Deinstitutionalization – a National Disgrace

Did you know that if a person has a developmental or intellectual disability they can have all the other diseases, illnesses and conditions that everyone else has?  I know this seems like common sense but at times I do not think that the Division of Developmental Disabilities  (DDD) understands this.  When it comes to the dual diagnosis of Intellectual Disability/Developmental Disability (ID/DD), as a cost saving measure for the DD Silo, DDD is booting out clients with DD who happen to have a mental illness.  DDD states that the problems are caused by the mental illness and not DD!

There are problems with service delivery within the DD system but from what I read and see these problems are not nearly as bad as in the mental health system.  So, rather than caring for these extremely vulnerable citizens in at least one system, they are being sent to a system which is much worse, where they will surely die.  Where is the humanity in this?

Right now there is a gentleman who is fighting for services.  He is 30 years old and has a history of developmental disability, he has been served all his life through DD and had a HCBS waiver to move into a supported living arrangement.  We all know that transitions are difficult and this transition caused a crisis.  This man is currently in the state mental hospital in the wing for people with DD.

Can you believe that our state made him ineligible for DD services stating he has a mental illness?  This man had an assessment done in March 2012.  One week the family received a notice, based on this assessment, that he was eligible for the CORE Waiver and listed all the services he would be getting.  The next week DDD sent them a notice (based on the very same assessment which qualified him!) terminating all services.  Is this how our state treats those in crisis?  They take away the services?

This is just one example.  I am contacting many families and we will be putting together our own report on our experiences.  It will be shocking.

Guns and Mental Illness written by New York Times Op-Ed Columnist Joe Nocera, spells out some critical information.

“”Ultimately, the article I wrote was about how the “deinstitutionalization movement” of the 1960s and early 1970s — a movement prompted by the same liberal impulses that gave us civil rights and women’s rights — had become a national disgrace.”

and

“The state and federal rules around mental illness are built upon a delusion: that the sickest among us should always be in control of their own treatment, and that deinstitutionalization is the more humane route. That is not always the case.”

The risks of deinstitutionalization (in both the DD and the Mental Health systems) greatly outweigh the benefits – it’s time the program planners and policymakers realized this truth.

3 comments on “Deinstitutionalization – a National Disgrace

  1. Paul Strand says:

    Everyone in the know should agree that people with DD are are being used for political reasons. These are the most vulnerable people we care for. They should not suffer from political ideology, instead we should offer them a continuum of care that meets their needs. Yes, it costs money but it,s a cost we must bear.

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  2. saskiadavis says:

    Deinstitutionalization, closure of residential mental facility doors in the 1960’s involved the same stupid rationalization about autonomy and the same empty promises for therapeutic support as does the attempt to close institutions for people with developmental disabilities, today. I was there during the push to extricate patients with serious mental illnesses from their safe havens. Nurses were instructed that we had to teach patients to fake mental health even if they didn’t have it. We are talking severe psychotics who knew they could not function in the outside world. They were promised resources that were not in place and that, due to their psychosis, they would not be able to take responsibility to access, anyway.

    True, circumstances within institutions needed to be improved, but closures were not a wise substitute for making the needed institutional improvements. The street poverty that the movement produced, then, has only multiplied. This is the opposite of liberalism. It is political selfishness, pure and simple.

    Now the same kind of ignorant, ideologue do-gooders and or people who stand to gain by dislocating people from RHCs and other developmental centers, nationwide, are pushing to repeat the disaster, this time at the expense of people with intellectual disabilities. Emergency departments sometimes refuse to admit or even treat such rejects from the DD system, leaving jail as the only recourse. If no one knows they are there and they can’t tell anyone, they may be there very inappropriately for a very long time. It happens all too frequently. We hear from parents who say they were told by DSHS workers that their options are to take their behaviorally out-of-control teen or adult-child home where their behavior cannot be controlled, or accept help finding a homeless shelter! Anything but admit them to an RHC, where they could be stabilized by professionals skilled in helping them achieve self control to live a decent, healthy life!

    True the developmental disabilities residential care industry is now pretty extensive, so there are more places to put people, but there is little to assure quality of care, only the good graces of those who own/run the facilities and some obligation on the part of DSHS to investigate complaints. By the time a complaint is lodged, harm has been done. In fact, harm could have been going on a long time given the inability of most residents with dd to lodge their own complaint.

    This is not to paint all members of the dd care industry with a negative brush. To be sure, there are excellent providers. It is the lack of preventative oversight that I address, because while there are excellent providers there are also some of the opposite kind, and this is not the type of consumer capable of rising up and demanding better!

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