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

Community Connections, Spring 2003

The Long Road Home: A Century of Adult Home Reform in New York State
by Helena Davis, Director, Anti-Discrimination Programs, MHANYS

The fight to secure appropriate housing for people living with severe mental illness is more than a century old. Perhaps the senior warrior in this battle is the Schuyler Center for Analysis and Advocacy (SCAA), which has been shaping policy for New York's people in need since 1871.

On May 1, 1891, a public meeting was held in New York City to commemorate the enactment of the State Care Law "which removed over 2,000 insane persons from the poorhouses of the State."1 At that meeting, the Honorable Joseph H. Choate gave the opening address. The following is an excerpt from that address.

“....When the attention of this Association and of its visiting committees was attracted to these unfortunates they at once sought to improve their condition.

It is eleven years since we had to appeal to the Legislature for the right of visitation to these county alms houses, and that was only obtained after very serious opposition in the Legislature. Through these visiting committees the condition of these insane annexes to the poorhouses was gradually brought to light...Such a revolting condition of things can hardly be imagined to have existed in a Christian and civilized community within the last fifteen years - degradation, filth, want of food, want of clothing, want of light, want of care, want of attendance, want from everything that was calculated to mitigate in the least the misfortunes of the insane....Agitation of this subject year after year, in a quiet way, by the committees of this Association, had very little effect; but at last, in the year 1887, they determined to make one resolute effort for reform, and it is the final success of that movement, after years of struggle, at first apparently unavailing, gradually commanding public confidence and public support, that this meeting has been assembled to commemorate.”¹

As we now know, the Honorable Mr. Choate’s hopes did not come to fruition. As the following timeline demonstrates, the investigations, position papers and legislation of the last three-plus decades also have yet to effect the systemic change they are meant to address.

Timeline²
1977 Deputy Attorney General, Charles Hynes, releases the report, Private Proprietary Home for Adults. A law requiring joint visitation by the Office of Mental Health and the Department of Social Services was enacted.

1979 New York State Department of Social Services commissions a report on characteristics of adult home residents. The Department develops a plan of action to address problems identified by the report.

1990 The Commission on Quality Care for the Mentally Disabled issues the report Adult Homes Service Resident with Mental Illness at the request of the New York State Legislature.

1996 New York State implements the Quality Incentive Payment (QUIP) Program to improve the physical plant in adult homes.

1997 The New York State Legislature requests the Office of Mental Health to undertake a study of the delivery of mental health services to residents of adult homes. The report is completed in 1999.

1998 Oversight authority for adult homes is transitioned to the Department of Health from the former Department of Social Services.

1999 SCAA, the National Alliance for the Mentally in New York (NAMI-NYS) and the Senate and Assembly Mental Health Committees host a symposium on adult homes serving residents with psychiatric disabilities. A stakeholders workgroup is formed to develop recommendations for improving the quality of life for these residents.

2000 The stakeholders workgroup releases its report, There’s No Place Like Home: Recommendations for Improving the Quality of Life in Adult Homes Serving People with Mental Illness.

2002 New York Times articles appear and the state responds with the creation of the New York State Adult Care Facilities Workgroup.

We are at the crossroads once more. We have made tremendous strides in understanding how best to support people living with mental illness through research, education and advocacy. Despite the challenges caused by lawmakers’ priorities and shrinking financial resources, there is forward movement. Progress is being made, slowly to be sure, but promising nevertheless. Through all the challenges, SCAA continues to use education, coalition building and creative problem solving to insure that people living with mental illness will attain equality in our communities and will have the safety, dignity and respect they need to live up to their fullest potential.

¹ Schuyler Center for Analysis and Advocacy. "The Cause of Dignified Living: The Psychiatrically Disabled in Adult Homes", p.4. Albany, NY 2002.

² Ibid., P. 24

The complete report can be found at the SCAA website: www.scaany.org/dignified_adulthomes.pdf.

The editor wishes to thank Karen Schimke, President & CEO of Schuyler Center for Analysis and Advocacy for her assistance with this article.

posted 6/13/03