Cheap housing

New York recently learned that it can either spend $40,000 a year to leave a mentally ill person homeless or $41,000 to provide that same person housing linked to comprehensive health support and employment services. The choice should be of special interest to Maine, which has an unhappy 30-year history with its homeless mentally ill.

The numbers for New York come from a newly released massive study of nearly 4,679 mentally ill people who had been placed in affordable housing with clinical and social support services. Tracked over five years and compared with multiple control groups with similar characteristics, those with housing were found to require total services that cost only marginally more than those left homeless. The study, done by the University of Pennsylvania’s Center for Mental Health Policy and Services Research, found that reductions in hospitalizations, incarcerations and shelter use among the homeless accounted for 95 percent of the cost of housing.

The actual cost of housing, however, would look even better had the study figured in other costs associated with homelessness, such as police and court time, soup kitchen usage and the cost of homelessness on local businesses. The study focused on monetary costs, but the humanitarian and social costs of leaving the mentally ill without adequate support, where they may come to harm or harm others, are also real and very high.

Maine began the process of emptying its state institutions for the mentally ill more than a generation ago and it still has not caught up with the need for housing, as the populations at the local homeless shelters demonstrate.

In many cases, lifelong institutionalization was not appropriate and those released found adequate care and services to lead happier lives. In many other cases, however, a lack of outside services made matters worse, bringing misery, emotional distress, physical danger and, occasionally, death. The large number of mentally ill locked up in Maine’s prisons has been repeatedly documented.

The New York study is compelling enough so that Maine lawmakers and the Department of Mental Health, Mental Retardation and Substance Abuse Services should work together to see whether similar housing in Maine is more affordable than previously thought. If their results are similar to New York’s, the next step is clear.