Candice, a fifty-three-year-old native New Yorker, was homeless for more than fifteen years when she was referred to Pathways. She stayed on the streets but slept in a tent that she frequently pitched in an Upper West Side park. Other campsites included the meridian that separates the northbound and southbound lanes of Broadway above 72nd Street. Her highly visible blue tent drew immediate attention from concerned citizens, outreach teams, and the police and typically resulted in a hasty involuntary transport and admission to one of the local psychiatric hospitals. A few weeks later, after discharge, this cycle would repeat. Because of her prominent symptoms of psychosis, which featured paranoia and fear about government control, most outreach and other aid workers encouraged her to seek treatment. The workers knew that without treatment they would be unable to admit her to a supportive housing program. She repeatedly and adamantly refused all psychiatric and medical treatments.

In their first meeting with Candice, Pathways staff offered to help her with anything she needed, including an apartment of her own—no strings attached. It took several visits to convince her that the housing offer was genuine, unconditional, and free of government controls. She accepted the apartment on the condition that her signature would not be required and that she would be permitted to pitch her tent inside her new home. After she moved in, staff continued to work with her and better understand her circumstances. They learned that she had been employed as a nurse at the time of her first psychotic episode, more than twenty years