January 27, 2023

I have mental health diagnoses and chronically sore feet. Despite these difficulties, I have my own apartment and a stable part-time job. In my experience, this is not the reality for everyone with these issues. This sad reality is little known. Therefore, without further ado, I will try to shed some light on this subject. Clarity can be helpful. Ideally, you will find my point of view useful and instructive.

As you, the reader, may or may not know, Minnesota offers many different mental health programs. I only have personal experience with residential use, so I’ll focus on that. The housing program that I lived in for four years included mental health services, counselors, food staff, nursing staff, and recreational staff. In my experience, program staff struggled to communicate clearly with residents and resolve issues on their own. The program traditionally had 40 residents, and residents traditionally paid for everything using a county-funded waiver. Our building was broken into several times, and the only thing that my fellow citizens and I expected was to participate in a welfare check every 24 hours. Other government services that I used had similar problems.


The government-funded waiver that I have access to has historically funded my access to housing as well as giving me access to other services. For a long time I used it to access Independent Living Skills Services (ILS). In my experience, the ILS staff I was assigned to were also unable to communicate clearly and solve problems on their own. Another major problem was that the service had problems with staff turnover. A problem that unfortunately plagued the housing program I lived in. Thanks to my refusal, I was also able to access transportation services.

In my experience, some transportation services designed for people with disabilities have proven to be more reliable than others. All of them faced staff turnover problems. In addition, drivers of some services have chosen not to wear seat belts. With that said, in my experience, transportation services don’t have as many problems as housing services or ILS services. Interestingly, all three types of services have one thing in common. They need more control.

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I tried to advocate for increased oversight of mental health programs. Advocacy groups with the potential to influence political change believe Minnesota’s current mental health system works. Its sole purpose is to get more funds to develop what already exists. Unfortunately, this means that clients must protect themselves. I speak with sadness because, in my personal experience, many of my fellow clients are unable to do so due to mental health issues. I have personally witnessed how ISPs have repeatedly exploited this problem. There is a name for this. This is called a customer-centric approach.


In a customer-centric philosophy, the customer is empowered to direct their services. On paper, this might seem like a good idea. If clients’ mental health problems pose a significant barrier, they should seek advice from their providers. In my experience, this loophole has allowed the housing program and ILS program staff to keep their jobs despite serious problems. In other words, they were legally allowed to run their programs as an experiment funded by taxes and donations, with no checks and balances. Based on some quick research, these experiments remain active.

I mentioned checks and balances in the previous paragraph. Different people have different attitudes towards regulatory oversight. This variation is the solution. Throughout this story, I have shared my experience as a client of various services. Providers have a different point of view, and so do local residents. In my experience, the problem is that customers need a voice.

If the board of directors of programs funding services does not represent clients, it depends on whether the people running the program are listening. As I mentioned, program staff have a lot of power because of a client-driven loophole. People working in these programs can tell board members, taxpayers, or donors that something isn’t working. However, those in power have no incentive to give up all their power. The good news is that the state has traffic laws in place that make utility vehicles safer. It is my understanding that this is not available in mental health programs and/or other waiver-funded services. Unfortunately, this will continue until regulatory oversight is put in place and enforced to ensure transparency and protect vulnerable adults using these services.


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