a response to the AIDS crisis.

On a national level, however, harm reduction remains controversial. Some fear that it condones drug use. In a nation submersed in the rhetoric of the war on drugs, "just say no" rings truer than "just stay alive." Congress has prohibited the use of federal funds for needle-exchange programs.

The Lyon Building’s funding sources understand the program's approach to providing services. This understanding is critical, Malone says, because "a lot of the homeless population is made up of people who don't tug on a lot of public heart strings, probably, especially, the male single adults, publicly visible out there doing activities involved with their chemical dependency problems or their mental illness. There isn't a lot of enthusiasm for directing funds toward people we don't find warm and cuddly."

Realizing the potential for public disapproval, AIDS Housing and the DESC did a lot of work up front communicating with neighborhood residents and businesses before the Lyon Building project opened. The program takes responsibility for how it might affect the community. Malone explained that the building staff works with clients so they understand how activities out in the street might be viewed by others and how that might come back to create problems for the program.

He says, "I think our clients can hear that message pretty well."

Residents, for their part, continue to struggle toward the goals they set for themselves. One resident donates his artwork to auctions for AIDS services or housing programs. Another is planning to sell a calendar of his pastel drawings. A few of the residents are drag queens who perform for fundraising events.

"If we can keep people alive, if we can keep them in the program and all hell isn't breaking loose," says Malone, "then we have a much better chance to help them get to that point that we would all love to see them: as some kind of happy, contributing, person."

For some residents, this has already happened. For others, it may never happen. The Lyon Building staff continues to work with all of them, one small success at a time.