The survey team's members had with them a "vulnerability index" developed by New York City nonprofit Common Ground, whose goal is seek to find and house the nation's 100,000 most at-risk homeless.
They wanted to know who was suffering from end-stage kidney or liver disease, who is HIV-positive or has AIDS, and who had been to an emergency room three or more times in the previous three months, or hospitalized three or more times in the previous year.
One of Phoenix's chronically homeless during the April 2010 survey for Project H3.
Paul Rubin
Russ Jefferson at his apartment with Community Bridges navigators Jeanne Allen (middle) and Liz DaCosta.
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Shadow Dwellers: A Series
What's the one image you took away from the Tucson shootings? We thought so. That mugshot of Jared Loughner is haunting. And for the world, it has become the face of mental illness in Arizona. Here, we know that's not true. A picture may be worth a thousand words, but the story of what it's like to be mentally ill in this place cannot be told in a single photograph.
Tens of thousands of seriously mentally ill people live in Arizona. Some of them look
just like you.
Other stories in the series:
Tucson's Cafe 54 Is the Real Face of Mental Illness in Arizona, Not Jared Lougher, by Amy Silverman
Meet Raven, a Homeless Man with More Community Than Many of Us Have, by Paul Rubin
Why Did the Arizona Department of Corrections Put a Mentally Ill Man in Cell with a Convicted Killer?, by Paul Rubin
Mental Illness Hasn't Stopped Chris Shelton from Becoming a World-Class Boxing Historian, by Paul Rubin
Jan Brewer's Response to Jared Loughner: Slash More Than 35 Million in Services from an Already Beleaguered Mental Health System, by Paul Rubin and Amy Silverman
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They also considered age (over 60 is a risk factor), plus a catch-all: mental illness, substance abuse, and chronic disease.
The Project H3 team found 262 people, of whom 208 agreed to answer questions, and this is what they learned:
The most vulnerable had been homeless for an average of almost eight years.
Fifty-five were military veterans, with almost half of those considered highly vulnerable.
The youngest person surveyed was 19, and the oldest was 77.
Half of the 208 interviewed reported a dual diagnosis of mental illness and substance abuse. (Most social scientists say that people routinely understate those issues, and that for more than half of the chronically homeless suffer from mental illnesses and addictions to alcohol and/or drugs.)
A third said they had been victims of at least one "violent attack" since becoming homeless.
The vast majority of the chronically homeless cycle repeatedly among the street, hospitals, and jail or other institutional care until they finally die.
Such troubles transcend the individual, at least financially. It costs taxpayers dearly when the homeless land in jail or in an emergency room on a regular basis.
Of course, the number of people surveyed (208) was little more than a drop in the bucket of the Valley's sprawling homeless population.
Hundreds more than that — no one knows the precise number — remain without permanent homes on any given night in Maricopa County. Almost 1,000 men, women, and children are sheltered at CASS (Central Arizona Shelter Services) on South 12th Avenue. Dozens more find temporary shelter through other area programs.
Clearly, risk factors for an early death increase exponentially without a roof over one's head.
But the notion of "housing first" actually is counterintuitive to traditional thinking. That model usually requires someone to be sober before being considered for permanent shelter.
Being off the streets and out of the elements (the Valley's oppressive summer heat and bitter winter nights) can make for a safer and potentially healthier life.
The illness and the addictions don't stop simply when someone finds a place to call home.
One of Project H3's tenets is to provide intensive one-stop assistance to its formerly homeless clients.
"We're into three prongs — behavioral health, health care, and recovery," says Phoenix police officer Margiotta, the "we" meaning Project H3, with which he has been closely involved.
"Some people still believe that all we need to do is to get folks into the behavioral health system and it's all going to be good. But it's not. Everything used to be in a silo, this agency here and that system there doing their own thing. That doesn't work. We do more than just get people into a halfway house. We — especially the 'navigators' — become totally involved in their lives."
That's where Jeanne Allen and Liz DaCosta of Community Bridges come in.
They work as navigators with 41 ex-homeless people, including Russ Jefferson, the friendly toothless fellow who loves motivational sayings.
(Another dozen or so Valley residents who have been deemed extremely vulnerable are monitored by other agencies.)
"We teach them how to use a cell phone, to make doctor's appointments, how to get money orders, what to do at a bank, all the stuff that most people take for granted," says DaCosta, a spunky 26-year-old originally from Gilbert.
"Most of them have nobody, and many are addicted to drugs and alcohol. Many have mental issues. These are my people."
No doubt, the lives of many have improved, dramatically in several instances.
But miracles, by definition, are rare:
The street still beckons many of the H3 clients — the guy who can't stay away from his old stomping grounds behind a funky building near Grand Avenue, the woman who landed in jail a few weeks ago for drinking in public on the cusp of an important meeting with mental-illness evaluators.
One of the original 50 slipped up badly enough to earn a short prison term on a drug charge earlier this year. He recently was released and, through channels, communicated with Allen and DaCosta, his onetime navigators. They say they will be trying to try to help him get back on his feet.
"We are not here to judge. We are here to help," Allen says. "What we do is to find out the most important thing to do for our people right now and we do it. We are peers, we've been to jail, we've done drugs, we've done bad things. We are them."
It is Veterans Day, a vacation day for most working stiffs.
But a 61-year-old woman we'll call Alice (she asked to be provided with a pseudonym) has just finished the graveyard shift as a part-time unarmed security guard at a state government office building on East Jefferson Street.
