From the Austin American-Statesman:

Boarding homes for elderly people and those with disabilities lack government oversight in Texas, leaving residents at risk for unsanitary living conditions, theft, assault and inadequate care, advocates say.

The problems were highlighted by the recent arrest of Tommie Yvette McKinney, a Texas boarding house operator who was charged with bilking one of her residents. Public records show that McKinney has had at least 14 theft convictions, and has been sent to prison for felony theft in three different Texas counties.

Advocates say unscrupulous operators are free to prey on vulnerable people in thousands of state boarding homes because regulations do not require that they be licensed, unlike nurses, massage therapist, locksmiths and other professionals who must undergo state background checks and inspections.

After years of debate, Texas legislators this spring granted individual cities the authority to license and regulate the homes but provided no funding for the task.

Advocates for elderly and mentally ill people say one reason the system has been permitted to exist with no oversight is that boarding homes provide cheap housing that government can’t, or won’t. The January report found that residents of boarding homes were among the state’s neediest. About a third of the residents had some form of mental illness; another third were elderly.

… Advocates say the system establishes a dangerous dynamic: Clients who most need assistance often can’t afford the more expensive licensed assisted living facilities that provide it and so end up at unlicensed boarding homes – which by law can offer no help, even with the most basic tasks, such as handling their many medications.

“Medicine bottles were everywhere; it was just a free-for-all,” said Carson Palmer, who last year was forced to live in a boarding home in Northeast Austin after a bad car accident left him unable to work. His mattress had blood stains, he recalled; cockroaches climbed over him at night.

From the New York Times, Newsday, AP and elsewhere:

A federal judge has ruled that New York state illegally discriminated against 4,300 people with mental illness by holding them in privately-run “adult homes” that were just as restrictive as the state-run institutions they were intended to replace.

“The adult homes at issue are institutions that segregate residents from the community and impede residents’ interactions with people who do not have disabilities,” Judge Nicholas Garaufis wrote. ” . . . Defendants have denied thousands of individuals with mental illness in New York City the opportunity to receive services in the most integrated setting appropriate to their needs.”

The individuals “are placed in Adult Homes by ‘luck of the draw for the most part,’ rather than any clinical determination that it is an appropriate setting,” Judge Garaufis wrote. He ordered the state to propose a remedial plan by Oct. 23.

The decision follows a 2002 series of articles by Clifford J. Levy of the New York Times that described scenes of misery, squalor and exploitation in the adult homes.

From the [Newark, NJ] Star-Ledger and Asbury Park Press:

Nearly 300 patients stranded inside New Jersey’s psychiatric hospitals for more than a year because of a lack of housing and outpatient treatment services will be discharged over the next five years, under a lawsuit settlement announced by a disability advocacy group and the state Department of Human Services.

The 2005 lawsuit contended New Jersey’s five psychiatric hospitals routinely and illegally confined hundreds of patients every year who are medically ready to leave but languish because they don’t have an affordable place to live with nearby treatment services.

The 1999 U.S. Supreme Court Olmstead decision affirmed the right of people with disabilities to live in their communities rather than in institutions.

Writing in the Boston Globe, James T. Brett and Marylou Sudders take Massachusetts to task for failing to provide community support services for people with mental illness. The authors chaired a state investigation of the Department of Mental Health’s adult psychiatric inpatient system. An excerpt:

Much of what we heard was troubling. The system was described as responsible for sentencing individuals to lifelong disability and creating an impoverished underclass through poverty, crisis-focused care, treatment that relies mainly on medication, and a lack of community supports.

… We urge Governor Patrick to hear above all else the voices of our citizens living with serious mental illness and their loved ones. The system is not working. Difficult fiscal times are not an excuse to warehouse people with mental illness or to dismantle critical community supports. Rather, it is an opportunity to ensure every precious dollar is spent in a manner that assists individuals to recover, live, and be served in the most appropriate setting possible. If as a society we believe that mental illnesses are as legitimate as physical illnesses, then it is time to stop treating people with mental illness as second-class citizens.

James T. Brett is president and CEO of the New England Council. Marylou Sudders is president and CEO of the Massachusetts Society for the Prevention of Cruelty to Children and a former commissioner of the Department of Mental Health.

From the San Jose Mercury News:

The owner of a controversial California doughnut shop, “Psycho Donuts,” will square off against the head of a leading state mental health organization in a half hour televised debate to be aired on KTVU -TV later this month.

The shop in Campbell, CA, features doughnuts dubbed “Bipolar” and “Massive Head Trauma,” and offers a straitjacket and padded cell for camera-wielding customers. Oscar Wright, CEO of United Advocates for Children and Families, says the shop’s theme stigmatizes families of people with mental disorders, but shop owner Kipp Berdiansky says it’s all in fun.

Earlier post here.

From the Regina Leader-Post, CanWest news service:

Michael Kirby, head of Canada’s Mental Health Commission, says the nation has made “the streets and the prisons the asylums of the 21st century” by closing institutions and then failing to provide community supports.

Kirby, a former senator who has a sister with severe depression, said he is fighting to reverse the overwhelming homelessness and stigma faced by people with mental illness.

When people were institutionalized, Kirby says, those with mental illness at least got three meals a day and a roof over their heads. Today, across the nation, there’s a lack of affordable, supportive housing for those who are mentally ill.

One in five Canadians experiences some form of mental or emotional health problem every year. Two-thirds will not seek treatment because they fear they will be labelled and viewed as dangerous, studies have suggested.

On the 10th anniversary of the Supreme Court Olmstead decision, the Bazelon Center for Mental Health Law called for a renewed effort to integrate people with disabilities in their communities. The organization’s report, “Still Waiting — The Unfulfilled Promise of Olmstead,” says federal and state governments could save billions of dollars by moving people with mental disabilities from institutional to community settings.

Among the report’s key points:

• States must end the unnecessary segregation of people with disabilities in institutions, and shift funding to appropriate community-based services;
• States continue to waste scarce resources by placing people with mental illnesses in costly, ineffective institutional settings, often under pressure by profit-making providers; and
• Supreme Court and other judicial nominees must have an understanding of and intention to uphold Olmstead, the ADA, and other civil rights laws.

“On this pivotal anniversary of Olmstead, we must take a hard look at what really needs to be accomplished to adequately serve millions of people with mental illnesses so that they receive the most integrated care possible,” said Robert Bernstein, executive director of the Bazelon Center. The report was released at a Washington press conference.