Severe mental illness is a complex issue that affects every facet of our community. We want to help support those who are struggling. We want to provide them with safe accommodations.
At the same time, we understand that supportive housing isn't always straightforward. Here's what you need to know.
What is High-Acuity Mental Illness?
Mental illness exists on a vast spectrum. Acuity refers to the intensity of interventions used when treating a particular condition.
Someone with a mild bipolar disorder, for instance, may need to optimize their lifestyle habits and take an antipsychotic medication to feel better. But someone with severe bipolar disorder may experience intense psychosis and manic symptoms that cause them to become violent. These episodes might require ongoing hospitalizations and support services 24 hours a day. Without that level of care, they may be at high risk for dangerous behaviors, like suicide.
Someone may have a high-acuity mental illness if they:
frequently engage in self-harm
experience ongoing psychosis
have a co-occurring substance use disorder
have had a history of suicide attempts (and are currently suicidal)
lack insight into their specific condition
Children may exhibit symptoms differently than adults. A child with high-acuity mental illness may have frequent tantrums and outbursts. They may have severe issues with authority figures or in school. They might also be violent towards themselves or others.
Conditions that are often classified as high-acuity mental illnesses include:
Bipolar I disorder
Substance-induced psychotic disorder
Personality disorders (depending on the severity)
Homelessness and High-Acuity Mental Illness
Homelessness remains a consistent problem for people with severe mental health issues. This is a complex community issue without clear-cut answers.
Research shows that approximately 45% of homeless people have a mental illness, and 25% of those people are severely mentally ill. These figures compare to the 4.2% of US adults that have been diagnosed with a serious mental illness.
Mental health often coincides with financial problems, which affects housing. Someone who is mentally ill, for instance, may not be able to work effectively in a job. If they can secure work, it may be low-paying. In addition, they might not be able to organize, budget, or save money to pay rent. A lack of low-income housing options may result in them ending up on the streets.
Furthermore, severe mental health also coincides with other sociocultural concerns, such as drug and alcohol abuse, criminal activity, and violent victimization. These combined risk factors may increase the likelihood of homelessness.
Finally, homelessness itself can exacerbate mental health problems. It's no secret that life on the streets is rough. and many people experience ongoing trauma during this time. Trauma activates a persistent fight-or-flight response, and it can aggravate anxiety, depression, psychosis, and other acute symptoms.
What Housing Options Exist for People with Mental Illness?
Mental health housing options range in type, cost, and accessibility. The type of housing that is best for you or your loved one depends on numerous factors, including:
ability to function independently
adherence to treatment protocols
past experiences with housing
Inpatient hospitalization (often known as a 5150 or 5250) is an immediate housing option for people who are in grave danger of harming themselves or others. This is the highest level of medical care.
Patients can check themselves in voluntarily. But, many times, inpatient hospitalizations are involuntary.
Patients cannot leave until they have achieved a specific level of stabilization. Hospitalization is not a replacement for treatment, but it will provide immediate assistance and resources upon discharge.
Shelters provide assistance against homelessness by offering people with mental illness a temporary place to live. Shelters may also provide other essentials, like food, water, clothes, and hygiene products.
Many of them contract with housing assistance programs to help people get back on their feet. Homeless shelters tend to have specific rules regarding curfew, substance use, and general behavior. You can look into your shelter options online or by working with a dedicated social worker or case manager.
Group homes provide a high level of support for their residents. This type of housing offers 24/7 monitoring.
Staff members help with all types of assistance ranging from dispensing medication to helping clients pay bills to supporting wraparound treatment. Residents often eat meals together, attend various group events, and participate in therapy throughout their stay.
Residential group homes for adolescents focus on structured lengths of stay (anywhere from 30 days to 12 months). These programs may be subsidized by insurance to cover costs.
Living With a Supportive Family Member
Sometimes, family members take in individuals with severe mental illness. To make this strategy work, it's important that the family member can maintain clear boundaries. They also need to be involved in the treatment planning process. Some people live with family members temporarily- others make this a permanent arrangement.
Partially-Supervised Group Housing
This group housing offers structure and support, but residents function independently outside of their homes. Many of them work, go to school, maintain relationships, and otherwise adhere to a daily routine.
Mental Health Transitions, for instance, is not a residential treatment center. We offer supportive housing while also providing ample opportunities for independence and autonomy. Our goal is to help community members feel secure while also working on their recovery.
