Home sweet home: Finding housing for mentally ill adults

May 4, 2012

Joe Linstroth and Caroline O'Donovan

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Finding affordable housing in the current economic climate is difficult, but it’s even harder for those suffering from mental illness. Fortunately for Laura Tinsley, who has a history of chronic mental health problems, she’s been part of Housing Options since 2008. The small social service agency located in Evanston provides housing and support services for severely mentally ill adults. They employ a team of social workers, counselors, case managers and psychiatrists who provide residents with everything from medical care to life skills counseling. Tinsley says she’s never been more independent: “I’ve never felt better than in 2012!”

Prior to Housing Options, Laura Tinsley lived in Greenwood Care, a for-profit nursing home also in Evanston. Places like Greenwood are called institutions for mental disease (IMDs), and Illinois is one of the few states left that still relies on them to house its most severely mentally ill adults. IMDs have a less-than flattering reputation among mental health professionals, who say patients are warehoused in these facilities and poorly monitored by staff. However, with the lack of affordable housing, many also admit that without them, folks would be homeless, in prison or worse. 

IMDs emerged in Illinois in the 1960s and '70s, after the state began closing its mental hospitals. Today more than 4,000 people reside in 27 IMDs across the state. Critics call the system “antiquated,” but it’s not just sub-par care that draws their ire -- IMDs are also extremely expensive. 

The state spent more than $122 million in 2010 on these facilities, according to the Associated Press. IMDs are not eligible for matching federal Medicaid dollars, making them even more costly. Yet there’s been little mention of IMDs in the discussions around Gov. Pat Quinn’s recent proposal to slash $2.7 billion from the state’s Medicaid budget. While proposed cigarette tax hikes and service cuts have Illinois residents up in arms, it’s worth talking about how much the state would stand to save by shifting resources to a more humane and less expensive independent supportive housing model. 

In 2005, a group of IMD residents did more than talk about it. With the help of the ACLU of Illinois, they filed a class action suit against the state. They argued that “they were not being housed in the least restrictive setting appropriate to their disabilities, as required by federal law.” In 2010, a federal judge ruled in their favor. The Williams v. Quinn decision gives the state five years to at least offer independent housing with supportive services -- like the kind Housing Options provides -- to all of its IMD residents. 

It’s only 2012, so they still have a few years to go. If the proposed cuts go through, however, many mental health providers worry that, even if the required housing options are made available (and that’s a big “if”), there may not be enough services left to make independent living a better option for their clients than IMDs.  

Friday on Eight Forty-Eight, Debbie Bretag, executive director of Housing Options, and Mark Heyrman, a law professor at the University of Chicago and one of the state’s leading advocates on mental health policy, discuss the ways to help the state’s most vulnerable residents live more independently. And former IMD resident Laura Tinsley shares her personal story.