Pennsylvania’s Office of Mental Health and Substance Abuse Services says state support shouldn’t be tied to the place where mental health clients live.
Pennsylvania wants to expand the housing options available to people recovering from substance abuse or mental illness.
For decades, community housing for people who’ve sought help for mental illness or drug problems has almost always meant a group home. Typically ten or more clients live together, and learn life skills together, under the close supervision of 24-hour staff.
Bishop: Imagine somebody said to you everyday if you don’t make your bed every day, that is a rule, you’ve broken it. You have to leave everyday at 8 o’clock and you can not come back until 3. I mean that just, really, is not home.
Shelley Bishop coordinates housing initiatives for Pennsylvania’s Office of Mental Health and Substance Abuse Services. She says the group home model can work well for people with serious mental illness, or in the early stages of recovery. But Bishop says Pennsylvania has little to offer clients when they’re ready to live more independently.
Bishop: It becomes like this clog in the pipeline so that people who might be ready to move from a state hospital or some other more restrictive setting don’t have the opportunity to move into a rehabilitation setting.
She says mental health clients also get stuck in group homes, sometimes for years, because there isn’t enough low-income or subsidized housing.
Bishop: People don’t have homes, most often because they are poor. It doesn’t have a whole lot, in most cases, to do with disability; it has to do with poverty.
Bishop says Pennsylvania wants to create more affordable housing in the community, and then make sure services like counseling, benefits advice, job help and medication management are available close by. That shift is mostly still in the planning stages, but a service provider in Cumberland County is one of the first to de-couple housing and mental health services.
New Visions is a county contractor and operates several group homes with live-in staff, but now the non profit also has apartments where people with mental illness live on their own.
Executive Director Craig Cordell says tenants stay as long as they like, and as long as they fulfill the conditions of their lease, and pay their rent.
Cordell: They are essentially living independently. Our staff just because they are responsible people are trying to sort of lay eyes on that person a couple of times a week so that we know that everything is going well, but they have as much freedom as they want there.
New Visions has also converted one of its rehabilitation group homes into a lodge, where three or four people live together, instead of 8 or ten. Cordell says group homes, which require around-the-clock staff, are an expensive option that probably should be reserved for clients who need close supervision.
Cordell says savings from the group home conversion helped to fund a local drop-in center. Residents with mental health disabilities — from across the county — can use the center’s computers or come in for companionship, whether or not they live in a New Visions housing unit.
Cordell: They would have to get up and leave Shippensburg maybe six in the morning to travel to Carlisle or Camp Hill to receive those services and we wanted something here in the community.
Since the group home was converted to a lodge, staff no longer live on site. Instead, a social worker supervises two different lodges 40 hours a week.
Cordell: So for the price of her salary and benefits we are supporting nine people in two locations, where previously to support six people, here, we were something around $260,000.
Forty-eight-year-old Steven Keith spent some time in a group home, where he dealt with an addiction to pain medication. He still struggles with depression and anxiety, but is healthier now and lives in one of the New Visions lodges. He was happy to shed some of his old roommates, and the group home rules.
Keith: Well, it was time to move on and take care of myself and be more responsible for what I want and my needs. Here you have your own space you don’t have someone looking out after, over you all the time, you don’t have to eat at a certain time. We don’t get in each others’ way and we are always around if they need us. It’s the in-between of being out on your own.
Thirty percent of Keith’s income goes toward rent, and he says it means something that he writes that check himself every month.
Keith: I’m paying my bills, it means it’s my home.
Bill Bacon is legislative director for the Service Employees International Union Local 668, which represents social service workers. He says Pennsylvania’s housing resources do seem to be expanding, but he worries that support services won’t go to the neighborhoods that need them.
Bacon: Oftentimes we find that the community is not equipped to handle these kinds of patients because of lack of resources.
Craig Cordell says he comes up against stereotypes about people with mental illness every time he tries to establish housing in a new community. But he says the tragic cases that make headlines when someone with mental illness becomes violent, invariably involve people who are not getting services.
Shelley Bishop — from the state Office of Mental Health — is also sensitive to those worries about client well-being and public safety, but she says part of Pennsylvania’s philosophical shift includes making sure that support services are in place.
Bishop: I do believe that if we did a better job of providing the right support services, engaging people in all sorts of different ways making sure that if safety was an issue you knock the freakin’ door down. Because the last thing I want to hear in five years is, it didn’t work.