Some people with severe mental illness are able to live independently. They may either rent or own property. This option, of course, requires a significant level of maturity. The individual must be able to maintain a sense of stability to manage their household effectively.
People may be able to live independently after living in more structured environments. They need to practice implementing healthy life skills to ensure that they can cope with potential stressors and obstacles.
What Should Supportive Housing Look Like?
According to the National Alliance on Mental Illness (NAMI), effective housing should meet each of the following four needs:
Affordable: Housing should work within your budget. Sometimes, this is easier said than done, particularly in areas that have higher costs of living. Many times, family members pool together financial resources to support a loved one's housing arrangements.
The right amount of independence: Many people with mental illness can and should have autonomy within their daily routines. That means that discussing housing options should be collaborative. If you or your loved one isn't compliant with housing, you may need to review an alternative plan.
Meets physical needs: Mental illness disabilities or impairments can affect the effectiveness of certain housing options. If, for instance, your loved one can't drive, they may need housing close to your work, treatment providers, or family.
Discrimination-free: The Fair Housing Act prohibits that rental properties from discriminating against tenants based on disabilities. A landlord or owner cannot refuse to rent to you based on your mental illness. You're also allowed to ask for reasonable accommodations that best fit your needs.
What Should Severe Mental Health Treatment Include?
Although there are no cures for mental illness, the right treatment can make a significant difference in providing a stable life for your loved one.
Crisis support: Severe mental illness often coincides with crises. These crises can be intermittent or fairly predictable. But they require acute care, and their housing should be equipped with resources or guidelines for handling these situations.
Therapy: Children and adults with mental illness often benefit from therapy. A therapist can help your loved one understand their symptoms, improve their ability to cope with stress, and build a positive support system. Family therapy is often recommended when working with children or adolescents.
Case management: Case managers often help with coordinating care. A case manager, for instance, may schedule doctor's appointments, discuss treatment progress with family members, and meet with individuals to review specific resources. They often have educational backgrounds in psychology or related fields.
Life skills: Life skills can refer to anything from learning to budget to working at a job to social skills. Life skills foster a sense of independence, which is essential for building resilience and supporting emotional well-being. Therapists, case managers, and support staff can all provide this type of practical guidance.
Medication management: Medication can help stabilize some of the more acute mental health symptoms. Unfortunately, many people with mental illness struggle to adhere to their medication treatment plans. They may forget or skip doses. Or, they might assume that they don't need the medication and that their providers are overreacting to certain symptoms.
What If I Don't Know What's Best For My Loved One?
Learning all the different types of housing can feel overwhelming. The anxiety may be particularly heightened if you're struggling with a current crisis. If you're not sure where to begin, contact us. We can help you navigate residential and independent living options.
What If I Can't Afford Housing?
If you are low-income, you may be eligible for financial housing subsidies through the state or federal government. Contact your local county department to look into specific resources. Section 8 Housing, in particular, offers a voucher-based system for helping people secure affordable housing. Keep in mind that there may be long waiting lists for some of these services.
What If My Loved One Refuses Treatment or Housing?
Unfortunately, this is a common trend for families facing severe mental illness. You may love someone who denies support. If that's the case, it's important to establish specific boundaries. You don't want to enable someone's self-destruction, but you can provide compassion. You can also help them locate adequate health care services. Keep in mind that your loved one may not appreciate your support. Mental illness can impact their thoughts and sense of safety with others. Stay consistent in how you maintain your boundaries but don't give up on emphasizing the benefits of seeking help.
What Is The Difference Between Mental Health Housing Services and Sober Living Homes?
Sober living homes emphasize abstinence from drugs and alcohol. These independent homes also offer support services, but they do not necessarily treat high-acuity mental health needs. Most people cannot use mood-altering substances in mental health housing homes. However, not all residents in these homes have substance use problems. Likewise, some of them may take controlled medications that would otherwise be prohibited in a traditional sober living home.
Supportive Housing Resources in Orange County, California
Our unique housing services provide safe and comfortable transitional support for all of our residents. We have houses for both men and women- each has spacious bedrooms, multiple leisure rooms, and is right in the heart of beautiful Orange County, California.
We offer full wraparound care in our housing program. Community members have access to our in-house psychiatrist, licensed therapists, case managers, and 24/7 support staff. We are dedicated to ensuring that your loved one establishes a healthy recovery.
Contact us today to learn more!