Bobby Livingston found it hard adjusting to life in his Senator Hotel room. Soon after moving in, he was screaming at neighbors and the management. (Genaro Molina / Los Angeles Times)

Bobby Livingston couldn't sleep. The indoor quiet was unnerving, the softness of his mattress all wrong. For weeks after moving into Room 216 at the Senator Hotel, he found comfort only on a hard tile floor that felt reassuringly like the pavement.

Horses and dogs flitted across the ceiling of his room, but he described the visions as familiar and untroubling, like the voices in his head. Sometimes the dead visited him full-bodied — long-gone family from the red clay roads of South Carolina — and he asked Jesus why he wasn't yet among them.

To rescue the 50 people deemed most likely to die on the streets in skid row, Los Angeles County had a pragmatic plan: Give them an apartment and all the help they'd accept, requiring little in return — not sobriety, not meetings, not psychiatric drugs.

Livingston and a handful of others posed the most extreme test of Project 50's premise. Merely living among others, with a modicum of structure and social rules, was proving a steep demand, considering what accompanied the hardest cases indoors: untreated mental illness and ferociously solitary habits formed by decades in the city's dope dens.

"If we can succeed with him — oh, my goodness," said the program's director, Carrie Bach. "If we can do him, we can do anybody."

Livingston, a cancer survivor with 37 years on the streets, was No. 1 on the list. He had accepted the room but cleaved to old habits, refusing his schizophrenia pills and plundering trashcans for aluminum to buy crack. So it surprised everyone when he appeared at a hotel community room one morning in May 2008 for drug counseling.

Attendance was voluntary at these twice-weekly group sessions, and though the host, Don Hashima, went door-to-door in the hotels, pounding, urging Project 50 clients to come, bribing them with snacks, he never got more than a handful.

With this crowd, Hashima was forced to jettison the drug-recovery philosophy — total abstinence — that he used to preach with the fervor of scripture. Expectations were adjusted. "If you're using not as much as you used to," he said, "that's cool too."

Livingston sat alone, but his body seemed in restless torment, eyes jittery, hands trembling. He grabbed a bagel and attempted to cut it in half with the handle of a plastic spoon. He chewed the mutilated pieces and shouted: "Dog eat dog! I am a pit bull! They call me Dirty Bob!"

He quieted long enough for the day's topic to be introduced: relapses and what trigger them. A round, wheezing addict who called himself Shorty needed no time to ponder. "Women," he volunteered, to mutters of agreement.

Flouncing into the room just then, looking for a snack, was an HIV-withered woman in flip-flops and pink hot pants. A veteran "strawberry," someone who traded sex for cocaine, she was in and out of the room in seconds, but her appearance shattered the brief calm in which Livingston dwelled. He began thrusting his pelvis in his seat, snarling and cursing.

Shorty, warming a bagel, thought he heard an insult and jumped in Livingston's face. "I'm at the microwave, minding my own business, and he's over here cussing me out!"

Livingston was on his feet in an instant, chest out, screaming, "I'll kill your mama! I'll kill your brother! I'll kill your sister!"

As Livingston was steered toward the door, his first group counseling session finished almost before it started, Shorty cried, "You ain't gonna kill nothing bigger than a $40 rock!"

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In policy circles, the watchword had long been "housing readiness": the homeless received a room after demonstrating that they were staying sober and seeking psychiatric counseling. Unless underlying afflictions like drug addiction and mental illness were reined in first, the thinking went, there was little chance they could keep a taxpayer-subsidized room.

Sam Tsemberis, a psychologist and housing activist who began providing apartments to the mentally ill in Harlem in the early 1990s, came to believe this a pernicious myth. Was there no help for the thousands who would not, or could not, endure the gantlet of demands?

Even paranoid schizophrenics — convinced, for instance, that they were hounded by aliens — knew where to get their food and find shelter on a cold night. If their psychopathologies were independent of their practical skills, why assume they lacked the ability to keep a home?

"They have organized a survival on the street that is more difficult than most of us can manage," Tsemberis said. When he put 99 mentally ill people in apartments, he discovered that 80% were still there after two years.