Abandoned by his family as a teenager, Leo became socially isolated and severely withdrawn. Then CHD’s Adult Mental Health-Connecticut staff began working with him—patiently and painstakingly—to establish trust and move him from a place of vulnerability and uncertainty into one of hope and perseverance.

Leo arrived at Odyssey House, CHD’s supervised community residence for high-risk young adults in Hartford, in the summer of 2022, under incredibly challenging circumstances. Born in Ecuador, he had been brought to the US by his aunt at 14, but she eventually left him to fend for himself because of difficulties related to his behavior.

From what is known about Leo’s past—and his memory is hazy about it, for reasons that are apparent later—the youth ended up in jail because of his mental health problems.

He was later a patient at Connecticut Valley Hospital (CRV), a psychiatric facility in Middletown, CT, and at 17 he began his journey with CHD, where he was referred. “We have a process when we accept a new client,” said Odyssey Home Senior Direct Care Staff Antonio Miranda. “We visited him at CRV, tried to get to know him before he actually stepped into the house—build up a rapport and see if he would talk to us. But he would just sit there with his head down, with his face covered with his long hair. All he would do is nod his head yes or no.”

Amy Woods-Sawyers, director of residential services at CHD’s Adult Mental Health-Connecticut, said it was obvious Leo’s personal care routines had been severely neglected for a long time. “He resisted bathing, changing clothes, cutting his hair, or engaging in basic hygiene practices,” she said. “Over time, and with careful guidance, they worked with Leo to introduce basic grooming and hygiene habits. Initial progress was slow, but over the weeks that followed, he began to respond positively to this structured approach. This progress was a key milestone, as it helped lay the foundation for further interventions.”

Trust as an Essential Step

It was Miranda’s first year on the job, and although he had worked in the mental health field for a while, he still had never met anyone as unresponsive as Leo. Fortunately, the youth slowly began opening up when he and Miranda started watching the anime TV show Dragon Ball Z together. Leo knew no English, but he enjoyed cartoons, and both of them started to connect. “That’s when he started trusting me,” said Miranda.

Staff soon found out that Leo had never been to a doctor in his life, but persuading him to undergo a medical evaluation proved extremely difficult. Leo was deathly frightened of needles and the prospect of a blood test. The answer was no. “I’m diabetic, so I showed him how I take insulin, but he refused to allow them to take his blood until the fourth trip to the doctor,” he said.

Doctors’ examinations found irregularities, and a brain scan revealed an 11-inch tumor in the front of his head that required emergency surgery. “At first he couldn’t fathom how serious the operation was going to be,” said Miranda. When staff described it to him he was shocked—an 18-year-old who had never seen a doctor until recently was being told that a surgeon was going to open up his skull. “It took a lot of convincing, lot of talking, a lot of crying, and a lot of hugging,” said Miranda. “It was tough for him to accept it, but in the end he trusted us. We told him he was in the best place possible, and everything was going to be fine.”

The surgery lasted eight hours, and successfully removed part of the tumor. However, it was clear that Leo would require a lengthy physical recovery—and considerable emotional support during this critical and vulnerable time, said Woods-Sawyers.

“Throughout Leo’s ICU hospitalization and subsequent recovery, CHD staff provided extensive and compassionate care,” she said. “Recognizing that Leo had no family or personal support system to rely on, the CHD team took on the role of caregivers, offering him emotional stability and consistent companionship. They provided him with daily home-cooked meals, organized activities to keep him engaged, and ensured that he received consistent attention to ease his anxiety during this difficult period. Their efforts were instrumental in fostering a sense of safety and stability for Leo, who had long been without meaningful personal connections.”

Following his release from the hospital, Leo returned to Odyssey House, where his recovery continued under the attentive supervision of the staff. While his physical health improved steadily, the team also focused on other aspects of his development. Leo began adopting better hygiene habits. Gradually, he started to show more interest in his environment and began interacting with direct care staff more openly.

