Housing Opportunities for Persons with Mental Illness

1. Housing Opportunities for Persons with Mental Illness Tanya Tull President/CEO Beyond Shelter, Inc. presented to: The President’s New Freedom Commission on Mental Health November 13, 2002

2. Ending Homelessness Homelessness is the most visible manifestation of increasing poverty in America. Deep pits have been dug in communities throughout the country, and more and more people are falling in every day. The safety net is disappearing and the ladder has been taken away.

3. Emergency shelters and transitional housing are simply “stepping stones.” If at the end of our interventions and our support, the homeless are still homeless – or at risk of another episode of homelessness – then what have we really accomplished?

4. Homelessness ends when an individual or family is stabilized in permanent, affordable housing, whatever that permanent housing type may be – and whatever the support systems that must be in place to help them stay there.

5. Two Premises of Housing First • Permanent housing should be the central goal of our work with people experiencing homelessness. • By providing permanent housing assistance immediately and up-front, we can significantly reduce or eliminate the time people spend in homelessness.

6. The “Housing First” Approach Moves homeless persons into permanent rental housing as quickly as possible, with the services traditionally provided in transitional housing provided after relocation into permanent rental housing. The basic goal of “housing first” is to “breakthe cycle”of homelessness and prevent a recurrence.

7. Components of Housing First • Crisis Intervention and Stabilization • Intake and Assessment • Assistance Moving into Permanent Housing • Home-Based Case Management (time-limited or long-term)

8. The “housing first” approach helps mentally ill persons move into permanent housing of many different types, including housing in the private rental market, often with a subsidy – and offers home-based services to help them stabilize and maintain their housing.

9. Benefits of a Housing First Approach • Uses Private Market Housing • Prevents Recidivism (return to homelessness) • Improves Client Outcomes • Leverages Existing Community Resources • Cost Effective • Offers Housing Choice

10. HUD Continuum of Care Model Outreach Intake Assessment Traditional Housing, no services Emergency Shelter Transitional Housing Supportive Housing

11. Modifications to the Continuum of Care Outreach Intake Assessment Traditional Housing, no services Emergency Shelter Transitional Housing Supportive Housing Service-Enriched Housing Indicates Modifications Traditional Housing with Home-Based Case Management

12. Housing Options • Permanent Housing – No Services • Supportive Housing – Services are available for people with special needs

13. Additional Housing Options • Service-Enriched Housing – Private or nonprofit rental housing, with services available to all residents, regardless of special needs. • Permanent Housing – Home-based case management available through outside sources, either time-limited or long-term.

14. Service-Enriched Housing Basic rental housing for the low-income population at-large, in which services coordination is available to ALL residents of a rental property. Service-enriched housing can be multi-family housing or single-family housing, owned by non-profit developer or a private landlord.

15. Components of Service-Enriched Housing • Mentally Ill persons integrated into broader community (families, seniors, working poor). • Services Coordinator available for crisis intervention, on-going support and linkages to mental health and other services for all residents.

16. Benefits of Service-Enriched Housing • Cost effective. • Leverages existing community resources, identifies problems prior to crises. • Improved resident outcomes (prevents homelessness, relapse and other negative behavior). • Offers more housing choice.

17. Simple mechanisms can be put in place where people live to meet the needs of all people living in our communities, including persons with mental illness, the elderly, families with children, youth, and persons with other special needs.

18. Neighborhood-Based Services Coordination An adaptation of the service-enriched housing methodology, in which a “central point of contact” for services coordination is available to all residents of a neighborhood - families, elderly, persons with mental illness, and youth.

19. Stress Management Psychiatric Services Counseling Services Transportation Health Care Employment & Job Readiness Services Mental Health Services Family Preservation/Reunification Linking persons with mental health problems to community services Socialization & Recreation Programs Child Care & Children’s Services Money Management Community Service Opportunities Crisis Intervention Parole/ Probation Home-Based Services Substance Abuse Services Grocery, landromat, bank, etc.

20. Given the inadequate supply of affordable and specialized housing, it becomes increasingly important to look at the existing housing stock at large as a source of housing for persons with mental illness.

21. Policy Recommendations to Improve Housing Opportunities for Persons with Mental Illness

22. Shorten Experience of Homelessness • Address barriers within HUD Continuum of Care. • Adopt a Housing First approach. • Make a variety of housing options available (match client to housing).

23. Support Home-Based Services • Can be offered through neighborhood center or other community-based resources and services. • Develop strategies to support mentally ill persons living on their own who are “isolating”. • Recognize and support “housing choice” for all persons with mental illness and the benefits of enabling them to live in neighborhoods and communities regardless of their special needs.

24. Meet Housing Needs • Integrate a “housing first” approach into all homeless programs and services. • Offer a variety of permanent housing models that integrate housing + services, to enable persons with mental illness to remain in communities of their chose, often near family and friends.

25. Prevent Homelessness • Address national shortage in affordable housing – especially for people with incomes below 30% of median income. • Insure that no Institution discharges someone without a viable housing plan. Provide housing search assistance.