A Lifelong Challenge
In the past, individuals with severe mental illnesses might face life in an institution. Today a number of programs provide them with support in reintegrating into the community.
For some, serious mental health struggles can be be lifelong.
The National Institute on Mental Health says that serious mental illness
(known as SMI) is “a mental, behavioral, or emotional disorder resulting
in serious functional impairment, which substantially interferes with or
limits one or more major life activities.”
In 2019, there were an estimated 13.1 million adults age 18 or older in
the U.S. with SMIs, also known as “serious and persistent” mental illness.
Examples can include schizophrenia or bipolar disorder.
According to the National Alliance on Mental Illness-Minnesota (NAMIMN), the four most common mental illness diagnoses for adults are
anxiety disorders, major depression, bipolar disorder, and schizophrenia.
For children and adolescents, the most common are anxiety disorders,
attention-deficit/hyperactivity disorder (ADHD), depression, bipolar
disorder, Asperger’s syndrome, and eating disorders. Degrees and expressions of these mental illnesses take a variety of forms.
According to Sue Aberholden (M.P.H. ’80), executive director of
NAMI-MN (namimn.org), the biggest challenges individuals with SMIs
face are finding stable housing and employment, along with appropriate
“Our mental health system isn’t broken—it was never fully built,” she
says, noting a better system would include more efforts to provide early
identification and intervention for mental health issues; having enough
beds and intensive services to address acute mental health crises; and
having better insurance support for long-term treatment. She also notes
that existing inpatient beds in Minnesota for individuals suffering from
mental health crises are often full to capacity on any given day.
As for supporting individuals with SMIs
within the wider community, Abderholden
says having multiple options are key.
“For some people, [living in] a corporate
foster care setting with a Medicare waiver is
going to work,” she says. “For other people,
[it’s] several small apartments that are in the
same building, while still providing support.
For still others, as long as they have housing
and someone to come in and check in on
them, as with a community support team,
they’re fine. But it is really hard.”
One program that exists in Minnesota to
help individuals with severe mental illness live
more independently is Tasks Unlimited, one
of the largest such groups in the metro area.
Founded in 1970, Tasks follows an alternative approach to hospitalization, popularized by social psychologist George W. Fairweather. Known as the Fairweather model, under this approach individuals with severe mental illness live together in small groups, providing support to each other, while also receiving job training or working. (See Bruce Ario’s first-person essay here about his experiences with Tasks.)
Tasks helps its clients find employment
through contracts it maintains for janitorial,
office, or remodeling work. Ashley Trepp
(M.S.W. ’04) is the director of mental health
services of the not-for-profit and oversees
staff who provide intensive residential
treatment services, case management,
adult mental health rehabilitative services,
and the peer-supported Fairweather Lodge
and jobs program. The group also offers a
homeless outreach effort and a day shelter
to reach individuals not supported through
other efforts, and also works with individuals
leaving Anoka Metro Regional Treatment
Center, Minnesota’s largest state-operated
psychiatric hospital, through a program
called “Whatever It Takes.”
“The vast majority of our [work] serves
folks with a diagnosed mental illness,” says
Trepp, noting that schizophrenia and bipolar
disorder are common. Tasks assists people
who have “enough functional barriers [with
daily life] where they are in need of services,”
The group serves nearly 300 clients, with 21 lodges around the Twin Cities metro area. It also has 14 job contracts, both federal and county, in Minneapolis and St. Paul. A number of specialized lodges through Tasks also support seniors or women or individuals convicted of felonies that stemmed from their mental illness.