When Barb Campbell thinks about the residential treatment home next door, she recalls car doors slamming and headlights shining.

That’s because her bedroom window is about four feet from the home’s driveway, and getting a good night’s sleep is a challenge when patients and employees come and go at all hours.

Campbell lives next to one of two residential treatment homes in Bend that opened with some controversy in 2010. She and other neighbors of the homes now say they’re concerned less with the proximity of people suffering from mental illness than with the fact that the homes, which are in essence businesses, were located in residential neighborhoods.

The homes, one on Northeast 12th Street and another on Northeast Edgecliff Circle, are owned and operated by Telecare Corp., an Alameda, Calif.-based company that contracts with the state to serve people who suffer from mental illnesses like schizophrenia, bipolar disorder and various psychotic disorders.

Telecare’s involvement in Deschutes County stretches back to 2007, when the state identified several projects it wanted to pursue locally. Tele-care was chosen to build the facilities, which include a pair of five-bed residential treatment homes and a 16-bed secure residential treatment facility.

The county provided land for the secure facility, and Telecare looked for houses that would work for the five-bed homes.

And that’s really where the trouble started.

“We looked all over the city, and the two homes we picked really were the best value and had the right characteristics,” said Kevin McChesney, who oversees all of Telecare’s Oregon facilities.

The company, he said, looks for large homes with outdoor space, room for indoor recreation and the right number of bedrooms. They also have to be close to shopping and other amenities.

Because many of those living in the homes are trying to return to independent living, they must be able to come and go.

“We want them to go back out into the community, so really we can’t say we’ll never let them out the door,” McChesney said. “We provide them with a really safe place to live where they receive treatment and get an idea of what living in a community is like. They can acclimate and they present less of a risk to society.”

Speaking of risk, McChesney notes that convicted felons often live unnoticed in residential neighborhoods.

“When we talk about people being released from the corrections system to the general public, there’s no attempt to monitor them. They’re just released out the door,” he said. “Lots of those people are completely unsupervised.”

Obviously, many felons will be supervised through parole and probation services. But McChesney said they can easily move into neighborhoods without notifying neighbors of their previous bad deeds.

And Eileen White, a board member with Central Oregon’s National Alliance on Mental Illness, said people who live in Telecare’s homes aren’t the ones people should fear.

“The best place for them is in care with meds. The scary scenario is a person being undiagnosed and not on meds,” White said.

Anne Pendygraft, the program director for the two Telecare homes, says the goal is to offer clients a comfortable environment where they can get closer to independent living.

“Many of these people have lived in institutional settings” where medicine is delivered in paper cups and a feeling of individuality long ago disappeared. At the Telecare homes, medications are identified and explained, and the clients are free to come and go as they see fit. But they’re also encouraged to interact, having community meals and meetings.

At the home on Edgecliff Circle, this is clear. Recipes and signs about behavior cover the walls of the kitchen, while a calendar with detailed listings of free community events fills another wall.

“We try to emphasize community involvement,” Pendygraft said. “We know they’re ready to leave when they’re spending more time out in the community than in the house.”

In 2011, the average resident stayed in the Telecare homes for 190 days. Telecare tries to keep the stays under one year, and only one person has stayed less than three months since the facilities opened.

The typical stay at the Tele-care homes is shorter than the state average. According to a 2009 analysis, the average patient stayed in a residential treatment home for 456 days. At least 20 percent of patients lived there for more than 600 days, or nearly two years.

Pendygraft said the homes have a calming feel, and that’s most important. She recalls one resident who entered the Edgecliff Circle home and asked, “I get to live here?”

“It’s different from a lot of housing options in the past. It’s homey and residential,” she said.

As a result, she says, “you feel like your life is returning to normal.”

There are few studies that evaluate what size treatment facility works best for patients, though a 2008 study from the Substance Abuse and Mental Health Services Administration found improved outcomes for people in small treatment facilities in their home communities.

When the Telecare facilities opened, neighbors expressed a range of concerns, from safety to effects on property values. That bothered HousingWorks Director Cyndy Cook, who has developed four housing facilities for people with mental health issues, including two in Bend and one each in Prineville and Redmond. Cook said she’s never had neighbors complain about the location of her facilities.

“I think it’s an intrusion,” she said of neighbors’ complaints. Cook pointed to families who bring services into private homes for mentally ill family members. “If you are my friend and you have mental illness, and three people I know have mental illness and I buy a house in the neighborhood and bring support services in, whose business is that?”

‘Diverse group of people’

She said it’s impossible to guarantee behaviors, even from people without mental health issues.

“‘Do you have teenagers? Can you guarantee the behavior of teenagers?’” she said. “There is a diverse group of people who live in neighborhoods. Seniors, young people, folks who have mental health issues.”

