Beyond the Open Door — Challenges in Housing for People with Mental Illness

Medicaid’s participation in prevention planning and implementation. Additionally, supported congregate housing, in contrast to the general housing market, requires a capital investment to finance the building of efficiency unit-housing facilities and a long-term commitment to support affordable rents despite market escalations.

What types of risk management approaches most effectively respond to legitimate community safety issues?

It only takes one or two well-publicized allegations of crime to further ingrain the stigma against people with mental illness. Widespread use of supported housing will force community-based agencies to train case management staff differently and develop clinical support tools to assist in consumer risk assessment and monitoring. Additionally, for parents with mental illness raising their children in supported housing, case managers with family development skills will be required to ensure child safety within the context of supporting the whole family.

Many of the lessons we at the Institute for Community Living have learned about community-based housing were gained through our work with the people we serve. One of the most important design elements is to enlist consumer participation in housing decisions. It is the hope of all mental health care providers that an ongoing conversation surrounding these topics will raise more questions than provide answers, thereby fueling the national dialogue on how to help people with mental illness — an incredibly diverse population — best integrate within the community.

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