Housing and the 'Right to Fail' For People With Severe Mental Illness (Full Documentary) | FRONTLINE

FRONTLINE PBS | Official・2 minutes read

A federal court ruling allowed New Yorkers with severe mental illness to live independently, raising concerns about transitioning from institutionalized settings. The challenges of moving into supported housing were explored, highlighting issues such as lack of supervision and coordination among implementing agencies.

Insights

  • Transitioning individuals with severe mental illness from institutionalized settings to supported housing raises concerns about the adequacy of care and support provided, as seen in the challenges faced by Nestor and Bernard in adjusting to independent living.
  • The lack of coordinated care and supervision in supported housing facilities, exemplified by Bernard's tragic death due to inadequate medication adherence and health monitoring, underscores the critical need for robust oversight and comprehensive support systems to ensure the well-being and success of vulnerable individuals in community living arrangements.

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Recent questions

  • What challenges do individuals face transitioning from institutionalized care to independent living?

    Individuals transitioning from institutionalized care to independent living face various challenges, including adjusting to newfound freedom, managing their own care, and coping with the responsibilities of living on their own. The lack of a gradual transition can lead to difficulties in adapting to the new environment, potentially resulting in struggles with daily tasks and mental health issues. The move from adult homes to supported housing may be immediate, posing challenges for those who require extensive care and supervision. Concerns about the supported housing system's ability to cater to individuals needing significant support also contribute to the challenges faced during this transition.

  • How did Nestor's experience in supported housing differ from his time in an adult home?

    Nestor's experience in supported housing differed significantly from his time in an adult home. While in the adult home, Nestor thought he was there for weeks but ended up staying for six years, highlighting the lack of progress and independence in that setting. However, in supported housing, Nestor was moved to an apartment where everything was set up for him, aiming to promote self-sufficiency and independence. Despite struggling with hallucinations, hearing voices, and memory gaps in supported housing, Nestor had the opportunity to receive the necessary support and care to help him flourish in his new living environment.

  • What challenges did Nestor face in his journey towards independent living?

    Nestor faced numerous challenges in his journey towards independent living, including struggles with managing his own care, adjusting to living on his own, and coping with mental health issues. His lack of coordinated care led to financial problems, a messy apartment, and feelings of hopelessness. Additionally, Nestor's roommate, Bernard Walker, tragically passed away after only 16 days of living together, highlighting the difficulties and risks associated with independent living for individuals with severe mental illness. Despite these challenges, Nestor persevered and eventually found success in a special apartment with a higher level of care and support.

  • What concerns were raised about the care provided to individuals in supported housing?

    Concerns were raised about the care provided to individuals in supported housing, particularly regarding the lack of supervision, coordination among implementing agencies, and support for vulnerable residents. The case of Bernard Walker, Nestor's roommate who passed away due to hypertensive cardiovascular disease, shed light on the challenges faced by individuals in these settings. The federal court monitor highlighted the need for better coordination and supervision to ensure the well-being and safety of residents in supported housing. Additionally, the lack of follow-up to ensure proper care and medication intake raised questions about the quality of support provided to individuals in these living arrangements.

  • How did Nestor's progress in supported housing impact his future care and well-being?

    Nestor's progress in supported housing had a significant impact on his future care and well-being. Despite facing struggles and needing daily assistance, Nestor flourished in his new living environment with the necessary support and care. However, his progress could potentially lead to the removal of support, jeopardizing his well-being and survival. This raises concerns about the long-term sustainability of care for individuals with severe mental illness transitioning to independent living. Nestor's experience highlights the importance of ongoing support and monitoring to ensure the success and stability of individuals in supported housing programs.

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Summary

00:00

Court ruling grants mentally ill independence, challenges arise.

  • A federal court ruling granted thousands of New Yorkers with severe mental illness the right to live independently.
  • The ruling raised questions about the success of transitioning institutionalized individuals into community living.
  • ProPublica and "Frontline" explored the challenges and risks faced by those moving into independent living.
  • Poor conditions in adult homes led to a court order allowing residents to move into supported housing.
  • Supported housing aimed at high-functioning individuals who could manage their own care.
  • Ilona Spiegel, a plaintiff in the lawsuit, successfully transitioned from an adult home to supported housing.
  • Concerns arose about the supported housing system's ability to cater to individuals needing extensive care.
  • The move from adult homes to supported housing was immediate, lacking a gradual transition.
  • Some individuals struggled with the newfound freedom, leading to challenges and failures in adjusting.
  • Cases like Abraham Clemente highlighted the difficulties faced by individuals refusing care in supported housing.

16:15

"Six years at care center, tragic roommate"

  • Nestor thought he was at the Queens Adult Care Center for weeks but was actually there for six years.
  • Nestor was moved to an apartment where everything was set up for him, but he struggled with being on his own.
  • Nestor lived in supported housing and experienced hallucinations, heard voices, and had memory gaps.
  • Nora Weinerth, a friend of Nestor's late mother, shared about Nestor's past and his mother's advocacy for mental health.
  • Nestor's mother, Elda, was an advocate for mental health and fought for supportive housing funds.
  • Nestor moved into his first apartment in July 2015 but struggled with independent living and suicidal thoughts.
  • Nestor's lack of coordinated care led to financial issues, a messy apartment, and feelings of hopelessness.
  • Nestor was paired with a roommate, Bernard Walker, who tragically passed away after only 16 days of living together.
  • Bernard's struggles with medication adherence and mental health issues led to his death.
  • The agencies involved in Nestor's care faced questions about their handling of the situation and the support provided to Nestor and Bernard.

31:59

"Tragic Death Raises Concerns in Care System"

  • An attempt to visit Bernard was made two days prior to his death, but he was not present, and there was no cause for concern at that time.
  • Concerns were raised about the lack of supervision in settings like Bernard's, with a federal court monitor highlighting a lack of coordination among implementing agencies.
  • The New York Office of Mental Health stated that most former adult-home residents thrived in new homes, but a small percentage did not succeed, with 39 returning to adult homes and 33 passing away.
  • Bernard's death was due to hypertensive cardiovascular disease, possibly a heart attack, and he was found naked, with uncertainty about his medication intake.
  • No follow-up was conducted to ensure Bernard was taking his medication or receiving proper care, leaving questions about his well-being unanswered.
  • Nestor, Bernard's roommate, experienced a series of traumatic events, including his mother's death and his own hospitalization due to injuries, likely from a severe beating.
  • Nestor's therapist disagreed with his discharge back to independent living, deeming it unsafe, but the decision required agreement from multiple agencies and clinical team members.
  • Abraham Clemente, another individual in the program, was found in poor health and eventually deemed unable to live independently, returning to an adult home.
  • Abraham expressed feelings of loneliness and worthlessness when living alone, highlighting the challenges faced by vulnerable individuals in independent living situations.
  • Michael Walker, Bernard's brother, faced obstacles in obtaining information about Bernard's death investigation, with agencies citing privacy concerns and withholding results from the family.

47:30

"Nestor's Journey Towards Independent Living"

  • Nestor Bunch, a person with severe mental illness, faced challenges but aspired to live independently after being discharged from a psychiatric hospital.
  • Nestor eventually moved into a special apartment with a higher level of care and a new roommate, Jeanne, where he received the necessary support and flourished.
  • Despite facing struggles and needing daily assistance, Nestor's progress could lead to the removal of support, potentially jeopardizing his well-being and survival.
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