So far, the Telecare homes have not generated significant safety problems. Since opening in September 2010, each facility has had 18 calls for service, according to Deschutes County 911 records. Calls for service can include 911 calls for medical issues, follow-ups to earlier issues, even fire alarms. Of the 18 calls at the 12th Street facility, six have been for concerns about an allegedly mentally ill person, one for an unwanted subject on the premises, two for a possible sex crime and one for a missing or overdue person. In previous interviews, police have said no serious crimes have occurred at the homes.

Of the 18 calls related to the Edgecliff home, two have been for concerns about an allegedly mentally ill person, three for overdue or missing people, and one each for a dispute and harassment.

Bend Police Sgt. Brian Kindel said his department has begun making visits to the two treatment homes, particularly when new clients move in.

“It’s really been beneficial, because some of these folks have a great fear of law enforcement or people or authority figures,” he said. “We talk to them and let them know that we’re human beings who make mistakes and don’t understand everything perfectly. We’ve gotten to dialogue with them.”

Kindel said it’s been a good opportunity for his officers to ask questions: for instance, how people with mental illness might feel when a police officer approaches them. But it’s also been an opportunity for Kindel and other officers to explain themselves as well.

“The insight has really been helpful,” he said. “When they do leave those homes, they know they have somebody they can talk to, somebody they can call.”

Neighbors’ concerns

Many say neighbors were simply afraid of the unknown, and McChesney said at this point he’d call the relationship between the homes and the neighbors “an uneasy truce.”

Pendygraft agreed. She believes the neighbors have warmed as she and her colleagues have reached out to them, holding quarterly meetings and starting neighborhood cleanups once each month.

“We know it’s not convenient to have a business in the neighborhood, but we’re trying to be a positive member,” she said.

Some neighbors aren’t so sure. They say Telecare has dismissed some concerns about cigarette butts on the streets and has reneged on promises.

For example, Telecare initially told neighbors it would not receive Psychiatric Security Review Board referrals. But the state has since told Telecare that PSRB referrals are a possibility. That board has jurisdiction over patients who have committed serious crimes but have been found guilty except for insanity by the courts.

After neighbors of the Edgecliff home complained about the number of cars in the cul-de-sac, Telecare moved its staff meetings off-site. The new site? The 12th Street home.

The Edgecliff home has been able to garner compromises from Telecare. For example, staff members no longer park in the cul-de-sac. But neighbors remain concerned about the facility’s impacts. Recently, for instance, Tele-care officials asked to break an agreement about clients having cars on the premises. A client needed a car for a few weeks to help her get to and from an appointment.

“The human part of me wants to say yes,” neighbor Mark Leary said. “But if I say yes, then it’s two cars. Then it’s three cars.”

Campbell said the people living in the facilities are not her primary concern.

“It has nothing to do with the residents having mental illness. It’s a business,” she said. “There’s a business in my neighborhood that runs 24 hours, seven days a week, forever. There are no vacations.”

Campbell and her partner, Foster Fell, live next door to the residential treatment home on 12th Street.

“Every seven hours there are cars coming and going. There’s a parking lot four feet from my bedroom window,” she said. “I think they did a spectacularly bad job choosing locations.”

Campbell and Fell wish Telecare had found homes on corner lots, or homes with more parking.

But according to Rebeka Gipson-King, a communications officer for the state’s addictions and mental health department, the residential treatment homes are not considered businesses, and “there are no laws regarding the notification of neighbors for any size residential treatment facilities for people with mental illness.”

Gipson-King said local zoning codes sometimes require notification when a facility will house six or more residents. These facilities are an “allowed use” in residential zones but sometimes must apply for conditional use permits if more than five people will live there.

“Residential treatment homes with five or fewer residents are considered ‘outright use,’ meaning they’re zoned the same as any other house in the neighborhood,” Gipson-King said.

“Our biggest argument was always, ‘Who was siting these?’” Leary said. “Why are these neighborhoods perfect for these types of homes?”

He thinks Telecare should take the general neighborhood into account in the siting of homes, not just what the actual homes are like.

“We just want some thoughtful criteria that has the community and the facility’s interest in mind.”

Holly Jackson, a neighbor of the 12th Street home who has young children, said she worries about potentially violent Psychiatric Security Review Board clients being housed in the Telecare homes.

“It’s not just about my property value going down, it’s not just about cigarette butts and garbage,” she wrote in an email. “It’s about safety and peace of mind. That is why I purchased a home in this neighborhood and I want it back.”

That may not happen. According to McChesney, the homes have contracts running through the end of June, and he anticipates they will then be renewed. But there’s some hope for neighbors.

“We are exploring the possibility (of) moving the Edgecliff home but would continue operations in either case as long as we have a contract with the county to operate the homes,” McChesney wrote in an email.

Still, neighbors continue to keep their fingers crossed.

“In a perfect world,” Campbell said, “they’d pick up and find different houses and see this as a learning experience.”