5. Services and Supports for Adults

5.1 Community Systems

(5.1.1) NAMI believes that it is the responsibility of government at all levels to develop and maintain comprehensive community support systems that include treatment and services, as well as short-and long-range plans, for all adults with serious mental illnesses.

(5.1.2) NAMI believes optimal treatment, favorable outcomes, and recovery are most likely to occur when comprehensive treatments and services are provided in an atmosphere of respect, acceptance, and hope.

(5.1.3) NAMI believes that all publicly funded community service providers must offer evidence based, promising and emerging practices and services that adults living with serious mental illnesses need. These practices and services must be recovery, resiliency and wellness oriented, culturally competent and readily accessible. These practices and services must include the availability of appropriate and effective medications, inpatient treatment, and outpatient treatment with mobile capacity, residential support services, transportation services, intensive case management, respite services, vocational and psychosocial rehabilitation, peer support, consumer-run services, and round-the-clock services that are available seven days a week. 

Service providers must prioritize access to services to people with serious mental illnesses, providing oversight and advocacy through well-trained care managers. Services should use an integrated consumer-centered approach that may take professionals out of the traditional office setting to a location that is comfortable for the consumer. Treatment should be delivered at the same treatment site using cross-trained staff.

( NAMI endorses integrated, rather than sequential or collaborative-parallel treatment programs for persons with co-occurring serious mental illnesses and addictive disorders treatment delivered at the same treatment site using cross-trained staff.

5.2 Continuity of Care

(5.2.1) Every consumer should have a single service manager or management team that is well informed about every aspect of the treatment and informs the consumer and other members of the treatment team. When an individual is hospitalized, the manager should be kept informed and should become a member of the inpatient treatment team. Whenever residence in a community is interrupted for any reason, continuity of care requires that the same service manager or management team retain responsibility for an individual's treatment unless the consumer desires a change.

5.3 Community Housing

(5.3.1) Housing is critical to recovery and should be immediately available to sustain treatment, resiliency, recovery and community for people with mental illnesses. People with serious mental illnesses especially need a wide array of options for decent, affordable housing based on individual needs and choices.

(5.3.2) NAMI supports housing choices for people with mental illnesses that include rental or ownership in independent living, supportive housing and group homes that include the availability of wrap-around services, other support and, when appropriate, education about maintaining living in and financing of housing. Based on individual needs and choices, living independently in the community should be given priority. Funding, services and support should follow the person with respect to all housing choices, including housing provided by care-givers. Available, affordable housing choices should also facilitate access to education, employment, transportation and other needs of daily living.

Federal, state and private financing of housing for people with mental illnesses should be better coordinated and integrated in order to link housing development with operating funds and funds for treatment, services and other support.

(5.3.4) NAMI opposes legal restrictions on housing that discriminate in location, limit and equal access, segregate, prevent family preservation or deny choices in occupancy or living arrangements solely on the basis of mental illness, including people who are seeking treatment or are in recovery from co-occurring substance abuse. Families must not be expected to be legally responsible for or pay for the costs of providing housing for adult family members with mental illnesses who are not legal dependents. No one with a mental illness should be housed in a nursing home and similar long-term care facility without an independent determination of a geriatric or other appropriate medical condition.

(5.3.5) NAMI affirms that persons living with mental illnesses have no less rights to dignity, privacy, security and stability in their living arrangements. People with mental illnesses should not be at risk of losing housing in the community during periods of crisis, hospitalization or inpatient treatment.

5.4 Education and Employment

(5.4.1) NAMI believes that people living with mental illnesses want, need and have the right to be meaningfully employed, including continuation and advancement on the job, in chosen professions and in businesses. Yet unemployment and under-employment rates are higher among persons with mental illnesses and result in undue reliance on public assistance.

(5.4.2) NAMI advocates full and fair access for people with mental illnesses to education, continuing education, vocational rehabilitation, training, professional development, personal development, employment, business and business assistance. Federal and state education, workplace rights, employment opportunity and worker’s compensation laws as well as business assistance must fully and effectively protect against stigma and all discrimination on the basis of mental illness. Disincentives to employment in Medicaid, Medicare and other federal or state programs that help fund treatment and support for people with mental illnesses must be eliminated.

(5.4.3) NAMI believes that people with mental illnesses must have the opportunity to be actively involved and supported in making personal choices related to education, training, employment, entrepreneurship and business development.

(5.4.4) NAMI urges employers to offer a variety of workplace options, including on-the-job personal and peer assistance, education, training and professional development as well as transitional employment, flextime and telecommuting that may be especially helpful to people with mental illnesses. Training should also be provided to managers, supervisors and other employees to raise awareness about maintaining a supportive workplace for people with mental illnesses.

(5.4.5) NAMI seeks effective cooperation and collaboration among public agencies, not-for-profit agencies, health care providers and insurers as well as family members and peers of people with mental illnesses in integrating and evaluating the most effective delivery of treatment, wellness, vocational rehabilitation, education, training, professional development, employment services, supported employment, transitional employment, business assistance, transitional services, family services and continuing support for people with mental illnesses entering, in and re-entering the active workforce.

(5.4.6) NAMI asks that federal and state labor agencies effectively measure, track and report unemployment rates among people identified as living with psychiatric disabilities.

(5.4.7) NAMI supports the development of effective recruitment and training of people with mental illnesses for employment and careers related to mental health care and support for persons with mental illnesses.

5.5 Consumer-run Programs

NAMI supports and encourages self-help activities and consumer-run programs including peer support, housing, day centers, small businesses, clubhouses, and drop-in centers. NAMI also supports and encourages all service providers to support the development of such self-help activities.

5.6 Educational Programs for Consumers and Families

(5.6.1) NAMI believes that a transformed and recovery, resiliency and wellness oriented system of care, driven by consumers and families, must guarantee the widespread availability of free educational programs for consumers and families, and must also empower consumers and family members as teachers in the education and training of all mental health care providers.

(5.6.2) Peer-designed and peer-directed educational programs must be valued and promoted as an integral part of the service system. The development and administration of peer-directed programs must be supported through specific public funding and further system resources must be made available in order for peer educational programs to be strongly evidence based.