Halfway homes, and more.

[Chemistry]

I'm planning on writing a story about people recently released from a psychiatric hospital and back into society. I haven't completely thought it all the way out in detail just yet, but trust me I'll get to that once I get over this little bump. So here's my question:

Most people who are just released from a psychiatric hospital would go into a halfway home of sorts, correct? Or would it depend on their condition, if they have other housing options, and stuff like that? What are halfway homes like? Are they more like normal living places but with doctor offices and curfews and stuff like that? Anything you guys know about this process and any exceptions I could work with would be so awesome.

As to what I was thinking the conditions would be like, was perhaps the characters of the story have apartments within the same building, but are required to have doctors come visit their apartments to check up on how they're doing, and also have them come in for appointments and whatnot. The characters are not really deranged, psychopaths, or anything like that. But their mental conditions are bad enough where they should still take medicine and see doctors. I should probably look up mental illnesses to be more exact, but that's taking awhile. Any suggestions for those would be great as well, haha, if you have any knowledge of that stuff.

Thank you in advance!

[AXJ]

I've known a few people who 'went into the hospital' so to speak. They were always just released. Well, with one exception.

There are psychiatric halfway houses (example (http://www.lacrossetribune.com/articles/2007/10/08/news/z01siena08.txt)), but most insurance companies don't cover the expense, so I'd imagine that your chars would probably mostly come from wealthy backgrounds, or have very committed families. When I mentioned that one exception earlier, that was my wife's aunt, who was in a residental program for ~6 months for bulimia and self-destructive behaviors. They wanted to discharge her, but she wasn't quite ready for the real world yet, so the family scraped together the money to get her in a halfway house associated with her hospital for about two months. We raised around $40,000, which bought her about two or three months, IIRC.

There might be some sort of state mandated halfway houses for violent offenders who are leaving on parole, but that doesn't sound like what you're looking for.

[strawberry-tea]

I wouldn't say that most people go into them, only the people who have really severe conditions and have been in the hospital a long time. The purpose of living in transitional housing is to ease slowly back into the outside world, to make sure patients get the care they need if they're recovering but still need a lot of support.

Curfews depend on the patient's condition. Some can be out of the house all day, some can be out for limited times while with their families, and some people can't leave at all. As far as I know there aren't any doctor's offices in the housing units themselves; doctors come over from the attached hospital. Medicines are delivered from... somewhere (and are sometimes late, especially around holidays and other times when lots of patients at once are ordering their medicine supplies).

Staff stays in the houses with the patients and keeps an eye on them. They're probably nurses, not doctors. Patients have their own rooms and sometimes roommates. The staff doesn't live in the houses (I don't think) but they change shifts so someone can always be there.

That's all I've gathered from my experience.

As for specific mental illnesses... I'd suggest looking over the DSM-IV. That's the best place to get accurate information. One thing to note: People with mental illnesses living together will equal trouble. People in transitional housing will not be very stable, and a lot of them will probably be very bad at interacting with others, controlling impulses, etc. A few of them will probably hate each other. It's great material for drama.

Hope that helps!

[Chemistry]

...

That helps tons, actually. I didn't even think about looking over the actual DSM-IV.

Initially I had thought about a regular apartment building, but with a few people that had left the hospital living there, and recognizing each other, hence perhaps friends/enemies and all that fun stuff happening between the people with mental illness kind of drag people that haven't been hospitalized for anything into their lives and drama that they make up. But a friend of mine suggested that they might have to live in a halfway home, but reading what you said, they aren't severe enough to really go through all that. But your information definitely helps a lot for any side characters that I will most likely get into the story later on.

My search for the right names for their illnesses is getting to be a drag, since there's a lot of possibilities apparently. I was thinking something of a personality disorder at least for the main male character. Looking up what's wrong with them mentally though, really gets me to get more into the character and work them out.

But thank you so much! You helped alot. Yay! I can move on, sort of.

...

