The Nation's Voice on Mental Illness
page printed from http://www.nami.org/
Grading the States 2006: Delaware - Narrative
"The Diamond State" is not a diamond in the rough so much as a diamond going through rough times. Delaware faces problems that one would not expect to find in a small state with only three counties.
Within the Department of Health and Social Services, the state's Division of Substance Abuse and Mental Health (DSAMH) administers community-based services through four community mental health centers, as well as four community continuum of care programs (CCCPs). For more intensive care, the state has the Delaware Psychiatric Center (DPC) in New Castle.
Introduction of the CCCPs in 2004 dramatically changed the system. Traditionally, people with serious mental illnesses had received intensive services fromcontinuous treatment teams (CTTs) based on the national Assertive Community Treatment (ACT) model. As part of a restructuring, DSAMH collapsed nine CTTs into the CCCPs. DSAMH reports that ACT teams are still embedded within each program, but advocates report decreased availability.
Advocates are concerned that the state is either not measuring the impact of the changes, or withholding information that may be less than flattering. According to one advocate, CCCPs are "gutted" versions of CTTs, with too large of a caseload to provide appropriate intensive services.
Other concerns exist:
On the positive side, Delaware has moved to implement an evidence-based, integrated treatment model for co-occurring mental illness and substance abuse. There currently are 22 such programs across the state.
Housing is an area of strength. The state provides consumers with a continuum of options. DSAMH supports a variety of group homes, supervised apartments, and rental subsidy programs. For ten years, NAMI Delaware also has provided housing using HUD Section 811 funds.
Nonetheless, the maintenance of stable housing for consumers relies on community support services - one more reason for DSAMH to evaluate closely the switch from CTT to CCCP. Analysis needs to include effects on housing status to ensure that people do not fall through the cracks.
A significant development is a growing partnership between law enforcement and mental health advocates. The Delaware State Troopers and New Castle County are moving to increase training about mental illnesses. The State Troopers have developed a Crisis Intervention Team (CIT), and the county recently passed a resolution encouraging the police departments to explore implementing CIT.
To continue the trend, NAMI encourages the state to review mental health services for inmates at the state prison to ensure that adequate, humane treatment is provided.