An estimated one in four Americans experience some form of mental illness each year, so chances are you know someone suffering from mental illness and just don’t realize it.
They are family members, friends and neighbors, and most of them live quiet lives trying to manage their disorders with no one the wiser, say mental health advocates.
“There is a very broad spectrum of mental illness,” said Barbara Mead, vice president of behavioral health for Pasco-based Lourdes Health Network. “I think people need to think about treatment for serious mental illness the same way as other conditions.”
But a stigma exists nonetheless that people with mental illnesses are dangerous or violent — and that stigma can prevent them from finding a place to live in the Mid-Columbia.
It can be especially challenging when their illnesses lead to trouble holding a job or they have run-ins with the police.
Advocates say there just is not enough housing.
“We, our community, need to step up to help,” Mead said. “Without that, those people end up on the street. Does that make the community safer?”
“It’s a huge need,” agreed Nan Bopp, president of the Tri-City chapter of the National Alliance on Mental Illness. “As we speak, we probably have half a dozen (NAMI) people who have loved ones at home because they can’t find housing. If they could, they would, but it’s just not available.”
Now advocates for people with mental illnesses fear the situation will become even more difficult after residents of the Sundance Mobile Home Park in Pasco are raising concerns following the March 6 stabbing death of Rodger Lincoln, 53.
Lincoln and his roommate Joseph W. Hart, the 27-year-old man accused of killing him, lived in a mobile home owned by Lourdes. The mobile home is one of several where people with mental illnesses can live while Lourdes helps them become self-sufficient.
Residents live in the mobile homes for up to 18 months under daily supervision as they learn the basic life skills to transition into independent living, said Tim Hoekstra, director of outpatient services at Lourdes Counseling Center in Richland.
But other residents of the mobile home park have told the Herald they question why people with mental illnesses are allowed to live next to them, and why they weren’t told those patients were there.
Mental health rights
Mead and Hoekstra said the answer is simple — because people with mental illnesses have legal and civil rights to live in the community unless they have demonstrated they are enough of a danger to themselves or others, or have a grave enough disability to justify sending them to a psychiatric hospital.
“It’s in the RCW, in the Involuntary Treatment Act,” Mead said. “How I think of (involuntary treatment) is suspending someone’s civil rights. It’s locking them up behind a closed door.”
Often the desire to lock away people with mental illnesses stems from incorrect perceptions about just what it means to have a mental illness, Mead and Hoekstra said.
“A mental health disorder does not mean the person is broken,” Hoekstra said.
It also doesn’t mean the person is a criminal, Mead added.
She likened having a mental illness to being diagnosed with diabetes or another chronic illness. Just as people with those illnesses can experience setbacks when faced with life stresses or problems accessing health care, people with mental illnesses also can be challenged in managing their illnesses when their lives are disrupted.
“What happens if that person loses their house or loses access to their medication?” she said. “With diabetes it gets worse. It’s the same thing with mental illness.”
Mead said it is a common misperception that people with mental illnesses are prone to violent behavior, when statistics show they are 11 times more likely to be the victims of violent crimes than the general population.
That number comes from a study published in 2005 in the Archives of General Psychiatry in which a team of researchers at Northwestern University looked at adults with severe mental illnesses.
Another study published in the Archives of General Psychiatry in 1998 found that people discharged from psychiatric hospitals were no more violent than other people living in the same neighborhoods. Though the authors found the risk of violence might increase if the person was using drugs or alcohol or not getting treatment for the mental illness.
Housing options limited
Mead said having an adequate supply of housing is critical to helping people with mental illnesses to become stabilized — and stay that way.Lourdes offers a variety of housing programs ranging from its 20-bed inpatient psychiatric hospital in Richland to the “supported living” mobile homes in Pasco. The programs are designed to accommodate a spectrum of people, illnesses and stages of treatment.
Cullum House, for example, is an eight-bed residential treatment facility where people might go after being discharged from the hospital and where they can get 24-hour, seven-day supervision.
Residents can stay for up to 90 days, and get individualized treatment that includes symptom management, life skills help, one-on-one staff time and vocational education.
“One thing we have to be clear about is that if they are a danger to themselves or others, or are gravely disabled, they belong in an inpatient setting,” Hoekstra said.
Up to 23 people who need less care than those in Cullum House, but still need help adjusting to day-to-day living, can stay in the supported living mobile homes for up to 18 months.
Those residents have case managers who help them at home, and the majority come to Lourdes Counseling Center in Richland for treatment and medication.
On-site supervision might include making sure they are doing OK cooking meals and washing their clothes or dishes, and that they are taking their medications as prescribed, Hoekstra said.
Again, the program is individually tailored to the person’s illness — which could be any one of a variety of mental illnesses — and is designed to help them overcome the barriers that might stop them from getting permanent housing, he said.
Hoekstra said he fears what would happen to those residents if programs like the supported living mobile homes didn’t exist.
“If you take a program like that and contrast that with a person on the street because we don’t have a housing program ... that person is set up for failure,” Hoekstra said.
Options often temporary
Judith Gidley, director of Community Action Connection in Pasco, said her agency serves a number of people with mental illnesses who have been homeless or are at risk of becoming homeless, and often it can be difficult to find housing for them because many work only part time if at all and live on meager incomes.
The overall supply of rental housing in the Tri-Cities remains tight enough that landlords easily can refuse to rent to someone who doesn’t have the money or has a history of being jailed when unmanaged symptoms of a mental illness lead to behavioral outbursts, she said.
“We’re at the mercy of the landlords and the people who are willing to allow someone with a mental illness or any type of disability,” Gidley said.
And programs that help tend to be temporary, she said.
“The idea of having housing for the mentally ill is a good idea if you have the ability to sustain that,” Gidley said. “But none of our programs sustain that.”
Hoekstra said there is some flexibility to extend stays in the Lourdes housing programs if the person isn’t ready to move to the next stage, but Tri-City mental health advocates all agreed more housing is needed.
Ed Thornbrugh, director of the Benton Franklin Department of Human Services, said one issue is that state funding for mental health programs has been reduced and so the money available has been prioritized first for inpatient stays and second for crisis and commitment services.
Residential programs are third on the list, but not much money is available, he said.
“There are a number of variables that can change what (funding is) available for distribution,” Thornbrugh said. “You go to a crisis-driven system which is much more expensive and much less effective.”
He said local mental health agencies are doing what they can to create partnerships to try to address the needs, but money is an obstacle.
“In the Tri-Cities, we are hard pressed in every category (of mental health housing),” Thornbrugh said. “It’s this battle between creating capacity and being able to afford it.”