Yeah, the violent offenders isn't at all what they're like. And they aren't from wealthy backgrounds, so I think a halfway home would be kind of out of the question I suppose, even if it was after gather information from the second helpful poster. Though one character does have a helpful uncle that is there along with her and basically her only support system outside of the hospital. I was thinking perhaps that the hospital, or some other agency, might've helped them find homes, which might be why there would be more then one person from the same hospital in the complex. I don't know how plausible that would be, so I don't know if I can use that just yet.

[AXJ]

And they aren't from wealthy backgrounds, so I think a halfway home would be kind of out of the question I suppose.

If you really want to do it, one possible workaround could be that the hospital in question maybe had a innovative new program structured to get around the insurance coverage issue- something like, the inpatient fees are elevated a bit, and a the increase goes to the hospital's 'community outreach' fund or somesuch... all of which is used to subsidize a transitional facility attached to the hospital, which may be used free of charge for up to (X) number of months by any patient who was in for more than (Y) number of months. That way the insurance isn't -directly- paying for the halfway house, they're paying for inpatient treatment, those fees just happen to subsizide a halfway house.

I'm sure the insurance companies may fight the increase, but if the inpatient facility happened to be the only one of its type in its geographic region, they might be able to push it through.

[AXJ]

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[MelancholyBliss]

It also really matters where this takes place.

AXJ's info only really applies to the US (sometimes) and similar countries that are not a welfare state.

Further, it depends on which state. Several places have federal grant-funded homes that cost nothing. But you have to compare that to population density and other social issues. New York, for example, has a lot of free programs for various disabilities and mental/emotional illnesses. It's also over-populated and for a lot of social reasons, there is a high rate of emotional illness and developmental disabilities. So while a high number of people are receiving free treatment, even more are without. Minnesota is known for having a lot of treatment centers that deal with a myriad of illnesses and disabilities. Some are for pay. Some are funded and free for consumers. On the flip side, you could have a developmental disability/mental illness/emotional disturbances on Guam and not have to pay for anything at all because the programs here are extremely well funded and the population makes it easier to deal with. It's so extreme that if there is someone on Guam with a disability who is still paying out of pocket for any kind of service, it's because they haven't checked out the services available for them.

But there's still another catch to those free programs (and paid programs, for that matter). This is a difficult job that tests the patience of the most caring and compassionate person. Many people involved with social work on any level will often opt for something less stressful or find out after a while that it's hard work they cannot deal with. And no matter who's funding the program, there is a bureaucracy involved. People who want to do good work have limits on what they can do and it's easy to become jaded with that work. This often results in a lot of volunteers or low-pay workers with little to no experience in health and mental services who don't really care that much. Combined with a high-stress job, even the most dedicated can lose it. With someone who doesn't care, it's worse.

Also learn the language. The vast majority of people outside of mental services don't know the language. It changes often so that's a difficult part, too. If this doesn't take place in present day, you'll have to find out what terms they used. Within the services, those involved use the language habitually because that's part of their job. Currently, anyone receiving services is a "consumer". Specifically, the rule when referring to any kind of disability, mental or otherwise, is "person first". "A person who is...", "A person with...", etc. Addictions and "temporary" depression/disturbances are still a part of this.

Conditions vary and that also depends on the same things I mentioned before (population, social problems in an urban environment, etc.) Another detail involves the culture of the area and, say, how common social work majors are. Of course people relocate to areas that have better programs but that's not always a possibility.

Group homes I've helped with had a few single rooms or doubles depending on the severity and a few common areas with attendants who come and go around the clock. They were transported for medical attention and physicians never came to the facility. Drugs - even prescription ones - are usually handled by a health-care professional like a nurse.

Also consider that even in a more socially-conscious area, the people who live in the same area where the group homes are located are often not comfortable with the locations.

But yeah, it's entirely plausible for someone to be put into a home and not need to pay a thing or have low fees. It's not all that common. But it's there.

[Aquamonet]

I don't know much on the subject but it might be worth looking into the British system (I would but am at work). We have government funded rehabilitation centres and this seems only a slight stretch from that.