The proximity to neighbors that comes with living in a high-rise or townhome HOA can sometimes amplify situations that might seem less urgent in more spread-out communities. Along with things like noise and odors, residents’ behavior can also impose itself on neighbors. 

When unsafe or problematic behavior is caused by ignorance, or by someone simply being a jerk, that’s one thing; when it’s the result of mental illness, the situation is more delicate, even if the results are the same. For example, a hoarder’s behavior may result in infestation by insects and vermin that will quickly spread to adjoining units. A neighbor suffering from dementia may leave a pot on the stove, causing a fire. A dear friend experiencing a psychotic episode may become violent, endangering neighbors as well as himself. The question is, how should neighbors, management, and even the board handle these situations, and when?

Reactive, or Proactive?

The truth is that there is no single, or simple answer for how a community should get  involved with or help residents struggling with mental health issues. The appropriate response depends to a great extent on the specifics of individual situations. For the purpose of this article, we’ll focus on the three main categories of mental health issues that most commonly impact dense, tightly-spaced residential communities (though of course there are many other possibilities). 

Generally speaking, shared-interest communities find themselves confronted by hoarding situations, elderly residents with cognitive decline and dementia, and others suffering from acute and/or chronic mental health issues that cause them to exhibit inappropriate or violent behavior towards other residents, staff, or visitors to the building. 

In all cases, the first line of defense is to contact a person familiar with the resident experiencing the problem, inform them of what’s going on, and ask for their help. That may be a family member, a friend, a clergyperson, or some other person closely aligned with the sufferer.

“The first thing we do is to try to find someone in the family who can help,” says Dan Wollman, CEO of Gumley Haft, a New York-based management firm. “Their child, or a sibling, someone to visit with them and see what’s really going on. They are the closest person to them and may have knowledge of the situation. Hopefully, they can take control. 

“We have one situation now in one of the buildings we manage where there is a couple in which the husband has dementia, and the wife is physically impaired. Three water leaks emanated from this unit, so we placed water detectors all around the apartment, connected to the super’s phone” which would alert him if a sink, tub, or shower was left running. Wollman says that eventually, locks had to be placed on the stove to prevent an unattended or spilled pot from causing a potentially deadly fire. 

“It’s become a community problem,” says Wollman. “The couple has a daughter, and when it became untenable, we brought her into the mix. She’s trying to help, but she doesn’t live here. We did everything we could do legally, but other residents of the building are freaking out.”  

Compassion + Communication 

In a situation like the one Wollman describes, community leadership and management must tread a very fine line. Not only is it vital to keep the humanity and wellbeing of the unwell resident in front of mind, it’s also important not to inadvertently expose your board or management to potential liability by overstepping their role. 

Because of the potential legal ramifications in these situations, “Speak to your community’s lawyer immediately” upon becoming aware of a mental health-related issue in the building, advises Scott Wolf, CEO of BRIGS, a Boston-based management company. “Get their advice on how to proceed with respect to each specific case. Do your best to listen and navigate, but do not try to be their therapist or counselor. Everything must be documented in case of future legal issues, so make sure you always respond with a proper written response. Most importantly, be respectful.”

“I’ve found the best way to address these types of challenges is to involve family members,” says Lisa Magill, of counsel with Kaye Bender Rembaum, a law firm located in Pompano Beach, Florida, “but sometimes family members cannot or simply do not want to get involved. As a preliminary matter though, anytime management or a resident believes that another resident presents a danger to himself or to others, it’s necessary to call local authorities. Most jurisdictions have a special unit for this purpose.”

A Practical Approach

Unlike problems with a building’s physical plant, or even most legal issues, there’s no one-size-fits-all approach to dealing with mental health issues. It can be very seat-of-the-pants.  

When the vulnerable resident is elderly or disabled but otherwise capable of living independently with a little support, says Wollman, “We start with the practical option; we have the concierge, doorman, or other staff call up to the apartment twice a day. We go up once a day to make sure the person is okay. As staff and manager we are not a care facility, so there’s not much more we can do beyond that.” 

Wollman also notes that management, building staff, and even neighbors should be observant of what’s going on with their residents and neighbors—not to be nosy, but just as engaged members of the community. 

What if it Turns Violent?

