This is a really sticky subject. After interviewing various people, I can see that this is not a subject that can be covered in one column. People have very strong feelings about where to house the young disabled (many of whom are mentally ill folks living in the community, outside of hospitals). Some seniors in senior housing resent having them placed in their facility, though they probably don’t mind wheelchair bound, physically disabled folks. I understand. I am 77 years old and I do not want to share space with my own mentally disabled relative. That is not because I fear violence or am particularly upset by some of the unpredictable behavior. It is because I am old and set in my ways. There is a reason women my age don’t get pregnant and have babies. We just are not flexible enough to weather the swirl of activity, emotional ups and downs, etc. of someone on a radically different time frame and agenda than our own. But the Federal Government, in its infinite wisdom, passed a law in, I think the 1970’s, in response to public outrage nationwide about the lack of housing for the handicapped and special needs population. It mandated that all Public Housing Authorities (PHA) must offer a protected status and shelter a percentage of the disabled. There is a 700 page Code of Federal regulations for PHAs which is strictly enforced and micromanaged.
When in the ‘60s and ‘70’s new medications were developed and there was a big push all over the country to close down mental hospitals and give patients a chance to avoid institutional living, the promise was that Community Centers would spring up all over the country to supervise, treat, and in some cases house folks in group homes. It was a lovely well meaning plan. I used to work with a Harvard educated psychiatrist who opened one of those in the late ‘60s in Concord, Mass. He did get it to exist, got it staffed and allied to an Inpatient Psychiatric Unit at Emerson Hospital. But that was the end of the story, basically. No one ever allocated enough money to fill the stated goals. There was no housing, very little outreach or outpatient supervision, and the patients were left to flop along on their own in the community, turning up for rehospitalization periodically when they experienced "An Episode". When I started working there in 1987 patients could stay in the hospital for about 30 days. They would be restabilized, observed, and discharged with a reasonably thought out aftercare plan and contacts. By the time I left in 1989 the stay was reduced to 14 days. I understand it is now somewhere around three days. It is a pitiful mess with no easy solutions.
The young disabled have a few options. They can apply for housing in a PHA. If they live on Social Security Disability (SSDI), they pay 30 percent of that (very skinny) monthly income for a place in a Public Housing Authority building. We have five of these in the Brattleboro area: Ledgewood Heights (up behind Price Chopper), and Moore Court, both primarily for families. Then there are Hayes Court and Melrose Terrace in West Brattleboro and the Samuel Elliot high rise apartment building in downtown. The latter three were originally built just for seniors. Rents are completely dependant on income. So, if your SSDI monthly check is $600, then you would pay $180 for your rent, leaving a rip snorting $420 for every other thing. Food stamps can help a bit. If the person can stay episode free for long periods of time, and can work SSDI allows income from say a part time job up to about $1,000 per month. An employer has to be willing to be very flexible and work around the ups and downs of the illness. Severe and persistent mental illnesses like Schizophrenia and Bi Polar Disorder are subject to recurrent flare ups, which often the patient does not see coming. Since medical care is directly tied to Disability, no one dares risk losing that designation, knowing they could fall ill again at any time and have to go through the reapplication process, which can take forever. If my relative did not have family to help out, that would be how it would turn out. Luckily we are able to pay for independent housing and Case Management. Not every family is so lucky.
Truly, mentally ill folks are much less likely to be violent than the general population. Actually, they usually get very confused, cannot focus, behave in odd ways and are much more likely to get hurt themselves than to hurt someone else. We live in a violent culture and are in danger from people who can focus, make a plan, though often a stupid one, and do others damage. Seniors today were raised in what amounts to prehistoric times where mental illness is concerned. Anyone who has kept up with the brain research knows it is a biochemically damaged brain causing these symptoms not bad parenting or severe toilet training. We are not terribly comfortable around people with Alzheimers or Parkinsons, Autism or closed head injuries resulting from accidents. But we do not blame the person for their illnesses.
So, seniors are left having to be the folks accepting these problems on their own doorsteps. Our local PHA says "We don’t screen people out. We screen them in," and accommodate as much as possible to keep them in their unit. Of course they do a criminal background check and a credit check during the screening process. Which kind of housing is very much dependant on location and size of the unit. Families, of course, require the larger units. Single folks without transportation who need to be able to access the medical and psychiatric services often end up on Elliot Street in the high rise apartment house. 28 people (38 percent) of the population of the Elliot Street high rise are identified as disabled or handicapped. 38 people (51 percent) of Hayes Court and 26 people (31 percent) of Melrose Terrace tenants are also so designated. There are 10 units overall in the five facilities that are fully handicapped/wheelchair accessible.
When Public Housing was begun in 1937 by the Federal Government as part of the government’s response to depression era homelessness and poverty there were very few options available. My town, Wilmington had its "Poor Farm"then, as did many other communities. Most of the public housing developments in Vermont were built in the late 1960’s-early ‘80’s. Federal funding has not kept up with the growing population of elderly and disabled. Lord knows what will happen to the tsunami of Autistic children when they reach adulthood (just at the same time the senior population explodes as well.) Next time I will try to tackle the local non-profit housing options (like Windham & Windsor Housing Trust) which operate somewhat differently.
Claudette Hollenbeck is a retired Social Worker, living in Wilmington and a Board Member of Windham & Windsor Housing Trust and a past Board Member and President of West River Habitat for Humanity.