Part I: Threading the NEEDLE and "Dangerous Binaries" When it comes to People with Serious Mental Illness and Fair Housing

*DOJ --if you're gonna enforce Olmstead uniformly & across the board and obtain SUPPORTIVE HOUSING for People with SMI in this Country --- great --- If not, what are ya thinkin'?  --- Residents & Families United to Save Our Adult Homes, et al. v. Zucker

In some instances we have tried to "BACKDOOR" Community Living for people with SMI (Serious Mental Illness) with:

• Medicaid’s Institutions for Mental Diseases (IMD) Exclusion Rule ...

"The IMD exclusion rule, which has been in place since the beginning of the Medicaid program in 1965, bars the use of federal Medicaid funds to finance services for individuals ages 22 to 64 residing in “institutions for mental diseases” or IMDs—hospitals, nursing homes, or other institutions with more than 16 beds that are primarily engaged in providing diagnosis, treatment, or care of persons with “mental diseases” other than dementia or intellectual disabilities."

So we actually have the LAWS now to REQUIRE STATES to Avoid the Unnecessary Institutionalization or Risk of Institutionalization of People with Disabilities.

We didn't have those LAWS when
De-Institutionalization was first becoming a big thing in the 1950s.

• Deinstitutionalization: Definition & History | Study.com

BUT our thinking on this has "EVOLVED" quite a lot.  The miracle of Psychotropic Drugs for some people led us not to build the INFRASTRUCTURE we needed to successfully integrate people with SMI in the Community.

I do think DOJ has a pretty good handle on what that SMI COMMUNITY LIVING INFRASTRUCTURE is or needs to be---

• DOJ does NOT have a good handle on enforcing that SMI COMMUNITY LIVING INFRASTRUCTURE across the STATES uniformly to prevent INCARCERATION and HOMELESSNESS of people with SMI and other Cognitive Disabilities.

THIS FAILURE OF ENFORCEMENT or POLITICS or whatever to provide that SMI COMMUNITY LIVING INFRASTRUCTURE ---- HAS ENORMOUS CONSEQUENCES --- namely, the MENTAL HEALTH CRISIS we're currently in ---

• And a lot of INCARCERATION and HOMELESSNESS of people with SMI and other Cognitive Disabilities

Image Credit:  PaulClairereaux.com

*Residents and Families United to Save Our Adult Homes, et al. v. Zucker

"On May 31, 2022, the United States filed a Statement of Interest in the consolidated case of Residents and Families/Empire v. Zucker. Residents and Families/Empire challenges a New York State regulation limiting admission of individuals with Serious Mental Illness (SMI) into segregated settings called Adult Homes, by alleging that the regulation violates the Fair Housing Act and the Americans with Disabilities Act.  

"The State issued the regulation in conjunction with the United States’ settlement in U.S. v. New York, No. 13-cv-4165 (E.D.N.Y. 2013) and consistent with its Office of Mental Health’s determination that Adult Homes “are not clinically appropriate settings” for individuals with SMI, “nor are they conducive to the rehabilitation or recovery of such persons.”  The Statement of Interest explains that the regulation does not violate the Fair Housing Act or the Americans with Disabilities Act. (5/31/22)"

Why Is This Problematic?

Advocates & Attorneys around the country like myself want to use Fair Housing and the ADA to get people with SMI a safe place to live.

Further, those people want a safe place to live.

Horror Stories

So if we don't UNDERSTAND --- THE REALITIES ON THE GROUND --- namely many people with SMI are trying to navigate a MINEFIELD in which  ---"ADULT HOMES" or even "NURSING HOMES" are not the "BEST" OPTIONS and they may not even be "GOOD" options--BUT the HORRIFIC OPTIONS that we thought our Society was TOO HUMANE TO ALLOW --- Is ALLOWING THEM. 

Vox:  Jails, prisons hold 10 times more mental health patients than state hospitals (2014)