Massachusetts

I have a few relatives who work in those community-based homes. You do realize there's no "care" available around the clock; there's one guy or gal who can call 911 and who doles out meds, breaks up fights, encourages "group" behavior like preparing meals together and picking up the common areas, but it's not like there's a crew of psychiatrists on duty for these folks.

My concern is that beds for the seriously mentally ill are in short supply; and some patients can't wait a day or two--like that kid who stabbed his father down in VA, who did so after being turned away because there were no doggone beds. I saw this happen with a friend of one of my family members who wasn't violent, but who needed admission due to ongoing depression and a danger of self-harm--we ended up taking turns "babysitting" the guy for three days (and I barely knew him, and frankly, had other things to do that went undone) because we didn't want his death on our hands. The guy had no family to give a crap about him and he was in a bad way--nevertheless, it's not really a good idea to depend on the kindness of near-strangers because there's not an available bed. I just think they need to assess carefully before they start getting rid of beds wholesale. It's way easier to dump 'em than get 'em back.

This newspaper article leaves the impression that community based care doesn't exist--nothing could be further from the truth. It does exist, the Mental Health department did a big long study to determine efficacy, and aside from that there are a number of private actors in the mix as well-- and a lot of this inventory is CONTRACTED out by the state--private, sometimes for profit companies housing the mentally ill and intellectually disabled in home-based care situations. These people, though, have already gone through the institutional process and are stabilized on their medications.

Sampler:

http://www.advocatesinc.org/index.php

http://www.wildacreinns.com/

http://www.windhorseimh.org/

http://www.austenriggs.org/

The private models have halfway decent reputations, the DMH forays into group homes for the mentally ill haven't all been sunshine and roses--they've had problems: http://www.wbur.org/2012/12/18/massachusetts-group-homes

Even with that, I don't object to group homes at all--I just think they need to be careful how they expand the existing program, and avoid problems that they had when they first started this effort.