LOS ANGELES — He’s pointing to a green circle, surrounded by two concentric circles — one orange, one red — they represent an individual’s path into and out of homelessness. Dr. Shayan Rab uses this model to explain his role as a street psychiatrist with Los Angeles County’s Department of Mental Health.

“This red ring at the end, that’s the reentry initiatives domain, people in the open-air asylum of the streets, the closed air asylum of the jails or the personal asylum of deep isolation,” he said.

Rab is associate medical director of the HOME Team, a program under the Department of Mental Health.

The HOME Team, founded in 2021, supports chronically homeless people in LA County. HOME stands for Homeless Outreach and Mobile Engagement. But rather than meet with clients in an office or medical setting, Rab meets them where they are on the street.

On a recent Friday afternoon, Rab was heading out to visit a client who asked Spectrum News to call her Cookie. She has experienced chronic homelessness for years and whose health had taken a major toll.

“It was terrible environmental conditions. I remember seeing her for the first time in her tent. She could barely talk to us — the tent was in terrible condition, there was rotten food, it was unsanitary,” he said.

But, after visiting her regularly with the HOME Team, Rab said Cookie was able to move inside and get both physical and psychological support — that’s the HOME Team’s goal. According to LAHSA, 25% of people on the streets self-report as having a serious mental illness.

Clients are referred to the HOME Team by other county agencies, LAPD or LA-HOP. Because the population is so unique and has so many challenges, Rab and the team have developed a new model and a new way of helping people, which sometimes means treating them on the streets in order to build trust.

“We want to build a connection with the individual because that’s what will drive our entire treatment team,” Rab said.

While housing is always the goal, Rab explained that it can take time to help someone get to a point where they feel comfortable saying “yes” to housing.

For Cookie, it took weeks, but eventually she agreed to move into an interim apartment near MacArthur Park. Even after their clients are housed, the HOME Team stays connected with them and regularly check ins.

Rab said Cookie’s done a full 180 since she was on the street, but still faces major challenges. On his most recent visit, he spoke with her about engaging with the community more. He suggested she leave her room more often.

“You said you’ve been sleeping a lot of the day,” he said to her. “Something we want to do is get some activities going on. We have a peer resource group in DMH that I’ll look into. There are also a lot of wellness programs — I’ll bring you some options,” he said.

Cookie was skeptical, but said she would give them a go. She agrees that her life has improved since she got connected with the HOME team.

“[Dr. Rab] didn’t want to see me in that situation. I’m grateful for that. To me, it’s awesome to know that there are people who aren’t out there to get me, but to help me and support me,” she said.

For Rab, seeing clients like Cookie take care of themselves, get off the streets and get healthy is the ultimate reward.

“Her essence wasn’t weakened. That light never went out. She wanted something better for herself and she got it when she got the chance,” he said.