Mental Health Association in New York State, Inc.
(Publication Archives)

Community Connections, Spring 2003

The ABC’s of Residential Services
By Richard Dowhy, Vice President, Living Opportunity of DePaul and Chairperson, MHANYS’ Board of Directors

New York State has developed a continuum of residential services for individuals with mental disabilities since the 1970's. The residential programs that are contracted out to not-for-profit organizations by the New York State Office of Mental Health (NYSOMH) include: Congregate Treatment Programs, Treatment Apartment Programs, Supported Housing Apartments, and Single Room Occupancy sites.

Each housing option has a specific objective relevant to the needs of the engaged individual. These needs range from restorative services to housing stablilzation.
In the year 2000, the NYSOMH put forth a laudable initiative known as the ABC's of Mental Health, meaning an accentuation on the Accountability, Best Practices and Care-Coordination. The ABC's of Mental Health were a response to a system that was increasingly demonstrating signs of a disconnection from its intended objective. The system has become woefully indifferent to a myriad of pertinent needs.

Nevertheless, among a select group, the residential service providers fervently embraced the ABC's of Mental Health. The prospect of an enhanced service system that was more accountable, promoted stellar practices and ensured a coordinated system of care, was perceived as a validation of practice by the residential service providers.

The ABC roots, as a foundation of residential practice, are essentially twofold. The values of ABC have been traditionally intrinsic to respective organizational mission statements. Further, in accordance with the design of an authorized residential program, these values have always been historically emphasized since the ascertainment of resources from OMH was predicated upon the adherence to these values.
Transferring these values into practice is exemplified during a typical eight-hour shift within a congregate treatment program. Generally, two staff members work with fourteen individuals. The staff's responsibilities include: assuring a total of between 40 to 80 medications are taken correctly; preparing a family style meal for 14 along with placing it on the table and clearing it; all transportation needs are coordinated; consumers are accounted for throughout the shift; answer the telephone; interact with family members; assist with chores; interact with affiliated service providers; ensure that all documentation pertinent to each consumer's rehabilitation activities (Medicaid Standards) are timely and correctly done; be available for a variety of consumers' needs; and with increasingly more frequency, the same staff must deal with all crises as they arise, be they medical or psychiatric.

The magnitude of these expectations requires a requisite amount of organizational and interactive skills, in conjunction with the ability to be cognizant of group dynamics, while being sensitive to each consumer's specialized needs as well as their aspirations. Furthermore, effective communication skills partnered with advocacy are deemed pertinent to accessing external services. The facilitation of these variables occur within the context of the watchful eyes of the consumers, family members, OMH, the local government unit, and the organization's internal quality management personnel.
As ardent practitioners of the ABC's, it would be a best practice to include the residential service providers within the development of a comprehensive statewide plan for mental health. For, in accordance with the precepts espoused by Abraham Maslow, the residential service providers are successful at being a conduit for the fulfillment of the hierarchical needs of many people.

(Maslow believed that there was a hierarchy of needs beginning with air, food and shelter, right on up to self-actualization. He recognized that an individual had to satisfy one level of need before achieving the next one. Generalizing from these principles, a person living with mental illness would be hard put to achieve recovery without safe, stable housing -Ed.)

posted 6/13/03