By Ret Boney
Having a safe, stable and affordable place to live is often the first and most important step in helping people with mental illness live independent and productive lives, experts say.
A shortage of such housing in North Carolina may soon be eased somewhat if state lawmakers approve a proposal for $11.25 million for construction of 400 new apartments for people with disabilities.
The state is home to half a million or more people with moderate to severe mental illness, estimates John Tote, executive director of the Mental Health Association in North Carolina.
And as many as half those people either have no home, or need more appropriate housing, he says.
With fewer than 2,000 such housing units available across the state, 400 more would represent a hefty increase at a time when the state is reorganizing the mental health system to deliver more services at the community level rather than at state-run hospitals.
“That’s where we’ll see reform succeed,” Tote says of housing. “It would mean a place to live for hundreds of folks – individuals and their families.”
The $11.25 million would go to the state’s Housing Trust Fund, a pot of state money for constructing or renovating housing for low-income people, and would be earmarked for those with mental illness, developmental disabilities or addictive diseases.
To help rents remain low, an additional $1.205 million is recommended to provide operating subsidies for the units.
State Rep. Verla Insko, a supporter of the additional funding, says housing is a necessary part of changing the mental-health system.
“If we don’t have housing in communities where people live, we can’t even deliver services,” she says.
Insko says she expects the funding to be approved during this legislative session.
If reform efforts succeed in reducing the number of people in state facilities while improving care through best-practice treatments, she says, additional investment may be approved in the future.
The Mental Health Association has built and operates about 1,600 housing units for people with mental illness, Tote says.
That housing includes independent apartments, group homes and duplexes, and those units represent the majority of such housing available in the state, he says.
With stable housing and supportive services, people with mental illnesses are often able to live independently, hold down jobs and keep their illnesses in check, he says.
“The popular notion is that these people need comprehensive services, but most people don’t,” says Tote. “Most have jobs, and with moderate support, they will be fine.”
But without such housing, problems can escalate, says Debra King, executive director of CASA, a housing developer and operator in Raleigh.
“Housing is an elementary, critical need,” she says. “It is the lynchpin for people being able to return to the community.”
Without a home, she says, it is difficult to carry out basic but critical activities like purchasing and taking necessary medications or interviewing and applying for jobs.
People often cycle in and out of state prisons and hospitals at great expense to taxpayers, King says, noting that about 16 people each month are released from Raleigh’s Dix Hospital onto the streets, where it is virtually impossible to access needed services.
Appropriate and affordable housing not only would promote better outcomes for people with mental illness, she says, but state funding of such housing is more cost-effective than the alternative.
A day in a state psychiatric hospital costs $600 or more, she says, while CASA operates its apartments, and partners with providers to offer supportive services like nurse visits, job assistance and help with apartment upkeep, for under $34 a day.
“It’s a humane and positive approach to helping people,” she says. “And it’s financially sound. You can’t get much better than that.”