Bazelon: From Housing First to Employment First

NYAPRS Note: I’ve had the honor to serve as a Trustee of the Bazelon Center for Mental Health Law for a number of years. Here’s an excerpt from a recent board report that demonstrates some exciting new trends.


With the November elections behind us, we now have some clarity about the program strategies and priorities we’ll be pursuing in the coming year. On some issues, the election outcome will allow us to build upon some of the landmark advancements we’ve achieved over the past few years. For instance, we made some remarkable progress in changing conceptions and practices with regard to integrated housing for people with serious mental illnesses (with important implications for individuals with other disabilities, as well).


After decades of relegating people with psychiatric disabilities to segregated congregate living arrangements, we’ve prodded public systems to offer truly integrated alternatives: ordinary homes scattered throughout communities with supportive services. Similarly, we’ve gained a foothold in changing the way systems evaluate the needs of people with serious mental illnesses so that integrated housing of one’s own choosing becomes the default, and routine referrals to vacant “slots” in group homes become a thing of the past. In the second Obama Administration, we expect to be able to continue the close relationships we’ve developed with key federal leaders around housing integration, working through litigation in partnership with the U.S. Department of Justice and collaborating with other agencies that are concerned with service funding, affordable housing and mental healthcare practices.


We also expect to be able to launch a new initiative around mainstream employment of people with psychiatric disabilities. In many ways, we see this as paralleling our work to change the culture and practices in public systems with regard to housing. Accordingly, our goal will not only be to increase employment among people with serious mental illnesses, but to ensure that employment occurs in ordinary work settings. In past board meetings, we’ve briefly discussed some of the factors leading us to take on this new body of work: the astonishing 80% unemployment rate among people with serious mental illnesses (and that’s pre-recession); systemic disincentives for people to enter the workforce; and the prospect that, as co-workers, individuals with psychiatric disabilities will, one-by-one, break down some of the false stereotypes sustained by segregation.


Just as we have promoted “housing first” as a system priority to overcome homelessness and institutional isolation, we expect to promote “employment first” as an approach for people with serious mental illnesses. And just as in the realm of housing, we are confronting static public systems that rely on outdated practices and providers with vested interests in the status quo...


Robert Bernstein


Bazelon Center for Mental Health Law