It’s crucial to know and remember that people struggling with mental illness are far more likely to experience violence than to enact it. That being said, residents’ concerns about sharing close quarters with an erratic, potentially violent person are valid. In any situation where a resident may become dangerous to themselves or the community, it’s always best to contact local law enforcement.

Magill cites an example from her own experience. “In Florida,” she says, “we have a ‘red-flag’ law, where law enforcement may remove guns and firearms from individuals who pose a threat. This actually happened at one of the properties I represent. The police responded to many calls over a period of time from residents complaining about threats made by an individual who was known to house weapons in his unit. Responding officers became convinced that the resident was a significant danger due to his mental state, his history of threats, and more than one occasion where the subject resident displayed his weapons in a threatening manner.” Sometimes, threats become reality, adds Wolf, who notes that “property managers have been shot.” 

Limited Options

The options available to boards and managers to intervene or take action when a resident is struggling with their mental health are extremely limited, primarily to contacting family or friends and doing what they can to coordinate with that contact person to effect a positive outcome for all involved. Even this can yield a mixed bag, however. 

“We have contacted family members in the past,” says Wollman, “and tried reaching out, but it can turn into a tempest, because the person affected by mental illness may react badly and challenge you. And if they are still ‘functioning,’ it can become a difficult legal issue. There may be privacy issues as well, in terms of what you can say to family members because of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).”

  And, adds Wollman, “The police often are not a realistic option in dealing with these problems; it’s not what they do. Unless [the resident] tells someone they are going to hurt themself, [law enforcement] won’t and can’t do anything unless the person volunteers. As an example, if you call the police and say your wife is running around with a knife and she then says nothing’s wrong, they can’t do anything—unless she also appears ‘unkempt!’ Even when someone is taken to a hospital, they can’t be kept there. The current system is woefully inadequate.”

Hoarding & Dementia

In situations where hoarding is involved, the community is faced with a problem that could explode—both figuratively and quite literally, depending on what the resident in question is hoarding. Piles of papers, trash, and other debris can cause fires, as well as impeding first responders trying to access and move around the unit; animals and accumulated garbage generate foul odors, attract vermin, and promote disease; sometimes the sheer weight of a hoard can strain the infrastructure of the building itself.

“Hoarding is the most common mental health problem we come across,” says Wolf, “and it’s becoming more and more prevalent. In these cases, we will try to find a family or a social worker to talk to the resident, but in practice we can’t really interfere. The community and management are walking a tightrope. We bring in the town or city authorities who are trained and equipped to deal with this, like health inspectors. We ask them to perform a check of the unit, and they’ll then require things to be done [to remedy the situation], and will bring in health services to work with the hoarder.”

A situation that often goes hand in hand with hoarding is perhaps the most difficult for everyone in a building community, from neighbors to administrators: a long-treasured resident becomes incapacitated by dementia.

Having engaged family members near at hand to help oversee day-to-day care and monitor an aging resident’s safety is hugely helpful, but that’s often not the situation. In the absence of relatives, empowered friends or legal guardians, boards and managers can find themselves with few options.  

“Most boards,” says Magill, “will not undertake an action to impose a legal guardianship, even when the resident could be a danger to the community by leaving a stove unattended, or the like. In order to seek an involuntary guardianship, someone has to file a petition in court. There are costs and expenses associated with preparation and filing that petition, and the person filing it has to explain their basis for believing the person to be incapacitated. This is a very high bar.”

 As a result of that expense and burden of proof, the board and management are typically limited to addressing the actions or behaviors of the resident purely in terms of whether they violate rules or nuisance provisions in the community’s governing documents. For example, if the community’s documents require residents to ‘properly maintain’ their unit and a hoarding problem has led to a rodent infestation, it may be possible to take legal action based on that. Or perhaps a resident with diminished capacity can no longer reliably comply with security protocols and lets anyone into the building, makes loud noises at all hours, or damages common property; those violations may open up possible routes to intervention, but again, it’s vital to consult with legal counsel prior to taking any sort of action. 

Mental health issues are perhaps the most difficult personal issues a shared-interest community must deal with. As with every consideration a board and management confronts, the community must be put first. But kindness should always be part of that consideration.

A.J. Sidransky is a staff writer/reporter for CooperatorNews and a published novelist. He may be reached at alan@yrinc.com.