I was struck recently by the news that there appears to be one issue for which there is a growing consensus between the Obama administration and members of Congress: the need for improvements to the nation’s mental health system. This push comes in the wake of the Newtown tragedy, but is nevertheless long overdue. While the details are still to be worked out, reforms could potentially mean increased Medicaid dollars for mental health care and better access to mental health services at the community level, bringing these services closer to where people live. Far too often, inadequate access to community-based treatment and support results in homelessness, incarceration, or the needless institutionalization of people with mental illness in hospitals, nursing homes, or board and care facilities.
Three of the Melville Trust’s national grantees are on the forefront of efforts to ensure that people with serious mental illness or other disabilities have the opportunity to live in safe, decent housing where they can access the supports they need to live independently: the Corporation for Supportive Housing (CSH), the Technical Assistance Collaborative (TAC), and the Bazelon Center for Mental Health Law. While each comes to the issue of supportive housing in different ways, they all share a commitment to the basic principles of the U.S. Supreme Court’s 1999 Olmstead decision, which affirmed the right of individuals with disabilities to live independently in the community. These principles are:
- Choice: ensuring that people have the right to choose where and with whom they live as well as whether to engage in support services;
- Access: expanding access to quality supportive housing options, and ensuring its availability;
- Opportunity: ensuring that people with disabilities live in housing that is integrated within mainstream society and offers privacy, autonomy, and the opportunity to interact with a variety of people.
While their overall goals are the same, each of the three organizations approaches supportive housing with a different skill set and area of emphasis. CSH brings expertise in the complexities of supportive housing that serves people most at risk of repeated or long-term homelessness. They provide critical technical and financial support to nonprofit housing developers, service providers, and government agencies. TAC brings expertise in state mental health systems reform and advocates for the use of Medicaid and Section 8 resources to create supportive housing set-aside units within privately-owned housing. Bazelon is a legal advocate, partnering with the U.S. Department of Justice and others to file actions supporting the civil rights of people with mental disabilities and negotiating legal settlements to expand scattered site supportive housing options.
These different approaches can provoke debate in the field over which interventions are most effective and fair for the most vulnerable populations. While CSH leans toward the development of new supportive housing, TAC advances unit set-asides and Bazelon promotes scattered site units. The fact is, all three types of housing are needed. Housing markets and housing quality vary from place to place, as does the availability and accessibility of quality services. An approach that works in one community may be next to impossible to implement in another. Additionally, people’s housing preferences vary. Many prefer an integrated community environment, while others may choose to live with people who share their experience.
What is important in any approach is a fundamental commitment to ensuring that people have a voice in where they live, and access to community-based services and housing that embrace choice, access and opportunity. By keeping their eyes on these principles, CSH, TAC, and Bazelon are working collectively to significantly expand the range and diversity of supportive housing options, creating greater choice and flexibility for people with disabilities and for the communities where they live.