Chelan-Douglas Regional Support Network/
Prepaid Health Plan

Financial Support
Paying for treatment and meeting basic living expenses can present a major financial challenge for people with serious mental illnesses and their families.  Some public money is available to help individuals and families meet these costs, but obtaining government benefits generally takes time and persistence.  People coping with disorders like schizophrenia and bipolar disorder usually need help with the complicated process of applying for the money they're entitled to receive.

People who cannot work because of a serious mental illness may be entitled to disability payments from the Supplementary Security Income (SSI), Social Security Disability Insurance (SSDI), or General Public Assistance (GPA) programs.  Money for medical treatment may be available through Medicaid or Medicare.

Be sure to ask for this kind of help if you think you are eligible.  By themselves, few families can afford to support a family member with a serious mental illness over his or her lifetime.  If you are eligible for support, you are entitled to receive it, and such income can help bring stability to you and your family.

To learn about the financial support available in your state and community and how to apply for it, contact your local Social Security Administration (SSA) field office.  The Social Security Administration should be listed in your telephone directory's U.S. Government section.  Your telephone book may also list local offices for Medicaid and Medicare.

Terms to know

SSI
Supplemental Security Income is a federal program to provide income to those who are aged, blind, or disabled.  (Some states contribute a small amount of money.)  Eligibility is based on financial need and disability determination.

SSDI
Social Security Disability Insurance is for disabled workers who have paid into the Social Security system through payroll deductions.  Some disable persons under age 22 may collect SSDI under their parent's account if the parent is retired, disabled or deceased.

GPA
General Public Assistance is available in some locations to those who are disabled and either ineligible or waiting for other assistance.

Medicare
A federal health insurance program for those over age 65 and disabled workers.

Medicaid
State and federal health insurance for those with low incomes.  Eligibility varies from state to state.

Representative Payee
A family member, friend, or community advocate who receives the monthly SSI or SSDI check for the person with a mental illness and helps him or her manage the money.

Questions to ask

Treatment and Crisis Intervention
Many people with serious mental illnesses need continuous, long-term support at some level to manage their medications and symptoms.  When a crisis requiring hospitalization occurs, they need people who know them to coordinate their care with hospital staff and ensure continuity of services when they return to the community.  While outpatient psychiatric and medical treatment services vary widely across the country, the most effective programs work closely with their clients to help them work toward recovery.  Good programs use the most effective new medications, prevent unnecessary hospitalization, and provide 24-hour-a-day, seven-day-a-week emergency aid when it is needed.

Terms to know

Crisis intervention services
Provide emergency help to people in psychiatric crisis.  Depending on the severity of the crisis, services may include telephone support, home visits, crisis residence, transportation to and from the hospital, and coordination with hospital staff on admission, discharge, and treatment.

Community Mental Health Centers (CMHCs)
Local facilities offering outpatient treatment and emergency services for people with mental illnesses.  They are often funded by the state and federal government and may also provide services and information for families.

Case management
The coordination of treatment, services, and supports.

Questions to ask

Housing
Like anyone else, people with mental illnesses want to live in places that are clean and safe, where they can be full members of the community and live as independently as possible.  Depending on each person's medical condition and the kinds of support services available, the degree of independence in housing arrangements varies.  Housing options range from fully supervised group homes, and board-and-care homes with meals and care provided on site, to more independent arrangements.  These include supervised apartments in which clients live independently, either in the same complex or in supported housing scattered throughout the community.  Supported housing allows people with mental illness to choose where they want to live and offers flexible services and supports wherever they are.  Service programs like Fountain House-model clubhouses and programs of assertive community treatment help consumers find housing in the community, and help them apply for government housing subsidies.

Terms to know

Group Homes
Provide 24-hour supervision, medications monitoring, and staff help to carry out the activities of daily life.

Board-and-care homes
Offer daily meals, dispensation of medications, and minimal staff supervision.

Supervised apartments
Generally several apartments within the same complex, supervised by a staff member who sometimes lives in the complex.  The focus is on developing social skills and independence, and supervision varies from daily to weekly contact.

Supported housing and satellite apartments
Allow individuals with mental illnesses to live wherever they choose within the community and receive whatever level of support they need to remain independent.

Section 8 housing
Federally subsidized housing for people with low incomes.  The public housing authority in your community manages Section 8 subsidies.  Those who qualify pay approximately 30 percent of their monthly adjusted income for housing.  A Section 8 subsidy can be for a specific apartment development of for an apartment with another landlord who will accept Section 8 vouchers.

Questions to ask

Employment
For people with persistent mental illnesses, having a paid job is a vital step toward independence.  Vocational services help individuals recover their ability to finding and keeping a job.  Programs offering a range of social, vocational, housing, and other services often provide work on site for members as well as transitional-employment programs to support them as they re-enter the mainstream work force.  Typically, rehabilitation staff provide placement, training, supervision, and backup for members in mainstream jobs.

Terms to know

Transitional Employment
Places people with mental illnesses in temporary, paying jobs in the work place.  Often, two people share an entry-level position.  An agency staff member helps with training and emotional support and fills in during absences.  The emphasis is on building skills and positive work experience for as long as it takes to achieve maximum independence.

Supported employment
Places people in competitive jobs in the community.  A job coach helps them learn job skills and adjust to the work environment.

Questions to ask

Personal and Social Needs
A serious mental illness often interferes with a person's ability to care for him- or her-self and maintain comfortable and satisfying relationships with others.  Comprehensive community services such as the Program of Assertive Community Treatment, or PACT, include help with personal care, housekeeping, and personal hygiene when it is needed.  Many community programs offers social and recreational activities to reduce the isolation, loneliness, and stigma that so often accompany mental illnesses.  Consumer-run drop-in centers provide a warm atmosphere of welcome and acceptance.  Consumers can gather whenever they wish and may develop positive, long-term relationships.

Terms to know

Clubhouse programs
Programs like Fountain House offer mutual support in a caring community setting.  Members have a strong sense of ownership and know that they are needed to make the clubhouse function.

Psychosocial rehabilitation programs
Often available through Community Mental Health Centers and hospitals, while some operate independently.  These programs provide a variety of services that may include vocational training, social and recreational programs, and personal support for independent living.

Drop-In centers
Places where people with mental illness can go for support  and socialization.  They are staffed by consumers, and some also offer job training.

PACTs (Program of Assertive Community Treatment)
Outreach-oriented, service-delivery programs for people with sever and persistent mental illnesses.  With a 24-hour-a-day, seven-day-a-week, team approach, PACT offers treatment, rehabilitation, and support services to consumers in their homes, at work, and in community settings.

Questions to ask

Managing Money
To achieve independence, those with mental illnesses need skills to manage their own money and make their own decisions about spending and saving.  In some programs, people with mental disorders can learn to prepare a budget, pay rent and other bills, manage a checking account.  Some also offer banking and small-loan programs.

Questions to ask

Education
Returning to school to acquire basic skills or technical training or to work toward a high school or college degree can help people with mental disabilities regain confidence, follow personal interests, and acquire skills and credentials for pursuing a career.  In come communities, supported education programs help people with mental illnesses enroll in school, apply for scholarships, schedule classes, and buy books and supplies.  Staff also support them as they learn to adjust to school atmosphere.

Boston University has created a continuing education program especially for young adults with a history of psychiatric disability.  When students in the program complete four semesters of course work, they can take other courses at the university or move into jobs.  An active alumni program continues to support students after they graduate.  Similar programs are increasingly available at local community colleges.

Questions to ask

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