Since the advent of key pieces of federal legislation, including the Community Mental Health Act of 1963, the Americans with Disabilities Act in 1990, and the Olmstead Decision of 1999, the trend has remained consistent towards locating services in the community and in the home for children and adults with all kinds of disabilities, including mental health challenges, intellectual disabilities, autism, physical disabilities, and others. In the Olmstead Decision, the Supreme Court held that community-based services should be provided to persons with disabilities when (1) such services are appropriate; (2) the affected persons do not oppose community-based treatment; and (3) community-based services can be reasonably accommodated, taking into account the resources available to the public entity and the needs of others who are receiving disability services from the entity.
When state psychiatric institutions were closed rapidly in the 1950s and subsequent decades when community-based services were not yet widely available, followed by legislation in the 1980s that drastically reduced spending on mental health services, there was a dramatic increase in homelessness of persons with mental health conditions that persists to the present day. Recent events in which people with mental health issues have had disastrous encounters with law enforcement have further illustrated the scope of unmet needs of individuals with mental health conditions.
Clearly the majority of people can be successful receiving services in the home or community, while a small number require a higher level of care and more intensive services. But thoughtful consideration must be given to creative and innovative ways to ensure that programs and services are actually available for people who require them, allowing for maximum choice on their part – especially those with complex needs. And these services should offer the greatest level of independence and safety for all community members.
This edition of the Social Innovations Journal focuses on the progress made in developing community-based services where once there were few or none, as well as policy implications surrounding services and systems which remain fragmented, and best practices and models. This edition explores a broad range of themes which address far-reaching topics relating to innovations in policy on how we will address the dire workforce crisis that touches nearly every corner of the human services sector, innovations in the use of data, and systems integration and models that exemplify innovative solutions to providing services in community-based settings.
Tine Hansen-Turton, Woods Services, Guest Edition Curator and Editor
Nicholas Torres, Co-Founder, Social Innovations Journal