When Mental Health & Addiction Have Been Mishandled

Allies in Recovery member gramma40 doesn't know how to help her 35-year-old son who struggles with alcoholism and mental illness. He has been hospitalized 33 times in the last 6 years.

My son is 35, has mental illness and been an alcoholic for many years. He has been homeless off and on since 21. He has never held a job. I recently had him apply for DMH services but it's been a few weeks and they still can't tell me if he has been approved yet? He tries to make it but being homeless (he is on SSI) and the rents even for a room are more than he receives each month. When things get so overwhelming and frightening for him, he starts drinking, gets way out of control, and eventually signs himself into the hospital. He will be there 2 weeks or more and then they discharge him to the streets, where the vicious cycle keeps continuing. Without a place to live I fear he will die sooner than later. He has had 33 hospitalizations since 2011~I am all he has but I live in a senior community on a fixed income that does not allow guests, so I can't help at all. He is the kindest, gentlest, human being, never been arrested or in any trouble and wouldn't hurt anyone except himself. I believe he is on the autism spectrum but since all doctors "know best" all they see is his alcohol abuse and will not consider the possibility. He was a special needs kid (ADHD), diagnosed at age 5 and put on stimulant meds that never worked, so this has become an ongoing learned coping mechanism. He needs a group home or a halfway house that is subsidized and that will accept a dual diagnoses individual on medication. Sober houses with felons and no real supervision will not work for him. I have nowhere else to turn. If you could give me some ideas I would appreciate it.
 

The sad state of affairs

Your son’s history is so sad and underlines what I was saying in the original post you responded to. Hospitals respond to acute care needs. Once stabilized they quickly discharge, too often without a carefully thought-out plan that considers both mental illness and substance use. Around and around it goes, while your son gets sicker and older and nothing gets resolved.
 

The family may be seen as a "bother" but you are in a good position to advocate

One person who can advocate prior to discharge from the hospital is the family. But be prepared, and this may not be true with every psychiatric hospital ward, but the family is too often seen as a thorn in the side. Perhaps the Loved One has also refused to sign a release that allows the family to speak to the clinical team. The quick discharge once stable, the family being seen as “noise,” and the lack of a release all conspire so that your son is discharged to the street and not stepped down to the next level of care and safe housing.

Your son, long ago, should have been treated for his dual diagnosis in an intensive, integrated, and comprehensive way, over a long period of time, which would include safe housing, since he struggles with chronic homelessness.

The repeated hospital stays should have signaled to the hospital staff the need for mental health case management, and a file should have been opened a long time ago.
 

Case Management via the Mass Department of Mental Health

Here is a link that describes the state of Massachusetts Department of Mental Health case management. For those in other states, google the state department responsible for mental health to see about case management.

So your son has now applied to be followed by DMH case management. Good but this isn’t a panacea. Services are often limited and may have wait lists but a case manager can push for these services in a way you or your son cannot. A Case Manager can complete paperwork for services and can follow your son from one treatment to the next.

On the site we talk about our methodology for finding treatment. One of the suggestions is to look for grant-funded programs in your state. Here is one I found. I suggest you call them to see how to get your son admitted. Even if you’re not in the western part of the state, give them a call.
 

Funded October 2016 by the Substance Abuse Mental Health Services Administration: Cooperative Agreements to Benefit Homeless Individuals

From the grant announcement:

“The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS) and Center for Substance Abuse Treatment (CSAT), are accepting applications for fiscal year (FY) 2016 Cooperative Agreements to Benefit Homeless Individuals (CABHI) grants. The purpose of this jointly funded program is to enhance and/or expand the infrastructure and mental health and substance use treatment services of states and territories (hereafter referred to as “states”), local governments, and other domestic public and private nonprofit entities, federally recognized American Indian/Alaska Native (AI/AN) tribes and tribal organizations, Urban Indian organizations, public or private universities and colleges, and community- and faith-based organizations (hereafter referred to as “communities”). CABHI grants will increase capacity to provide accessible, effective, comprehensive, coordinated, integrated, and evidence-based treatment services; permanent supportive housing; peer supports; and other critical services for:

• Individuals who experience chronic homelessness and have substance use disorders (SUDs), serious mental illness (SMI), serious emotional disturbance (SED), or co-occurring mental and substance use disorders (CODs);”

Contact: Elizabeth Bienz, ServiceNet, Northampton, MA 413 585 1300. She is the person listed on the grant award. Ask her to put you in contact with the project director.

Finally, people with substance disorders are so often as you describe, kind and gentle. We are also very often thin-skinned, so intensely sensitive, and find life to be hard. Whether we are born this way, as I believe, or develop this disposition, we all have landed on what we believe to be the answer: a drink or a drug. A goal of recovery work is to find some natural confidence and new and better ways of coping with life. I hope for your son that he can find a safe home, treaters, and community that surround him with hope. May he go gently forward.