Community Living At The Bridge
I work in an apartment building specially designed to help mentally ill people regain independence. It's called a community residence for the mentally ill, and it's located in Manhattan's lower East Side and operated by the Bridge, Inc. I am one of the housing counselors who provide 24-hour staff coverage to supervise and support clients.
The residents live in studio apartments with a two-burner stove, refrigerator, and full bathroom. They are responsible for the upkeep of their own apartment, and they have a key to it. The residence is NOT a hospital. Residents go in and out as they please except for an 11:30 curfew, and they can have overnight guests and go on extended trips. If they get sick, their bed is held for 90 days. Thus they can have significant relapses and still have a place to come home to.
Everyone takes medication. The staff watches to see that they are taken correctly but clients are responsible for measuring the pills out of their own bottles. At medication time, which is a two hour period during which they drop in at the office at their convenience, clients recite the names and doses of their meds and sometimes what they are taking the meds for. In this way the staff makes sure that everyone knows what he or she is taking and why. Clients can be given a week's supply of meds to take by themselves if they learn all their meds and show up regularly to take meds on time.
Everyone takes turn cooking and shopping for dinner, when a group meal is offered. Clients are not required to attend it, however. They may have as much or as little independence as they want. People eat lunch in their own apartments or cook in the community kitchen. Lots of people eat downstairs because it is more social but no one is required to eat meals together. Laundry facilities are provided, and each person has a set time to do their laundry.
Most clients attend the Bridge Day Program, which they get transported to by a van every morning. They also get primary medical care at the Bridge. Other medical care is arranged by the staff. Clients may also work or attend school instead of going to Day Program. One of our clients is taking a course at City College. Others attend GED programs. Some clients have vocational rehabilitation jobs within the Bridge. Others attend MICA programs or Vocational Readiness programs at the Bridge or elsewhere.
Each client has a counselor and a case manager. Together, they set treatment goals. Typical goals might be achieving self-medication, behaving appropriately in social situations and making friends, getting a job, joining a GED program, learning to clean your room, or reducing auditory hallucinations. Objectives -- tiny steps by which the goal might be met -- are established and the client works towards the objectives with the help of the counselor. The counselor might teach a client how to clean the bathroom, help them look for a job, or teach them the names of their meds, for example.
The cost of the program is covered by SSI and Medicaid, although not a lot is left to the client for spending money. Sound good? It is. The Bridge houses 400 people in its programs and there are around 4000 units in the five boroughs run by various agencies. Unfortunately, there are not that many vacancies, and the wait can be from 6 to 20 months for a bed. However if you are homeless or in the hospital you may be able to get a bed quickly. The first step is to get the form filled out so that you are authorized to apply for available spots. Then you can get the list of vacancies from the CUCS, either by mail, in person, or on www.cucs.org. The vacancies are listed with phone numbers, and you can apply directly to the residences, or the CUCS social workers may be able to place you.
To apply for supported housing, call the Center for Urban Community Services (CUCS) at 1-800-801-3300, and arrange to fill out an HRA-1995 form with a social worker. The form will include a recommendation of which level of supervision you require (I am describing a Level II -- more supervised -- residence in this article). You will need a doctor's letter stating that you require mental health housing.