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The war against group homes and day treatment

June 26, 2010
by Terry L. Stawar, Ed.D.
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For over 30 years group homes and day treatment programs have been in the forefront of the deinstitutionalization movement in America. While these programs may not always promote the degree of normalization that everyone desires, they have provided a gateway for community reintegration for a significant number of people, previously relegated to isolated state operated facilities. The Olmstead decision has reinforced our commitment to community based services.

These modalities have also evolved over the years and have become more recovery oriented. Compared to various wraparound, supportive, and assistive service programs, their age is beginning to show. The next generation of behavioral health leaders, however, tend to view these programs with the contempt reserved for “your father’s Oldsmobile”.

I am always fascinated by how easily authorities, who preach consumer/family choices and empowerment, within the recovery approach, are blithely able to eliminate such programs, because they don’t fit with their person conception of recovery.

As I write this, my organization is shutting down three group homes for people with dual MH/SA diagnoses and converting our day program into a part-time, time-limited resiliency program.

Gone is the volunteer club which allowed participants to fully engage with their community by working on local projects to benefit others. Gone is the hard won self-esteem created by working together in a community garden, which provided produce for a community kitchen, which fed the homeless. Gone is the opportunity for a peer support group that allowed for ongoing social interaction for many people whose natural folk-support system had abandoned or rejected them.

I am not arguing that we can’t do better than these modalities, but I am arguing that we need viable funded alternatives before we pull the plug. I feel like we are reneging on the promises made when we took people from state operated facilities and put them back in our communities. We risk people languishing in the community just as they previously did in institutions.



I believe this article has missed its purpose in regards to the anonymous comments made. While I do not articulate negativity toward Personal Care Homes and specifically the ones you are referring to in Kentucky, I do see a problem with the language. "the MI community" does not sit well with me as I have advocated for person first language to reduce stigma. Also "We administer" and "we allow", I feel, does not represent the innovative thinking of Terry Stawar's article. I appreciate your passion and drive to help those with mental health disabilities recover, but the point is to totally remove programs, agencies, PC homes that do not give individuals the empowerment to recreate their lives with the strength that comes from recovery, lived experience and the personal talents of what has been a stigmatized population.

I have the answer, in Kentucky, anyway. I worked for a man who has aided the MI community for over 40 years. He owns 5 Personal Care Homes in the state of Kentucky. I, myself, have been involved with one of them for the majority of my life. My mother was the administrator for 40+ years and now I am working in the same environment. We are a state licensed PC home which houses 140 residents. Our facilities provide all the comforts of home with the assistance of our trained and certified staff. We administer all medications and treatments, provide 3 meals a day, laundry services, activities, etc. Our facilities provide all the comfort of home for them and we allow them there individuality. If you have any questions about our facilities and how we can help your community, please contact us at Fern Terrace of Mayfield, KY at 270-247-3259 and ask for Cindy in Admissions.

So, the driving force is obvously financial. Possibly the most important issue is the clinical outcomes. Can you create new residential alternatives to address an envioronment of recovery? There must be a creative answer.

I am impressed by the description of the group home in the above article. Unfortunately, not all are as well run and I know of some who have sent their residents 7 days a week to PHP programs so that they did not have to take care of them during the day. Group homes should not force residents to attend programs just to act as "baby sitting services" so that the group home can get away with less employees.

I have seen some good group homes - but there are many that need to be changed.

Terry Stawar

President/CEO (LifeSpring, Inc.)

Terry Stawar


Terry L. Stawar, EdD, is President and CEO of LifeSpring Health Systems, a community behavioral...

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