Housing
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For someone with a mental health condition, the basic necessity of a stable home can be hard to come by. The lack of safe and affordable housing is one of the most powerful barriers to recovery. When this basic need isn’t met, people cycle in and out of homelessness, jails, shelters and hospitals. In Santa Cruz County, Encompass Community Services, Front Street, Inc. and Santa Cruz County Mental Health Housing department coordinate most of the housing for people with a mental health condition.
Types of Housing - Housing options range from completely independent living to 24/7 care. The type of housing that is right for you can depend on whether you need assistance paying your bills, cleaning, making appointments or require no assistance at all. Below are some of the types available in our county. Board and Care Facilities - This type of housing provides the most support for its residents. Trained staff members are present 24/7 to provide care and assistance with things like medication, daily living skills, meals, paying bills, transportation and treatment management. List of Board and Care for Adults (18-60 years of age)
List of Board and Care for Older Adults (older then 60 years of age)
Supportive Housing - Supportive housing provides limited assistance. The residents of these homes live almost independently and are visited by supported housing coordinators 2-4 times a month. However, they do have someone to call and resources available to them if a problem does arise.
Subsidized Rental Housing -This type of housing is for someone who is completely independent. Rent can be paid for in full by the individual or subsidized by a third party, such as the government or a non-profit agency. For more information on subsidized housing for people with a low income or disability, see:
Private Pay Case Management - Front Street, Inc is dedicated to providing the highest quality of individualized services for independent living such as shopping, eating well, maintaining safety in housing, and accessing community resources. The service can follow an individual from renting a room in a family member’s home to living more independently in the community. (Housing is not provided by Front Street.) Call for more information: Megan Shell (831) 420-0120;101 Community Residential Treatment Systems (CRTS) also know as Social Rehabilitation Programs (SRPs), which are licensed by the California Department of Social Services (CDSS); provides an activity program that encourages utilization of community resources for no longer than 18 months. An advantage to this program is that it provides the needed supports and time to transition successfully to independent living. This program existed in Santa Cruz but there was a problem with Medi-Cal reimbursement and it was no longer financially viable. |
Recording from July 2016 Speaker Meeting (more recordings)
Links
Life Skills Support ServicesLife Skills Support Services is a curated service designed for individuals who want to enhance a variety of independent living skills.
Work with an intimate team of experienced support staff from an organization specializing in behavioral health services for over 30 years. The LSSS team's mission is to work collaboratively with individuals to identify and achieve both short and long term life skills goals. The frequency of one on one support varies per person - a support service designed by you, for you. Contact Front St. Inc. team for more information: 831-421-1130 Housing that Heals
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Long Term Strategies for Community Placement: Alternatives to Institutions for Mental Disease Final Report October 2005
Beverly Abbott, L.C.S.W; Pat Jordan, L.C.S.W; Joan Meisel, PhD; J. R. Elpers, M.D
Funded by: The California State Department of Mental Health
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IMDs (Institution for Mental Disease) are locked facilities that people sometimes go when conserved after multiple mental health crisis and subsequent hospitalizations. "Expanding community living situations for persons with serious mental illness was consistently identified as critically important to enable people to move out of IMDs. Counties also confirmed the importance of ACT/AB34 and AB 2034 (programs providing comprehensive services) and intensive case management programs in supporting persons in the community." Finding 4 elaborates on the study's findings for more community supports and inclusion of family members.
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FINDING 4: IMPROVED COMMUNITY RESOURCES WILL ALLOW FOR MORE APPROPRIATE USE OF IMD/STATE HOSPITALS
4A. Lack of adequate housing resources and intensive case management in the community were cited as the major obstacles in transitioning clients out of IMDs back into the community. Appropriate housing and
sufficient support services can be and are made available in a variety of structures in different counties. Ideally, someone could be able to return to an appropriate permanent living situation, where they can remain as long as they choose while supports would be made available 24 hours a day and 7 days a week as necessary.
4B. Counties have reduced IMD usage through the development of specific combinations of housing-support services. While temporary programs are not a recommended direction for the system as a whole,
step-down programs which combine housing and treatment services may be particularly helpful as options in achieving immediate reductions in IMD utilization while a county is building its more permanent supportive housing. Additionally, intensive case management, ACT teams and integrated service agency programs can provide structure and support services to augment other types of housing such as board and care facilities, apartments, and room and board places.
4C. While more housing and case management resources are needed, coordination and integration of the available and existing resources can improve a county’s use of IMDs. Responses to the Tracking Study questionnaire made it apparent that the IMD staff/county monitors did not think in terms of community preparation. It is difficult to prepare clients for community living when the staff is not thinking in terms of what it takes to succeed in varying community settings. Similarly, resource shortages limited success of policies requiring community care case managers to follow their clients while they are in an IMD. Teams comprised of IMD staff, county long-term care staff, the Public Guardian and community program staff that work with clients on transition out of IMDs as soon as they are placed into the facilities are helpful.
