Email this article to a Colleague Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles via Google Scholar Articles by Milne, D. Search for Related Content Related Article

Outreach Soothes Opposition To Group Homes

Communities trying to establish group homes for people with mental illness can learn from other communities that have done so with success. This is the conclusion of a two-part series.

Although group homes for people with mental disabilities are a tough sell in many communities (see box on page 20), most problems can be solved and tensions defused by a combination of education and mediation, according to mental health officials.

All agree that good communication is the key to healthy community relations and that it is in the interest of both the neighborhood and the special needs housing facility to formulate strategies toward that end. Depending on the nature of the facility, the site, and the neighborhood, this can take many different forms.

In situations in which the housing provider, the residents, and the neighborhood have few concerns about the nature and operation of the facility, the communication strategy may be fairly informal. A presentation at a neighborhood association

"The biggest challenge is that early piece of understanding of [what] a group's potential impact is going to be on the neighborhood."

meeting may suffice. When there are many issues of concern between the neighborhood and the housing provider, a more formal strategy may need to be developed.

"It is important that communities have these discussions in a way that the state facilitates thoughtful dialogue instead of just having general discussions with knee-jerk reactions," said Michael Allen, a senior staff attorney for the Bazelon Center for Mental Health Law, a Washington, D.C.-based civil rights law firm that focuses on mental disability issues.

One of the country's most successful programs is the Group Homes Mediation Program (GHMP) in Portland, Ore. For the past 10 years it has been at the forefront of educating the public about the general needs of people with mental disabilities and also providing mediation services when instances of outright opposition to a group home has arisen. Portland uses mediators to get neighbors, developers, and facility residents talking about their worries, offering a variety of ways to engage specific issues and trying to resolve them.

Eric King coordinates the City of Portland/Multnomah County Community Residential Siting Program (CRSP) through the City of Portland's Office of Neighborhood Involvement. The CRSP is designed to be a centralized point of information and referral to deal with questions and concerns about choosing sites for residential social services, as well as to provide mediation/facilitation services for groups in conflict.

"While most of the kinds of housing we deal with are not legally required to participate in the CRSP's siting facilitation process, our experience has shown that when providers get involved with our office at the early stages of the siting process, many of the pitfalls of siting a facility are avoided, and the results are more often satisfactory to neighbors, providers, and clients," King explained to Psychiatric News.

Once a facility is established in the community, the CRSP can provide further assistance to neighbors if problems should arise with that facility's operation. If a good-neighbor agreement exists, they can help make sure all parties follow this agreement in good faith through mediation services or they can help create one if none exists. In addition, they can also act as a go-between to facilitate good relations between the facility's operators and their neighbors.

"It is really difficult sometimes for a provider to go into a neighborhood and site special-needs housing and try to control that process," King said. "One challenge is providing residents with information and educating them about what it means to live with someone with an illness or who has a mental disability or who is recovering from a drug or alcohol problem. A multitude of services that are provided with the housing must be tailored to meet a variety of individual needs."

A major hurdle, King observed, is disabusing people of what they have read in the media about group homes and mental illness. Many people get their perception of what it means to have a disability or mental illness from the media.

"The biggest challenge is that early piece of understanding of how a group's potential impact is going to be on the neighborhood. It revolves around community members being very concerned about the population living there. That's the main concern of the majority of people. Other concerns arise around the design of the housing if it is new construction, and how it is going to fit the character of the neighborhood. A simple thing like parking space might pose a problem for some people. If there are other group homes nearby, people might be worried that the neighborhood is becoming saturated with them."

Community concerns are not always obvious. Some often mask the real issue, which is the fear many people have of new residents who come from an institution. Neighbors have trouble forming a realistic picture of them and cannot get away from worrying about the risks involved. People do not seem to have enough trust in the system to appreciate that the newcomers will be adequately placed in a community-based environment, he said.

"After placement, an untoward incident may occur only 1 percent of the time. But for some people even 1 percent of the time is a big deal, and they don't want to be part of that statistic," he added.

To allay community fears, King arranges for a neutral party to enter into a dialogue with neighbors to inform and educate them about the role and functions of providers and their services. At the same time, he encourages the person moving in to ask questions about the living and service arrangements. This leads to a better understanding of how the services are going to be provided, what kind of training the staff is going to have, and other details that give neighbors a better picture of how the group home will be integrated into the neighborhood.

"This process has to take place over some time," he emphasized. "You can't expect to have one neighborhood meeting and everything will be straightened out. Lots of the concerns are complex, and people are highly emotional about them because they involve their homes."

King is especially aware that for most people their home is their number-one investment. He knows people will react strongly and get very emotional to anything that threatens it, whether real or perceived.

While he stresses the importance of devising a public-involvement process that educates people and enables them to get answers to their questions about the group home in their neighborhood, he is not content to stop there. He is also keen on educating residents of communities with group homes about the various types of mental illness newcomers might have.

"One of the difficulties in doing this is you don't want to violate any confidentiality. Because of client confidentiality considerations, agencies often cannot provide people with much information about a given facility. But when they can, this offers us a chance for fostering understanding."

Neil Beroz, vice president of housing at CRSP, the largest mental health care provider in Portland, told Psychiatric News that Portland's CRSP has been of great help in mediating differences with the neighbors in local communities, in providing a forum for neighbors and service providers to come together to discuss their concerns. They are also a neutral party to whom others can complain about how residents are treated.

"It's a very worthwhile program, and it has made our job a lot easier in terms of fighting things," he added.

Virtually every state or county mental health authority has someone, such as a chief psychiatrist, in charge of considering the effect of its residential program, but most psychiatrists at behavioral health care centers are busy with clinical care.

When asked whether it would be helpful to get psychiatrists involved in siting groups homes and the mediation process, since most Americans place stock in what physicians tell them, Beroz replied that it might be worth doing.

"We don't do that currently. Siting takes lots of time, and most groups keep their psychiatrists busy enough with their patients."

More information about Portland's program is posted online at <www.portlandonline.com/oni/index.cfm?c=32417>. Information on the Building Better Communities Network is posted online at <www.bettercommunities.org>. Stories that show success in siting housing are posted under "Success Stories" on the left side of the homepage.

Related Article:

Two Success Stories
Psychiatr News 2005 40: 20. [Full Text]

Email this article to a Colleague Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles via Google Scholar Articles by Milne, D. Search for Related Content Related Article

Get information about faster international access.

Privacy Policy

Copyright © 2005 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us