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1997 LICKING COUNTY HOUSING FORUM:
The Need for Housing for Persons with Mental Illness and Substance Abuse Issues
Recent research indicates that. approximately half of all persons with severe mental illness have a co-occurring substance use disorder - termed dual diagnosis. Substance abuse in combination with mental illness adversely affects their psychiatric symptoms, functional capacities, relationships with families, residential stability, participation in treatment, and outcomes. Additionally, such persons are more likely to be homeless particularly if they have schizophrenia), to live in public shelters, to use hospital emergency rooms repeatedly, and to be in and out of jails and psychiatric hospitals. Their behavior is often very inappropriate and their self sufficiency skills very limited. They also tend to lack adequate community supports. Dually diagnosed males in the age range of 18 to 25 years appear to have the most difficulty in establishing and responsibly maintaining decent housing.
The Ohio Department of Mental Health and the Community Mental Health and Recovery Board believe that decent, safe and affordable housing should be available for all persons with mental illness, and that the housing should be located in setting which maximize integration of mentally ill people and increase opportunities for acceptance and inclusion into the community. Therefore, such settings should include the same range and types of living environments as are available to the general public. People should actively participate in the selection of their own housing from a full range of options and opportunities, and assistance must be available regardless of where they choose to live. The impact of this belief as it translates into practice is considerably different from the long-standing view of mental health residential services as a continuum of treatment facilities through which a person "progresses" from one type of facility to the next.
Many effective housing programs and opportunities which support the above belief (and goal) exist in our community today and, as a result, many persons with serious mental illness are now living fulfilling and productive lives in settings of their own choosing within the community. Unfortunately, however, the scope of existing housing programs cannot adequately address the extensive needs of the dual diagnosis population and, while it is "difficult to house" this population, an absence of suitable housing - temporary, transitional, and permanent - contributes to enhanced problems for the individuals, their families, and the community. Such individuals don't "fit" into the categories or requirements for traditional services, special housing, or entitlement programs. They have low tolerance for rules, low coping skills, and a history of poor choices. Additionally, their behavioral problems, eviction histories, lack of social/living/self-sufficiency skills and involvement with the judicial system disqualify them from many housing settings. These persons have fallen through the cracks of our existing social system networks, yet their potential for homelessness is ever present.
While this picture may be bleak, it does not need to be hopeless. The mental health system, in conjunction with other service providers who recognize this as a community problem, has identified housing and program needs which it believes will begin to address the numerous needs and problems of this target population. Obviously, the greatest of these is for additional funds but, to date, requests for grant funds have been unsuccessful. Funding, if and when it becomes available, would be utilized to:
- Develop Safe Haven and/or Single Room Occupancy (SRO) Housing which could be temporary or permanent, some with on-site staff.
- Provide a wide array of intensive supportive services which would include:
- cash assistance for security deposits and rent
- emergency monies for clothes, bedding, etc.
- transportation to various needed resources
- mental health services, assessment for medication, counseling, adult case management
- linkage and referral to other needed community social service agencies
- teaching independent living skills, household management, etc.
- assessment, linkage and follow-up to community sobriety programs
- assertiveness and flexibility in engaging persons in a relationship and in engaging them in substance abuse treatment - emphasizing outreach, practical assistance and working with family members, landlords and other supportive services
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