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Make A Full Commitment To HousingAn Opinion by Michael B. Friedman, CSW
I first became aware of the need for housing for people with serious mental illness in the early 1970’s. It was the height of deinstitutionalization in New York State. (From 1968-1973 the population of state hospitals dropped from 80,000 to 40,000). I worked at a psychiatric rehabilitation center on the Upper West Side of Manhattan, one of the very few in New York State at the time. The people who came to our program lived in single room occupancy hotels (SRO’s), which were a major source of housing for very poor people. All of them were squalid places, and many of them were exceedingly dangerous. Muggings were a daily fact of life. Murders took place from time to time. They were dreadful places for people with mental illness to live. In truth they were dreadful for anyone. I learned, however, that our clients preferred to live in them than in the state hospitals of the time, which they found even more dangerous, and at least equally squalid. I also learned that a huge number of patients were discharged to their families and that many were sent to adult homes, which often were as terrible then as many are now. 70’s Housing Initiative Brought HopeNew York State’s decision in the late 1970’s to initiate a major housing program for people with serious mental illnesses brought a great deal of hope to all of us who were trying to help people who would have lived in state hospitals in another era to live decently in the community instead. The new housing program was quite successful. It is and should be a matter of pride to New York State that roughly 25,000 housing units have been created since 1978. We’ve come a long way. But there is still vast unmet need, and people with serious mental illnesses should not have to wait another ¼ century or longer to get the job done. Time to Declare “The Decade of Housing Reform”It is time for the Legislature and the Governor to declare the next ten years “The Decade of Housing Reform” and to make a commitment to meet the housing needs of people with serious mental illness by 2015. Many of us estimate that there is a need for at least 35,000 units of housing for people with serious mental illness in New York State and that the need could run as high as 70,000. Unfortunately, it is impossible to project the housing need with any precision because New York State has not done an assessment of housing need for people with serious mental illness since 1993. At that time, the New York State Office of Mental Health (OMH) acknowledged a housing shortage of 20,000 community-based housing units statewide. Since then, the state has established about 9,000 additional units for adults with mental illness—a shortfall of approximately 11,000 units. Factors That Affect Need for Housing Were Not Taken Into AccountThat estimate, however, did not take into account a number of factors which have become clear over the past decade including:
When all of these factors are taken into account, it becomes clear that OMH’s 1993 estimate is way out of date. Surely, New York State should try to meet this need as rapidly as possible, so that the current generation of people with serious mental illness who need housing can get it before they die. What are the chances? Well, OMH now plans to develop about 5,000 additional adult units, a shortfall of at least 30,000 and perhaps as many as 65,000 units of community-based housing. At the rate of housing development over the past ¼ century (about 1,000 new units per year), it could take well over ½ century to meet the current need. Isn’t it obvious that the pace of housing development must be vastly increased?
In addition, the failure of funding to keep pace with inflation over the past decade has resulted in two very
serious problems:
I believe that a disaster is just waiting to happen. And the Governor apparently agrees, since he did propose
an infusion of $9 million in this year’s budget for community residences (CRs). Unfortunately, it is not nearly
enough for the CRs, and it cannot be used for “supported housing”—the most common type of community-
based housing in New York State.
As I have said, I believe it is time for New York State to commit to a Decade of Housing Reform and
to meet the housing needs of people with serious mental illness by 2015. Specifically that will require
that OMH conduct a systematic needs assessment and issue a multi-year plan with specifics about how
many, where, and when. This should be done through a broad-based planning process with oversight
by an independent advisory committee. The plan should reflect a fundamental change of policy
regarding the use of adult and nursing homes. In addition, because of problems developing housing
sites, the state should enact a Mental Health Property Reinvestment Act, giving priority in the use of
state psychiatric center property to provide community housing.
New York State also needs to take steps to protect and preserve existing housing programs by
providing an infusion of funding for both community residences and supported housing far beyond the
$9 million that the Governor has proposed and by establishing an annual “trend” factor (i.e. an
automatic cost of living adjustment) to prevent further erosion and a reoccurrence of the crisis that we
now face.
I think back over the past 30 years with a great deal of satisfaction about what has been accomplished.
But I find it sad to think that people with serious mental illness will have to wait another 25 years or
more to get the housing they deserve. The time has come for New York State to finish the job it began
a ¼ century ago.
(Michael B. Friedman, CSW is The Director of The Center for Policy and Advocacy of The Mental Health Associations of
New York City and Westchester. The opinions in this article are his own and do not necessarily reflect the positions of The
Mental Health Associations.)
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