Thresholds

Mark Ishaug Speaks on Housing for Persons with Disabilities in Chicago Metropolitan Region

Mark Ishaug. Photo by Andrew Collings.

Mark Ishaug, CEO of Thresholds, recently was invited to give remarks at the Chicago Community Trust’s event New Partnerships and Novel Plans: Housing Solutions for People with Disabilities, held on September 9th at the Federal Reserve Bank of Chicago, before more than 200 stakeholders that included federal, state and county officials; local mayors and municipal leaders; housing developers; disability advocates; service providers; and persons with disabilities. Here are his remarks from the event:

Good morning everyone. It is so great to be here with all of you.

I am Mark Ishaug, CEO of Thresholds. Thresholds is the oldest and largest community mental health organization in Illinois. We provide housing, healthcare and hope to over 6000 clients a year with serious and persistent mental illness in Chicago, the suburbs, McHenry and Kankakee.

I’d like to start my remarks by sharing the story of one of our clients, Bruce, in his own words:

    I’m Bruce. I’m a Vietnam vet. I was homeless, alcoholic and broke. I was living on streets. The VA got me into a 21 day program. Then they connected me to Thresholds. The Thresholds Veterans Project.

    Thresholds got me a security deposit, helped me find an apartment, furniture, pots and pans and I everything I needed to get started and make it work. And the counseling was great.

    Having my own apartment means that I am finally stress free. Before that, my blood pressure was 254, my diabetes real bad, and I was suicidal. Now I sleep 8 hours a day, I don’t drink any more. My bosses say I am changing.

    You know, there are a lot of vets who are homeless just like I was. They just want a roof over their heads. And if you are living on the streets, how do you clean up for a job interview? You need housing first.

    I keep a stack of all the things Thresholds does and hand ‘em out whenever I can.

    I love my apartment, I love it. And I am back!

As you all know, without safe, decent, affordable, community based-housing, recovery for Bruce and millions of others disabled by mental illness and addiction would be tough, if not impossible.

Without permanent, supportive housing, people with a wide range of physical, emotional or intellectual disabilities risk long-term institutionalization, poor health and social outcomes, and premature death. In fact, people with severe mental illness in this country die 25 years younger than those without. A national tragedy.

And what’s the not-so-secret sauce of success to homelessness prevention, housing stability, self-sufficiency, independence, and physical, emotional and social health? Yep, support services. Plain and simple.

Here are just a few examples of what I mean by support services.

• Job training, search and placement
• life skills coaching
• crisis intervention
• community support and case management
• supported education
• talk therapy
• medication education and support
• legal services
• transportation
• linkage to medical, behavioral and social services
• tenant/landlord relationship coaching
• family reunification
• benefits and entitlement advice and application

And the list goes on!

These and other critical services can be provided in a number of settings in a variety of ways, from group homes or 24-hour supervised residential facilities, the most restrictive on the continuum, to (Community Integrated Living Arrangements (CILAs), to subsidized, supported apartments, to scattered-site independent living.

Study after study after study has shown that housing and supportive services are effective and cost effective. They are far cheaper, and not to mention more humane, than shelters, jails, prisons, nursing homes, and institutions of mental disease.

Studies have shown that housing and support services help people increase their income, work more, get arrested less, make progress in recovery, and become more active, valued, and productive members of society.

Studies have also shown that housing and support services are good for communities. The reduce crime, revitalize challenged neighborhoods, and enhance local businesses. Thresholds has proven this through our own housing development projects in Rogers Park, Austin, and Englewood, to name just a few.

Let’s be real. Funding for supportive services is hard, very hard to come by. For people with severe mental illness, Medicaid and Social Security are primary and critical funders, as they are for those disabled by AIDS and other chronic medical and physical conditions. But mostly we all struggle to braid and bundle resources from HUD, the Illinois Department of Human Services, the Chicago Department of Family Support Services, and of course generous private foundations, corporations and individuals.

I am hopeful, downright optimistic, that with the expansion of Medicaid through the Affordable Care Act, and better care coordination, we will find creative ways to meet the service needs of our very vulnerable low-income, disabled, and medically compromised clients.

Here’s the take home: supportive services work. Support services are worth the money. Support services are evidence- and outcomes-based. Support services show IMPACT!

I is for Individualized. One size does not fill fit all. Different people want and need different levels and types of support. Some people need housing and no services. Don’t provide them! All services must be voluntary, customized, flexible, and variable in level and intensity. I is for Individualized.

M is for Measurable. We must measure outcomes such as housing stability, client satisfaction, social and community interactions, increased income and employment, improved physical and mental health. M is for Measurable.

P is for Person-Centered Partnerships. Supportive services only work if clients, providers, landlords, property managers, health, and social systems work together, not at odds, with the client at the very center of the relationship driving the service plan and delivery based on his or her needs, hopes, and dreams. P is for Partnerships.

A is for Affordable and Accessible. If the services are not affordable, and not readily accessible, nothing works.

C is for Choice. Old models and old thinking that segregate and separate people and deny choice must evolve. Why should funding entities and lawyers say you can live in this type of arrangement but not that, you, X person, can live with your peers if you want, but you, Y person, with your particular disability, can’t, even if you want to? We all want control and choice over our lives and living arrangements, and the services we get or decline. People with disabilities deserve nothing less. C is for Choice.

T is for Transformation. Quality affordable housing and client-driven, flexible services transform the lives of individuals, families, communities, and society at large.

I want to wrap up my remarks with Ron’s story:

    I first experienced psychosis while in college. After graduation, symptoms of major depression and schizophrenia escalated, leading to 11 psychiatric hospitalizations and 2 sets of electroshock treatments.

    When I was released from the Elgin Mental Health Center, I was placed in a nursing home where I resided for about a year.

    While in the nursing home I got connected to Thresholds. Thresholds services played a significant role in my recovery, by providing counseling and therapy, affordable housing, and job placement. Thresholds helped me return to school where I earned an accounting degree. For 10 years I worked in the Thresholds accounting department.

    I also got involved in the rollout of a number of recovery programs. I was given full support for several of my own initiatives, including a bike and walking club and a computer literacy program.

    When the Director of Recovery left, I was encouraged to apply for the position. This seemed like a natural step for me. I have served as Director of Recovery for 5 years now.

    Thresholds services, and my own efforts to manage both my physical and mental health, have enabled me to recover from mental illness. I have been recovered for 10 years. I now own a home, am happily married, and enjoy a satisfying career. Community-based mental health services made this possible.

T is for Transformation.

T is also for Thank You. For all you do, and for your commitment to making this city and state and country a better place for all of us, for especially those with disabilities.