5. Services and Supports for Adults

5.1 Community Systems

(5.1.1)    NAMI believes that it is the responsibility of federal, state, and local governments to develop and maintain comprehensive community support systems of treatment and services for the priority population as well as short-and long-range plans for all those 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 recovery oriented, evidence-based practices and services that customers need and can readily access. These must include the availability of new generation 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.

(5.1.3.1)      NAMI endorses integrated, rather than sequential or collaborative-parallel treatment programs for persons with co-occuring[1] mental illness and addictive disorders. (Revised March 2006)

(5.1.3.2)      Because the majority of people with serious mental illnesses have a co-occurring substance abuse disorder, NAMI believes that integrated mental health and substance abuse treatment must be delivered at the same treatment site using cross-trained staff.

5.2 Continuity of Care

(5.2.1) Every person should have a single service manager or management team who keeps 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 the individual's treatment unless the consumer desires a change.

5.3 Housing

(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. NAMI reinforces and encourages living in the community whenever that option is available and suitable to a consumer's needs and choices. Funding mechanisms should support consumer choice.

(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 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, and ordinances in housing that discriminate by limiting fair and equal access for people with serious mental illnesses, such as special use permits, occupancy limitations, mandated dispersal of residences, or private restrictions included in covenants, deeds, or lease agreement. In addition, 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 the independent living arrangement is shared by two or more persons, it is preferable that the choice of "roommates" be left up to the residents.
Providers and caregivers do not have the right to restrict such choices or determine compatibility based upon age, race, ethnic background, disability, religion, diagnosis, or other such 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.

(5.3.7)    NAMI believes that it is not the family's responsibility to provide housing for a family member who has a serious mental illness. For those willing to accept this responsibility, there must be adequate training and education about available benefits and options.

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 and 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 grooming and attire, medication and money management, social, physical, and recreational activities, volunteer opportunities, and whatever else the individual service plan directs (i.e. nutritional planning, transportation consulting, vocational training, etc.) Additionally, persons may need assistance with the development and/or redevelopment of their social skills and ability to meaningfully interact with others. Rehabilitation counselors must fully inform consumers of all services that will assist with their personal goals and to provide smooth and timely access to these services, including aptitude testing, vocational skills, GED education courses, job coaching and job placement.

(5.4.4)    NAMI believes that state vocational rehabilitation 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 refinement of the definition of serious mental illnesses under the Individuals with Disabilities Education Act (IDEA) in order to improve the access to the design of appropriate individual programs to meet each person's unique education needs.

(5.4.6)    NAMI endorses an affirmative-action policy for 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.

5.5 Consumer-run Programs

NAMI supports and encourages: 1) self-help activities; 2) 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 recovery-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 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 government grants, and further system resources must be made available for peer educational programs to establish an evidence base comparable to the rigorous scientific studies conducted by fully funded system-based programs.

[1] "dual-disorders" changed to "co-occurring" by friendly amendment in Board discussion 11/11/05

5. Services and Supports for Adults

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