Mr. Gerry Akland begins his article with a statement that the Department of Justice/North Carolina agreement “requires” that people living in adult care homes be moved into independent housing in the community. This is simply not true. In fact, the entire “in-reach” process is generally done by specifically trained Peer Specialists who themselves have once struggled with serious mental health challenges but who have since recovered meaningful lives by living actively to manage their health. Their efforts are aimed at engaging people in these facilities in order to offer them the information, the support, and as necessary, the advocacy they may need to help them find a different home in a community—IF they wish to relocate.
In fact, many people are so disabled by the very passive lifestyle North Carolina has allowed to develop in these places that they are afraid of the world beyond the parking lots. They have less resilience and may lose initiative toward growth and change. Many years before this settlement between the federal and our state government, community members tried to give input to rules developed by the Department of Health and Human Services so these places could offer more support health and growth, yet our attempts were neglected.
Perhaps readers do not realize that we are not talking about assisted living in the usual sense of the word where there are Activity Directors, van drivers for non-medical outings, and medical oversight. No holistic approach here, and insufficient medical care! Under-qualified staff are given just a few hours training before they are tasked with dosing medications to patients. And very few of these settings have ensured that staff have training in responding to mental health related needs.
I once visited an adult care home in Yadkinville (and have been in many since). This “home” had 190 beds and, while our policies had once assumed these settings would be for the “frail elderly” I saw very few of these. There were, in fact, young people in their 20s, 30s, and 40’s as the majority of the population. They were very eager to talk and have company, and I could not imagine why they were in such a setting that snuffs hope, does not cultivate engagement, does not offer exposure to new interests, etc. I could only think of two things: 1) these individuals are seen as without hope for a more meaningful life and therefore exhausted families and under-resourced systems have resigned themselves (and these residents) to this lifestyle in the name of safety and 2) this unregulated industry must have continued to grow because somebody else’s (or several somebodies’) interests are involved.
I am a person who has a psychiatric diagnosis. I spend much of my week with people who hope for more value in their lives in spite of their diagnoses. Through a locally operated peer center, they are connecting, learning self-help skills, recovering their own lives and may well be on their way to employment and more! (Many of us with psychiatric diagnoses do get well enough to work and contribute!) Yet many of these have also had families that were eventually exhausted by them and others who gave up on them.
I encourage readers not to give up on us. We do have the capacity to grow, to heal enough from the trauma that has often been a triggering event in our lives that we can become courageous and learn how to manage our lives so that we stay healthier! And I encourage communities to support recovery in the lives of as many of their citizens as possible! Don’t hide us away, and don’t take away our hope, our sense of person.
I am one who looks forward to North Carolina continuing to focus the rights and the full humanity of citizens with mental health challneges. Each individual should have the right to be welcomed back into our communities if they should choose to come, and we should welcome them with hope and expectation, because communities can offer far more than pills to help people regain dignity and well-being.