Common housing options for people with serious mental illness
This custodial housing option is for people (usually aged) whose symptoms prevent them from living independently. Typically, rest homes are in large, institutionalized settings. They do not have staff trained to offer specialized mental health support.
Family Care Homes
Usually located in houses, this custodial housing option carries a warmer, more family-like feeling for its several residents. For example, meals are often prepared in the kitchen, and residents eat together in a dining room or kitchen. They do not have staff trained to offer specialized mental health support.
Mental Health Group Homes
Mental health group homes house just a few people and work with other service providers to maximize care. The home's structured daytime schedule and its staffing levels of trained service providers improve functioning, reduce anxiety, and maximize quality of life. Residents use group homes as a step towards independent living, or as a permanent home.
These full apartments have kitchens, living rooms, and bedrooms, and they offer support from an on-site apartment manager. The manager is trained to address mental health concerns and provide crisis intervention, and is also responsible for helping to coordinate care for residents.
These full apartments have amenities provided by the apartment complex, but they do not offer the specialized support of trained staff on site.
Single-Room Occupancies (SRO) and Boarding Houses
These inexpensive housing options may be attractive to people with SPMI, but they tend to draw people with substance abuse issues or legal problems. The chaotic nature of SROs and boarding houses increases stress for people with SPMI. And because SROs don't have kitchens, residents can't cook for themselves and take full advantage of resources like food stamps. They do not have staff trained to offer specialized mental health support.
Homeless shelters are considered housing of last resort for people with mental illness, yet national statistics show that 39% of homeless people report some form of mental illness - and between 25 and 30% of them have a serious mental illness. A landmark study conducted by the University of Pennsylvania in 2001 found that the homeless mentally ill use $40,500 a year in public funds for shelter and hospital services - not including costs incurred through the criminal justice system or the effects this population can have on commerce and tourism. Providing homeless mentally ill individuals with "supported" housing would cost about the same (est. $41,000 per year), but would also cover comprehensive health and other life supports.
Creating safe housing options for people with severe and persistent mental illness (SPMI) can be a daunting project within any community and there are many challenges, including:
Ideally, a community would be able to offer a range of housing options for people living with SPMI. Reality dictates that most communities focus their efforts on what they can afford. However, even with budget limitations, building a successful program is possible.
Research Shows Some Housing Models Are Better Than Others
Seminal research by Trainor et. al. (1993) proves that structured day program models lead to better outcomes for people with SPMI than custodial models. Without doubt, rest homes and family care homes offer shelter and have been accommodating about accepting residents, but they are not designed to improve functioning or maximize independence of those living there.
For a housing program to address the needs of people living with SPMI, they need to:
Considerations for Local Communities
To address the housing needs for individuals living with SPMI, local communities must understand that this type of housing is not likely to be self-supporting. Rather it is an investment in its quality of life for the entire community.
Stakeholders also need to understand that: