What Is “Home” for a Mentally Disabled Person?

Letters to the editor in the New York Times come with the provocative headline: “Can There Be Good Mental Asylums?” As the father of a 25-year-old son with severe autism, I think about this a lot.

Our son Brendan now lives in a group home which we helped set up in Silver Spring, Maryland. It seems to work for him, although for a parent, eternal vigilance is required. Brendan is out and about in the community every day: at his day program sheltered workshop, and with his “one-on-one” at weekend activities like Special Olympics, trips to museums, dinner at our house, and all sorts of good fun. That’s the ideal for any human being.

But look around you. Huddled in the doorway of an office building, sitting in a prison cell — lots of mentally disabled people have no real home.

Especially when the issue is chronic mental illness like schizophrenia, instead of a developmental disability like Brendan has, it’s far more likely that the disabled person will be out on the street instead of safe in a home.

The large state mental hospitals that used to house such people are now mostly closed or greatly shrunk in size, since the deinstitutionalization movement of the 1950s and 1960s. The intent behind that movement was good. Who should have to live in a prison without a release date, when they haven’t done anything wrong except be unable to take care of themselves?

But people who cannot work for a living and cannot speak up for themselves get the short end of the stick from state governments. So the community mental health system and affordable housing subsidies, which were supposed to replace large state hospitals, is overwhelmed and underfunded in most states.

And housing opportunities are spotty, and depend on state budgets and the generosity of the local community.

The debate now is over whether a new kind of mental asylum can be built to house the disabled in a more humane, life-affirming way. The letters in the Times, which responded to an op-ed piece suggesting it was time to develop a 21st century version of the asylum, do a good job of capturing the range of the debate.

One letter writer, Kathy Winer, the director of a documentary about state institutions, said:

[I]t is folly to think that we would do any better today in a time of budget cuts, mounting fear of mental health conditions, and misconceptions about what constitutes effective treatment.

Another, a disability lawyer with the ACLU named Susan Mizner, wrote:

We know that large-scale segregation leads to abuse and neglect. We also know that properly funded community treatment and housing are not only successful, but also more cost-effective. No “mental asylum,” modern or otherwise, is the solution.

Let’s face facts. Plenty of non-disabled people would prefer that the disabled stay “out of sight, out of mind.” Not long ago outside our local parish church, a woman lectured me that I should not bring Brendan into church because “they have televised Mass for people like him.”

I ignored her. But I know that many people are uncomfortable around disabled people. They can be dangerous, for one thing. And they’re different.

I have no glib answer. I do know there is no one-size-fits-all solution for what is home for a disabled person.

We as a society need to reflect quietly on what we stand for. Cardinal Roger Mahony (and before him, Churchill, Truman, Pope John Paul II and others) said:

Any society, any nation, is judged on the basis of how it treats its weakest members; the last, the least, the littlest.

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