Woman's death spurs change in shelter system

When Margaret Jones, 61 and severely mentally ill, died in a SEPTA stairwell in Center City on Jan. 19, Philadelphia's mental-health system knew that she was missing. And its homeless-shelter system knew where she was.

They never connected.

The death of Jones, whose decades-long odyssey on the streets was chronicled in an April 5 story in The Inquirer, led to a review by the Philadelphia Department of Behavioral Health/Mental Retardation Services. This week, a new course of action emerged - one that may seem simplistic but could save lives, city officials said.

Starting immediately, the city's emergency drop-in shelters, called "overnight cafes," will report the names of people who stay there to the behavioral health department.

The cafes - four in the winter, three the remainder of the year - attract a disproportionate number of mentally ill people who shy away from the larger, crowded main shelters. Jones had been at a cafe at Eighth and Arch Streets for several nights before her death.

The new process of disclosure will be one-way: Because of confidentiality laws, the behavioral health department will not be allowed to share with shelters any information on the people it helps.

Nonetheless, access to the cafes' lists is expected to allow mental-health specialists to locate clients and reconnect them with services or caseworkers.

"While I don't know if this would have helped Margaret Jones, this unfortunate tragedy really presented an opportunity for us to take another look at the whole system," said Arthur C. Evans, director of the behavioral health department.

The city estimates that 70 percent of people living on the streets have some degree of mental illness.

"You have a homeless system and a mental-health system, and there's a lot of overlap," Evans said. "What we're discovering are ways to better integrate work we can do together."

Jones was among 26 homeless people to die on the streets this year, according to the Philadelphia Medical Examiner's Office.

A mother of two with a history of schizophrenia, she walked away from a personal-care home in Germantown on Jan. 6.

Jones died of natural causes on a 25-degree night, a block from the homeless cafe where she had spent the few nights before she died. Yet, the operators did not know she was the object of a search by her family and her city mental-health caseworker.

"There was a huge disconnect," said daughter Ira Mia Jones, an urban designer in New York. "There must be some way to get information out."

Last winter, the city's four overnight cafes housed about 250 people a night. The facilities tend to be not only smaller than the main city shelters, but also less restrictive.

David Dunbeck, director of homeless services for Horizon House, a nonprofit mental-health agency that runs an overnight cafe in West Philadelphia, said it was an ongoing frustration not knowing whether a mentally ill person who came to the shelter already had help.

Allowing the behavioral health department to know who is there is "a great idea," he said.

While the department is asking overnight cafes for names, it remains constrained from sharing its own information, even about a missing person, said Marcella Maguire, head of homeless services for the behavioral health department.

For instance, the boarding house where Jones had been staying filed a missing-person report with police. But the behavioral health department could not disseminate that to shelters.

"We're able to take in a great deal of information," Maguire said, "but for legal reasons that have to do with federal and state statutes, we're limited. . . . We can't share who's receiving mental-health services."