A new report released last week shows Delaware making progress toward hitting benchmarks set out in its 2011 settlement with the federal government over issues in the state’s mental health system.
Robert Bernstein is the court monitor in the case, and also the Executive Director for the Bazelon Center for Mental Health Law in Washington D.C.He says the First State is on track to achieving its goals.
He also admits that the initial settlement set out extremely lofty benchmarks, in his words seeming to require “10,000 things that the state should do all at once,” and said that some of those things had to be reevaluated along the way.
“I advised the state…and the Department of Justice was in discussion on this…rather than try to do everything and do a lot of things badly, let’s focus on putting in the building blocks of what it takes to get the system in place,” he said.
Those things that took priority included: ensuring a strong peer movement and other wraparound services such as supportive housing, supportive employment and assertive community treatment teams.
Bernstein says that’s why things like risk management and quality assurance – which took the back burner initially – are included in the 9th court monitor report.
As part of his role in ensuring the First State’s compliance with the settlement, he’s been meeting with those living with serious and persistent mental illnesses: often living in their own homes, a significant improvement from years prior.
He related the story of one man he went to visit.
"While we were talking a buzzer went off and he said excuse me, that’s my washer I have to put my clothes in the dryer, Bernstein said. "And it occurred to me at that moment. What could be more ordinary than having to put clothes in the dryer? And this is a guy who was in Delaware Psychiatric Center I think for 15 years and had been in jail before that."
Bernstein says supported housing is just one part of a complete culture change he’s seen in Delaware’s mental health system: centered around a strong group of individuals living with mental illness living successfully in the community, supporting one another, and voicing concerns about areas that need improvement.
"What I’m hearing now are not so much systemic problems from people…there is no housing in the state or there is no in-home service I can get…it’s much more individualized, he said. "That, my case manager hasn’t seen me in three weeks. Or I’m very dissatisfied with the things my psychiatrist is doing."
He says connecting those individuals with personal issues to a person who can address and correct them remains an area the state needs to work on.
Ninth Report of the Court Monitor Us v Delaware 11-591-Lps
