9 Reasons Why We Need Facility-Based Residential Programs

 We need facility-based residential  programs for individuals with dual diagnosis because: 

1. Those with dual diagnosis with severe challenging behavior are not usually welcome in group homes. 

2. When residents display challenging behavior, staff often call 911, and the police are often summoned and bring the resident to the hospital. In a facility, staff from other units may be called to help deal with the crisis. 

3. Facilities offer more stimulation for service recipients who thrive on activity and “noise” 

4. Facilities have the infrastructure to use mechanical restraints, personal control techniques, and hands-on behavior management techniques. Group homes are very hesitant to use these strategies and only use them after 911 has been called. Facilities avoid calling 911. 

5. Facilities reduce the waitlist for residential services since there are more beds in facilities than in group homes. 

6. Facility-based programs allow families to have choices for residential care. 

7. A facility offers more structure than a group home, and some people need structure only for the support found in a facility-based program. Daily schedules and activities are a hallmark of programming in a facility, and group homes are less structured. 

8. Some people need more skills training than is available in a group home. A facility offers more opportunities for skills training in a controlled environment. 

9. Group homes do not work for everyone!!! 

We need more campus programs and dormitory-style large buildings with locked units to serve the most difficult service recipients with dual diagnoses. 

Note that I don’t use the term “institution” to describe these programs, as that term is very reminiscent of the 1980s, when there were "real" institutions. 

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