Saturday, March 24, 2007

Deinstitutionalization

When you read story after story in the News & Observer chronically pining about deinstitutionalization and the lack of services in the community for the mentally ill, what they’re complaining about is the lack of comprehensive care.

One in four of us will experience some form of psychiatric illness in our lifetime. This statistic alone communicates how widespread and common it is for any of us to fall prey to depression, an eating disorder, anxiety, substance abuse, or a psychotic disorder.

For one in seventeen of us, mental illness will be severe. Severe psychotic illness most frequently comes early in life—in youth, when individuals are their most productive. Not only is the productivity impaired, but the nature of the brain disease also damages insight, cognition, and behavior.

A young person discharged from a hospital after being temporarily stabilized, gets released into the community with no plan, no job skills (never got a chance to learn them with the illness hitting so young), and no rehabilitation focusing on their illness and behavior, is destined to fail.

For all of the limitations of a hospital, it did provide comprehensive care. Caramore provides comprehensive care. Caramore is the community service that people wish existed for the mentally ill.

Caramore attempts to provide comprehensive assistance for as long as it takes. We centralize medication, shelter, food, therapy, and rehabilitation in one place and we do it for the length of time necessary, and to the degree necessary.

There is no cure, but almost all brain diseases can be treated, and part of the treatment requires (along with the traditional model of drugs and doctors) comprehensive and intensive support and rehabilitation. The beauty of Caramore is that it is not a hospital—it’s essentially the real world, with real jobs, real friends, and real apartments. But it provides that underling helpful and watchful guidance. We find that our clients want to be independent—not dependant, and when they gain the maturity and perspective regarding managing their illness, they rise to the occasion, attempting to achieve all that they can, while remaining aware of their illness.

Our model is worth copying in all communities.

D. Cooley

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