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Are Good Intentions Enough?


Are Good Intentions Enough?

In 1963, President Kennedy called for Congress to replace institutions with comprehensive community programs that would provide outpatient care, day treatment, rehabilitation, foster care services, and public education with mental health and related services. Congress responded to President Kennedy’s challenge by creating a commission that in turn recommended that communities take greater responsibility for the treatment of persons in institutions with locally-based programs. Because of the refocusing of services, the population in state mental hospitals from 1956 to 1980 fell by three quarters. The Joint Commission also recommended a ten-fold increase in spending on community mental health programs and services over the next ten years, as well as an increase in training to ensure availability of the necessary workforce to serve this population. The idea was that funding would be redirected away from long-term institutional services to community-based hospitals and nonprofit agencies. Eventually, it was hoped that state hospitals would be completely replaced by a comprehensive community-based service system. The federal government agreed to pay for the treatment of the mentally ill in community based programs and provided states with massive financial incentives to deinstitutionalize mental health treatment and to rely on the federal government to pay for the care of the mentally ill.

In one sense, the first stage of deinstitutionalization has been a complete success: very few people live in state institutions. Yet today’s mental health system is a picture of broken promises and partially fulfilled dreams, and the developmental disabilities system is being eroded year-by-year. State and local policymakers discuss grand plans that, if implemented, might radically alter the experiences of people with developmental and psychiatric disabilities. But instead we see too little funding, an overburdened workforce, overwhelmed families, very poor, often marginalized consumers, and a system under siege.

Another solution is knowledge. As stated by Chaz Gross in the paper The Heart Of The Challenge – Providing Public Education Regarding Mental Illness, “Combating the stigma surrounding mental illness and enlisting broad-based support for improvements to mental health policy requires education. Until the general public comes to understand mental illness as a physical illness, public support for improved mental health services is unlikely to increase.”

Families are doing the best they can to access resources in order to provide acceptable care for their disabled loved ones. The problem is that the public doesn’t really understand the importance of these programs, or the fact that most people with disabilities are living at a subsistence level. The general population must be made aware of the fact that the community service system is on the verge of collapse. They need to understand the true ramifications of such a collapse on persons with disabilities and their families, and they need to understand how this situation affects them. In short, we need to build passion and knowledge within the community. Only then can our elected representatives develop the political will to make the necessary course correction and commit the resources to revive the system.

It is also important for families to both financially and politically support their favorite disability organization whose survival may well depend on discovering new funding sources. Groups like the ARC, the National Alliance for the Mentally Ill (NAMI), the Autism Society, the National Down Syndrome Society, United Cerebral Palsy, California Disability Community Action Network, local residential providers and day program providers are the voices advocating for the needs of our disabled loved ones. They need our support, be it money, assisting at hearings, or talking to neighbors.

The disabled community is in real danger of losing what services it has, and now is the time to pull together.  Please look at the left-column to find ways you can take action.

Let’s make 2013 the year of outreach to our disability community!