|National Alliance on Mental Illness
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5. Services and Supports for Adults
5.1 Community Systems
(5.1.1) NAMI believes that it is the responsibility of government at all levels to develop and maintain comprehensive community support systems that include treatment and services, as well as short-and long-range plans, for all adults with serious mental illnesses.
(5.1.2) NAMI believes optimal treatment, favorable outcomes, and recovery are most likely to occur when comprehensive treatments and services are provided in an atmosphere of respect, acceptance, and hope.
(5.1.3) NAMI believes that all publicly funded community service providers must offer evidence based, promising and emerging practices and services that adults living with serious mental illnesses need. These practices and services must be recovery, resiliency and wellness oriented, culturally competent and readily accessible. These practices and services must include the availability of appropriate and effective medications, inpatient treatment, and outpatient treatment with mobile capacity, residential support services, transportation services, intensive case management, respite services, vocational and psychosocial rehabilitation, peer support, consumer-run services, and round-the-clock services that are available seven days a week.
Service providers must prioritize access to services to people with serious mental illnesses, providing oversight and advocacy through well-trained care managers. Services should use an integrated consumer-centered approach that may take professionals out of the traditional office setting to a location that is comfortable for the consumer. Treatment should be delivered at the same treatment site using cross-trained staff.
(22.214.171.124) NAMI endorses integrated, rather than sequential or collaborative-parallel treatment programs for persons with co-occurring serious mental illnesses and addictive disorders treatment delivered at the same treatment site using cross-trained staff.
5.2 Continuity of Care
(5.2.1) Every consumer should have a single service manager or management team that is well informed about every aspect of the treatment and informs the consumer and other members of the treatment team. When an individual is hospitalized, the manager should be kept informed and should become a member of the inpatient treatment team. Whenever residence in a community is interrupted for any reason, continuity of care requires that the same service manager or management team retain responsibility for an individual's treatment unless the consumer desires a change.
(5.3.1) Individuals with serious mental illnesses need a wide array of options for permanent, decent, and affordable housing, based on an individual’s needs and choices. These options may include group homes and independent living in apartments or houses. Living in the community must be given priority whenever that option is available and suitable to a consumer's needs and choices. Funding should support and follow consumer choices, which allow the consumer to retain independent housing.
(5.3.2) No individual with a serious mental illness should lose his or her housing in the community during periods of inpatient treatment.
(5.3.3) NAMI recommends that an equitable portion of federal and state housing funds be designated for persons with serious mental illnesses and redirected to an integrated funding stream in order to finance the housing component of a unified system of treatment, services and supports for persons with serious mental illnesses.
(5.3.4) NAMI opposes all statutes, regulations, ordinances and other restrictions in housing that discriminate by limiting fair and equal access for people with serious mental illnesses. NAMI insists that persons with serious mental illnesses not be specifically singled out for living arrangements segregated from other populations in publicly supported housing.
(5.3.5) NAMI believes that in those cases where an independent living arrangement is shared by two or more persons, it is preferable that the choice of "roommates" be left up to those sharing the independent living arrangement. Providers and caregivers do not have the right to restrict such choices or determine compatibility based upon age, race, ethnic background, culture, sexual orientation, gender identity, disability, religion, diagnosis, English proficiency or other discriminatory criteria. In no cases should residents in independent living arrangements be expected to develop a custodial role unless they so choose.
(5.3.6) NAMI affirms that consumers have the right to privacy in their living arrangement.
(5.3.7) NAMI believes that it is not the family's responsibility to provide housing for adult family members who have a serious mental illness but are not legal dependents. For those willing to accept this responsibility, there must be adequate training and education about available benefits and options, and services should continue to be provided to individuals with serious mental illness regardless of living arrangement.
5.4 Rehabilitation, Employment, and Education
(5.4.1) NAMI believes that consumers have the right to participate in activities that are productive and meaningful to them and that they must be offered extensive training and rehabilitation to help them achieve their highest potential level of recovery and independence.
(5.4.2) Individual service plans must be flexible, open-ended and based on consumer preference, allowing for change as the consumer requests it or need it.
(5.4.3) Care managers must be responsible for providing programs for consumers to learn or relearn daily living skills; appropriate personal care; medication management and overall wellness; financial management; social, physical, and recreational activities; volunteer opportunities; and whatever else the individual service plan directs. Additionally, persons may need assistance with the development or redevelopment of social skills. Rehabilitation counselors must fully inform consumers of all services that will assist with their personal goals and to provide smooth and timely access to services, including aptitude testing, vocational skills, GED education courses, job coaching and job placement.
(5.4.4) NAMI believes that state vocational rehabilitation agencies, state employment agencies and state mental health agencies should develop cooperative agreements to ensure that long-term supports are available for people with serious mental illnesses who are in supported employment.
(5.4.5) NAMI continues to advocate for a redefinition of serious mental illnesses under the Individuals with Disabilities Education Act (IDEA) in order to improve the access to appropriate individual programs that meet each person's unique educational needs and provide for transition to adult services.
(5.4.6) NAMI endorses recruiting consumers as students in educational programs that will prepare them for careers in the delivery system that serves persons with serious mental illnesses. NAMI encourages hiring such persons as service providers.
(5.4.7) NAMI supports the availability of a wide array of training and retraining, including professional development, in order to support the greatest return possible of persons with serious mental illnesses to active employment.
5.5 Consumer-run Programs
NAMI supports and encourages self-help activities and consumer-run programs including peer support, housing, day centers, small businesses, clubhouses, and drop-in centers. NAMI also supports and encourages all service providers to support the development of such self-help activities.
5.6 Educational Programs for Consumers and Families
(5.6.1) NAMI believes that a transformed and recovery, resiliency and wellness oriented system of care, driven by consumers and families, must guarantee the widespread availability of free educational programs for consumers and families, and must also empower consumers and family members as teachers in the education and training of all mental health care providers.
(5.6.2) Peer-designed and peer-directed educational programs must be valued and promoted as an integral part of the service system. The development and administration of peer-directed programs must be supported through specific public funding and further system resources must be made available in order for peer educational programs to be strongly evidence based.