29 July 07
By Rev Paul N. Papas II
Good Housing is Good Medicine
Consumers believe and studies strongly support permanent housing as a basis for mental health recovery. Consumers are much more responsive to accepting treatment after they have housing in place. (The President’s New Freedom Commission Report, p42). Housing, eating, personal hygiene and safety are basic human needs. Once these needs are addressed then others such as employment and socialization are more readily to follow. The housing problem is exacerbated when one has any type of disability, including anyone suffering from a mental illness. This could be the chicken or egg argument for some people. It has been shown that without an address most employers won’t hire you. If you need to carry your belongings with you, have no place to shower and don’t know where your next meal is coming from then you will not be too amenable to treatment. Having your diabetes, heart condition, high blood pressure or mental illness treated is not something you can afford or may not even be on your radar screen.
What kind of housing is best? In a perfect world a lot of people would like to have their own home in a good neighborhood. Each person has their own view of what “home” looks like to them. For some people a home includes support services. They would need to be flexible, mobile, and individualized support services. The ultimate goal is to have each person live at the highest level possible as a productive citizen.
If you have an auto accident and spend some time in the hospital you may need some rehabilitation time before you go home. There then may be some time of rest before you are cleared to return to work. Change the scenario to be a time spent in hospital for a psychiatric condition. Right away there is a different feeling about this that is stigma. As soon as you tell your friends or employer that you were treated for a medical condition called mental illness and not an auto accident the looks and treatment you receive from them is quite different, again that is stigma.
For those who suffer from a severe mental illness a home could be a group home where supportive services are readily available. With the ultimate goal of having each person live at the highest level possible as a productive citizen the support services need to be tailored to individual needs. Many will move on to shared apartments or one on their own. Medication is only a part of what some people need. The length of time medication will be needed is to be determined by a medical doctor.
Other therapies are available to assist people to live at the highest possible level such as: individual and family therapy, group therapy, developing positive leisure time skills, work training and work skills, nutritional counseling, social skills, life skills, dealing with destructive behaviors, medication education, and perhaps trust work to name a few.
Not everyone requires hospitalization and the above work can be started on an out patient basis. If it begins in a hospital, then there needs to be continuity between the hospital stay and a release back into the community. The greatest potential for a relapse is when there is no continuity of therapy. This is a time when family, friends and advocates are most needed to make a successful transition.
“The lack of decent, safe, affordable and integrated housing is one of the most significant barriers to full participation in community life for people with severe mental illness” (The Presidents New Freedom Commission on Mental Health, p 31). Across the country, permanent supportive housing has proven to be overwhelmingly successful: it’s cost effective, community friendly alternative to shelters, institutions or other restrictive residential settings enabling people to remain stably housed and achieving greater levels of self sufficiency. Specifically it: increases residential stability and community tenure; decreases use of in-patient settings; reduces days in jail; increases life satisfaction; may reduce psychiatric symptoms; may increase social functioning; reduces costs in other systems.
The ultimate goal is to have each person living at the highest level possible.
Rev Paul N. Papas II is a Pastoral Counselor with Narrow Path Ministries and current President of NAMI (National Alliance on Mental Illness) Greater Framingham. NAMI Greater Framingham has support groups for family and friends in Framingham and Uxbridge, and Peer Support Groups in Marlborough and Milford and a Family to Family 12 week Education Course in Framingham and various Education Meetings, The next major event is a 5 K Walk/Run and fund raising dinner September 8,2007 to benefit Domestic Violence programs in MA and AZ. www.narrowpathministries.org and http://home.earthlink.net/~nami01704