As part of its task to conduct a comprehensive study of the U.S. mental health care system, the President's New Freedom Commission on Mental Health held its second meeting last November to focus on the critical role that housing plays for people with mental illness.
Most discussions about housing focus on the public sector, where the majority of people with serious mental illness receive treatment and where the supply of safe and affordable housing is in short supply.
Housing is also a concern for the private sector. Patients with serious mental illness who are seen in private practice settings are of a different socioeconomic status than those treated in the public sector, but they still run the risk of losing the supports that keep them from entering the public system--namely employment, insurance and housing.
People under psychiatric care who are in the middle- and upper-income brackets often have family support above and beyond what is available to individuals in the public sector, Darrel Regier, M.D., executive director of the American Psychiatric Institute for Research and Education at the American Psychiatric Association, told Psychiatric Times.
However, that support is not guaranteed for life. Housing concerns are especially severe for aging middle-class parents who are providing for an adult child with mental illness. Their support, at the very least, helps keep the person out of the hospital and, in other cases, allows the person to hold down a job and receive private insurance benefits.
"The main worry in their lives is when they die, who's going to take care of these kids, and are they going to have adequate services for chronic illness?" Regier explained.
Those services include housing, drop-in centers and case management for coordinating the full range of medical care and other supports. While some parents will leave a nest egg that will provide their child with housing, the majority of parents will have exhausted their reserves on long-term health care costs that exceeded their insurance.