Miranda finally felt comfortable enough to be frank with Leo about the way he ate. He told him that he had to stop slurping his food. “We also had to tell him that he can’t burp in front of people, and if he did, we told him to say, ‘Excuse me,’” said Miranda. “He didn’t understand why. He had gone without adult supervision for years. I said, ‘You’ve got to trust me on this.’” Miranda explained to Leo that table manners, other forms of etiquette—and societal norms and rules in general—were necessary for people to co-exist harmoniously. “I told him that it was kind of like a traffic light—that if we didn’t have traffic lights, there would be car crashes, and people trying to cross the street would get hit,” he said. “He understood this. He had been on the streets.”

Leo’s eyesight was never great to begin with, and the tumor’s location near his left eye resulted in some permanent vision loss, leaving him legally blind. CHD staff immediately coordinated with medical professionals, including optometrists, to ensure that he received the appropriate care and support for his visual impairment. This included the provision of any necessary adaptive equipment, as well as ongoing follow-up appointments to monitor his condition.

In addition to addressing Leo’s immediate medical needs, CHD staff also worked diligently to coordinate with various agencies, including the Department of Children and Families (DCF), and legal professionals, to secure essential services and protections for Leo. “I wrote a letter to the mayor,” said Miranda. “I called the Hartford Board of Education. I wouldn’t take no for an answer.” Staff ensured he had access to the resources necessary for his continued care.

They enrolled him in English as a Second Language (ESL) classes and advocated for him to participate in CHD’s vocational training program—he has taken on weekly responsibilities in cleaning services at Odyssey House, where he earns a stipend. They also connected him with Connecticut’s Bureau and Education Services for the Blind, which supplied him with a “white cane” mobility stick, and that agency is going to teach him Braille.

Keeping the Faith

As for Leo’s conduct, Miranda noticed a substantial change in him about a year ago. “He went from having no manners at all to having all types of manners. He’ll tell staff, ‘Excuse me, you left an empty cup over there,” said Miranda with a laugh. “After all, it’s his home.” He also regularly attends Mass at Our Lady of Sorrows right around the corner. “He really opened up to the pastor,” said Miranda. “Leo has a great relationship with CHD staff, but I think he needed someone outside of the agency to relate to.”

Leo explained, through Miranda as a translator, that his faith is important to him. “When I was with my family, it was a big tradition to follow the Catholic Church,” he said. “When I was little, we used to go to church every Sunday. I believe that God has helped me—especially with all the things that went bad when I was younger, and I’m blessed to be in this house. If I didn’t come here, I would have had one more month to live.” Indeed, doctors said they performed surgery on him just in nick of time.

He is also thankful for Miranda coming into his life. “He is a really good person and he has helped me a lot,” he said.

Leo’s room is decorated with several of his paintings, assiduously copied—despite his visual impairment—from other drawings. There is a Nativity manger scene, and paintings of Spider-Man and Pikachu from Pokémon. Leo is modest about his artistic abilities and is still a bit shy. “Something to pass the time,” he said with a shrug when asked about his art.

When asked about his time spent at the hospital for his surgery and recuperation, he said he hated being cooped up in one room—that reminded him of his incarceration. Seeing other sick and injured patients in the ICU was disturbing as well. He wasn’t prepared for that, nor the narrow bed they gave him.

“I kept thinking I was going to fall off the bed,” he said. “And I didn’t like the hospital food.”

He is also interested in eventually getting a job—and making new friends.

“Antonio told me you’d like work at some point?” he was asked.

“Yes, and also to get to know people outside of the house here.”

“But you’ve already started to do that with your church, right?”

“Yes, but the people at the church are much older than me.”

Obviously, like any 20-year-old, he’d like to associate with more people his own age.

Miranda can’t help but wonder how much the tumor, when it was growing, had affected not only Leo’s vision and memory, but also his past behavior, since the frontal lobe of the brain controls personality and emotions. Nevertheless, hindsight can only do so much—now is the time to look forward, and with the help of CHD staff and other caring people, he is making steady progress. Leo’s time at Odyssey House continues to be a transformative experience for him, and Miranda feels that staff are helping “give him two legs to stand on. He has his life now—he has a chance.”

Woods-Sawyers said that while there are still many hurdles to overcome, Miranda and his colleagues remain committed to Leo’s long-term success. “They are providing him with the support and advocacy necessary to build a brighter, more secure future,” she said.