4D. Board and care facilities are not sufficiently funded and supported by counties and licensing agencies to play the role they are forced to currently play in the system of care. While better alternatives could be available in the long run, counties are heavily dependent on board and care facilities as discharge placements from IMDs, yet board and care funding, staffing and licensing standards leave them woefully inadequate to the task.
4E. Families are an important resource for many clients. Many clients in the study counties were living with their families prior to going into an IMD, and many returned to families upon discharge. Families involved with clients can be important components of clients’ social networks and are important to clients’ recovery, but families are not fully included in the processes and planning for their loved one.
RECOMMENDATIONS
4.1. The development of additional flexible supportive housing resources at both the state and county levels is critical in reducing IMD utilization.
4.2. ACT-type teams and integrated service agencies can be used as helpful alternative resources for returning long-stay IMD and state hospital clients to the community.
4.3 Intensive case management services help clients be more successful in their transition to the community.
4.4. Counties could consider the development of a range of augmented residential programs.
4.5 Implementing more effective discharge planning processes can reduce lengths of stay and recidivism.
4.6 Counties who must rely significantly on board and care facilities for the near future could enhance quality of life and recovery opportunities for residents in such facilities.
4.6 A collaborative effort initiated by DMH with Community Care Licensing (CCL) would help to promote the appropriate use of community care facilities for clients with serious psychiatric disabilities.
4.7 Counties could consider developing programs to assist families who provide housing and other support to their family member with mental illness, and IMDs could enhance family involvement in their programs.
4A. Lack of adequate housing resources and intensive case management in the community were cited as the major obstacles in transitioning clients out of IMDs back into the community. Appropriate housing and
sufficient support services can be and are made available in a variety of structures in different counties. Ideally, someone could be able to return to an appropriate permanent living situation, where they can remain as long as they choose while supports would be made available 24 hours a day and 7 days a week as necessary.
4B. Counties have reduced IMD usage through the development of specific combinations of housing-support services. While temporary programs are not a recommended direction for the system as a whole,
step-down programs which combine housing and treatment services may be particularly helpful as options in achieving immediate reductions in IMD utilization while a county is building its more permanent supportive housing. Additionally, intensive case management, ACT teams and integrated service agency programs can provide structure and support services to augment other types of housing such as board and care facilities, apartments, and room and board places.
4C. While more housing and case management resources are needed, coordination and integration of the available and existing resources can improve a county’s use of IMDs. Responses to the Tracking Study questionnaire made it apparent that the IMD staff/county monitors did not think in terms of community preparation. It is difficult to prepare clients for community living when the staff is not thinking in terms of what it takes to succeed in varying community settings. Similarly, resource shortages limited success of policies requiring community care case managers to follow their clients while they are in an IMD. Teams comprised of IMD staff, county long-term care staff, the Public Guardian and community program staff that work with clients on transition out of IMDs as soon as they are placed into the facilities are helpful.
4D. Board and care facilities are not sufficiently funded and supported by counties and licensing agencies to play the role they are forced to currently play in the system of care. While better alternatives could be available in the long run, counties are heavily dependent on board and care facilities as discharge placements from IMDs, yet board and care funding, staffing and licensing standards leave them woefully inadequate to the task.
4E. Families are an important resource for many clients. Many clients in the study counties were living with their families prior to going into an IMD, and many returned to families upon discharge. Families involved with clients can be important components of clients’ social networks and are important to clients’ recovery, but families are not fully included in the processes and planning for their loved one.
RECOMMENDATIONS
4.1. The development of additional flexible supportive housing resources at both the state and county levels is critical in reducing IMD utilization.
4.2. ACT-type teams and integrated service agencies can be used as helpful alternative resources for returning long-stay IMD and state hospital clients to the community.
4.3 Intensive case management services help clients be more successful in their transition to the community.
4.4. Counties could consider the development of a range of augmented residential programs.
4.5 Implementing more effective discharge planning processes can reduce lengths of stay and recidivism.
4.6 Counties who must rely significantly on board and care facilities for the near future could enhance quality of life and recovery opportunities for residents in such facilities.
4.6 A collaborative effort initiated by DMH with Community Care Licensing (CCL) would help to promote the appropriate use of community care facilities for clients with serious psychiatric disabilities.
4.7 Counties could consider developing programs to assist families who provide housing and other support to their family member with mental illness, and IMDs could enhance family involvement in their programs.
