Mental Illness and Community: Does it Matter?

When mental illness meets recovery, does community matter?

You bet it does.

I just returned from a meeting with my son's new support team. This meeting was demanded by the the Wicked Witch (me, in this case), who was upset with the way the transition was handled from group home to supervised independent housing. In the space of two weeks, I've seen signs that Ben is lost, lonely, unmotivated, forgetful, swinging from depressed to hyper, and probably not taking his meds when he can get away with it. Schizophrenia still looms underneath all the progress he's made.

Back and forth went the conversation, over and over again.

me: Where was the support for Ben's transition from 24/7 supervision to independent living?

caseworkers: We were told by his group home that he was doing great and is ready for independence.

Ben: I'm fine. I'm taking my meds!

me: If someone is doing well with constant supervision, accountability, community, and structure - what makes you think he will be the same way when all that is taken away?

them: It's his responsibility now. We were assured he was ready for our program.

me: By the people who have never seen him completely on his own.

Ben: I'm fine. Leave me alone.

me: How do you know he can take on all that responsibility without the community that guided him for seven years?

them: We wait 30 days to see how someone does, and then see what he needs in the way of support.

me: Really? When he can land back in the hospital in two days?

Finally, we came up with a plan for added structure: a weekly home visit or caseworker check-in; a blood test to determine if med levels are therapeutic; a requirement for weekly NA/AA meetings to continue; an introduction to a community of others in Ben's situation who get together to play sports, go on day trips, take classes. It's something. It's a start. And Ben is better today. He needs to know someone is watching, as much as he claims to hate it.

In the 1990's, a panel of consumers offered a list of "essential ingredients" for recovery at a NAMI National Conference. On the list:

• a safe and stable environment
• the best medical treatments
• someone who sees me as special, who will share themselves
• an educated, supportive family
• something to get involved in: work, community, advocacy
• education about the effective management of my illness
• focus on consumer strength and self-determination
• sustaining hope and a vision of what is possible

For these needs to be met, everyone needs community - mental illness or no.

Next week I speak to the members of just such a place: Fellowship Place in New Haven, CT. I wish Ben lived next door to this wonderful campus, where respect and possibility for those with mental illness is provided each and every day.

Ben lost his community when school and his living situation changed at the same time, and there were no pillows to cushion his fall. A sense of purpose is vital. What about those who don't know how to ask for what they need - or who have no one to advocate for them? I wonder. And worry. For now, we've dodged the bullet. But why did no one see what would have prevented these steps backward?