The Group Home Problem in Texas for the Mentally Ill and Dev. Disabled

Texas has a terrible problem of limited funding and shortage of group homes for its Developmentally Disabled (DD) and Mentally Ill populations.  I hope that they do not make the mistakes we made in Michigan.

     At one time in Michigan, I was the Regional Liason for the Developmentally Disabled.  As such I was administratively responsible for budgets and programs, the three inpatient hospitals and four outpatient facilities, the 258 Community Mental Health Board,  DD groups , DD Area Groups, DD Advisory Groups, Program Revision Requests, Program Revision Inquiries and DD Grants for the State of Michigan. At one time Michigan would spend a million for one patient per year in a specialized group home if the behavior warranted it.  We had million dollar contract homes.  What we learned over time was that there was not a bottomless pit of money.  Moreover, there was no difference in the specialized group homes and the regular homes in terms of behavioral gains.  The question then was why spend the money for something that was not doing anything?  There were no real gains in the specialized homes.  There was a lot of money being spent.  Additionally, I worked my way through undergraduate school by working on the back wards of Austin State Hospital.  I also worked at Brown School for Emotionally Disturbed and was a Supervisor of the Big Buddy Program when I was in graduate school. There was a world of difference between Texas and Michigan treatment for the mentally ill and developmentally disabled.  At this point, neither state is doing well in treating their mentally ill, but Michigan has a better handle on the problem despite being challenged for funds. The state and counties are almost bankrupt.  At least they use qualified staff in their programs.  Texas is about 50 years behind them in almost everything.  For example, I was being burglarized a lot before a got a camera and alarm system.  After my second burglary, I was told that my burglaries were being classified as mental cases.  They did not give a reason for this classification. ( Remember, I trained master’s level students for twenty four plus years).  However, they sent two people out to see me.  Neither person was qualified to assess anyone for mental illness.  Neither person made a mental assessment.  They did not even know what questions to ask.  They were not working with a psychiatrist or Phd. psychologist.  They did not do a social history.  They asked me if I had a gun and if I wanted to kill myself.  That was it and I was classified as mentally ill because I had been burglarized two times they said.  This was enough.  Two or more reports of a crime in a year was sufficient in Texas for a mental illness diagnosis. I suspect that they are fudging figures for their mental health grant from the federal government. 

     In Michigan, I had to be board certified to make assessments and I worked with a medical doctor and psychiatrist.  I did the social history and then the psychiatrist made an assessment.  Both of us made an assessment but I made a psychosocial diagnostic assessment. The psychiatrist made the psychiatric diagnosis and prescribed medication if needed.  I worked in the Inpatient Psychiatric Assessment Center (MPAC)  in Detroit.  I worked in Emergency Rooms in hospitals in Michigan making assessments.  I was MSW, ACSW and had more than the two year requirement of training for making such assessments. In Texas, the training and supervision is not done at all.  Untrained and unqualified people are being sent into the community with an untrained policeman to make such assessments.  They do not have a clue what to look for.  For example, I volunteer at a church that distributes food.  One of the women came in and told us yesterday that her boyfriend cuts himself and threatens to kill her and himself stating if he does not have her no one will.  I viewed this as a danger to self and others warranting admission to the hospital if he cannot contract for safety which he could not.  He was walking around without hospitalization or medication.  He will eventually kill himself or her and her children. She calls the police and no action is taken.  He is never seen by a psychiatrist during observation or given medication. This would not happen in a center in Michigan when I was working there. Texas is a time bomb waiting to explode with its poor care for the mentally ill.  There is a group home issue but they must treat the mentally ill better in both assessment and treatment before they get to the assignment of a home.  Perhaps group homes would not be needed if the persons were properly assessed and medicated and given supportive counseling or support in the community.  I do not know about their home respite programs.  These are much needed programs for support in the community trying to de-institutionalize. Better training is needed in Texas.