Teresa Pasquini and Lauren Rettagliata have a story to tell. These two moms who live in the Bay Area have sons living with Serious Mental Illnesses (SMI) and would like to share their experience with those who care to listen. Whether or not you know of someone with a serious mental illness, this compelling story is guaranteed to move. Tears may flow and anger may spout, but a reader can’t help but be touched by two moms who love their sons and just want them to be safe and happy. Isn’t that the dream of every parent?
Recently, Teresa and Lauren published a paper, “Housing That Heals,” that recounts their years of experience with sons who were diagnosed at an early age, one with schizophrenia, one with autism, and another with schizoaffective disorder. Over the years, their sons have experienced homelessness, drug addiction, and suicidal feelings. Teresa and Lauren are from upper middle class families with great husbands. But income level and social standing prove futile when faced with the way people living with SMI are treated in California. These moms have spent the past 40 years fighting for services for their sons, with frequent frustrations and tragic failures to show for it. But what makes Teresa and Lauren’s story one that we all need to know is that what is happening to our youth with mental illness is tragic, and can be avoided. It is not too late. Danny, Teresa’s son with schizoaffective disorder, is alive and doing well at a home for psychiatric patients in Morgan Hill. There IS hope.
A lack of resources is not the problem. Over $200,000,000 per year is spent on the chronically homeless in Santa Clara County. (Economic Roundtable Report of 2015) Of the approximately 2500 people persistently homeless, seventy-seven percent are living with a SMI and/or has a substance use disorder (SUD). Serious Mental Illnesses include schizophrenia, bipolar disorder, extreme anxiety, and is sometimes combined with drug abuse. (Santa Clara Co Homeless Census 2019)
$200,000,000 is a lot of money, but those who persistently live on the streets, in squalor, are not being served. They have greater risk of the coronavirus, typhus (rat bites), tuberculosis, hepatitis A, tuberculosis, staph and Sexually Transmitted Diseases (STDs). (Forbes, 8-19-19)(STI.BMJ.COM)
Sadly, people living with SMI often commit crimes and end up in jail and prisons. Teresa’s son has spent time in jail.
Teresa Pasquini and Lauren Rettagliata have been interviewed by NBC Bay Area and testified before US Congress. They have traveled around the state to tour facilities for the mentally ill. Their story is telling truth to power.
Here are some of Teresa and Lauren’s truths, as reported in “Housing That Heals:”
- California’s delivery system design and financing are flawed: SMI and SUDs (Substance Use Disorder) are managed in two separate delivery systems with separate waivers and funding streams.
- SMI Funding is convoluted. California sends funds to counties, and counties are sitting on millions of dollars designated for those with a serious mental illness.
- There are millions spent on programs that are meant to prevent serious mental illness. There is a belief that prevention and early intervention will prevent serious mental illness in the future. Sadly, this is rarely the case.
- The Federal Medicaid IMD Exclusion (Institutions for Mental Diseases, or IMDs) prevents states from using federal Medicaid funding for long-term psychiatric hospital beds in facilities with more than 16 beds. This is one of the main reasons that acute and sub-acute hospital beds have closed in California. There is often a direct correlation made between the closing of hospital beds and the increase in mental health jail cells occupied. (https://www.treatmentadvocacycenter.org/storage/documents/final_jails_v_hospitals_study.pdf)
- California once had many Institutions for Mental Diseases (IMDs). What happened to them? They were closed. People with SMI in acute conditions are in need of a modern and therapeutic IMD so they can rehabilitate and recover enough to be transferred to a longer term care facility with psychiatric support, also known as a Mental Health Rehabilitation Centers (MHRCs).
- Because of the IMD exclusion for Medical funding, those diagnosed with SMI are suffering without access to appropriate and medically necessary hospital-based or community-based treatment.
- The few IMDs that remain do not use subversive or abusive treatment on their patients. Teresa and Lauren argue passionately and compellingly thata locked facility is sometimes the best place for a person with SMI who has recently suffered a breakdown.
- Teresa and Lauren advocate for a continuum of care that would include locked facilities, unlocked psychiatric support centers, and then, if appropriate “housing” with psychiatric services available when needed.
- When funding is diverted to other social entitlement programs or to “any mental illness” that may or may not be “serious,” counties are prevented from providing adequate and medically necessary treatment in a Mental Health Rehabilitation Center (MHRC) or Institution for Mental Diseases (IMDs).
- “Housing First” is a slogan used by some who advocate for “helping the homeless.” Although “Housing First” may help people who have lost their jobs and/or have moderate mental illness, those living with a Serious Mental Illness are not helped by providing housing alone. In fact, “Housing First” for those living with SMI is exactly the formula for homelessness. Teresa and Lauren’s sons were placed in a “Housing First” without adequate services, and both of them had serious relapses which required a great deal of recovery to overcome. “Housing First” without psychiatric care may inadvertently foment and abet homelessness, at least for the persistently homeless living with SMI.
“Housing That Heals” is an inclusive term, a term that connotes a continuum of care. With so many people promoting the idea that “Housing First” is all that is needed for the homeless, it is inspiring to know that some people are unafraid to tell the truth. Teresa and Lauren are tireless and valiant truth telling heroines. Their story is found on https://namica.org/community-voices/team-nami-spotlight-housing-that-heals-project-report/
There are serious challenges to be overcome here in Santa Clara County and throughout California. Realignment funding has been used to pay for housing and services for the moderately mentally ill at the expense of the seriously mentally ill. In Santa Clara County, the Board of Supervisors recently allocated $137 million for low income housing and extremely low income housing. Board President Cindy Chavez said, “This money will help the homeless, victims of domestic violence and mental health issues.” She added, “It’s important because we have homeless dying on the streets.” What she may not realize is that the people most likely to die on the streets are the chronically homeless, who have Serious Mental Illnesses, and housing alone will not break the cycle. Teresa and Lauren have told their story; people living heroically with SMI need Housing That Heals.