21. Thoughts on Natural Supports

The greatest barrier to employment and an enriched life for those who have a family member who are developmentally and/or psychologically disable is no natural supports. What are natural supports? First of all, we must remember there are two models for services, the Recovery Models and the Clinical (professional) Models. Natural supports have a long and established history in the Recovery Models. Typically, natural supports are relationships and connections that occur in everyday life. They typically involve the extended family members, faith communities, friends, work, and other acquaintances. Natural supports are a network that provides services to those who have disabilities and impairments. In many natural support networks, the primary role of professionals is to provide medical and counseling services, they generally do not provide support services and programs. These are provided by an extended natural support network.
Natural support systems are basically a return to the family structures before our modern era and faith communities existed as collectives that provided a variety of support services.

The idea of natural supports being the primary means of support has been on the table for a long time now, but has received lots of resistance and for a variety of reasons. Faith communities are resisting because of the behavioral health issues often associated with disabilities, they want to become places that are safe and removed from challenging behavior. The anti-domestic violence community has deep reservations about the disabled in family homes and neighborhoods, because they are opposed to aggressive behavioral symptoms. Families are resisting the idea of becoming care givers again, many have delegated care giving to professionals and programs. Social organizations like the YMCA and Boys and Girls Club are resisting because of liability concerns.

Because of the below market reimbursement Medicaid has only a small market and state resources for the disabled and impaired is limited, therefore the dependency on natural supports by government agencies and their case workers will continue.
While states want natural support networks to provide a meaningful life for the disabled, the private sector is largely unaware of this. While state and private social and health programs know about the desire by the states for natural supports, many other parts of American society have not received the message and there are many reasons why the word is not getting out into a larger audience. Because of the ongoing reduction in government funding, the states are going to use recovery based resources, but many in society prefer to use professional services.

Developing and maintaining a natural support network for those who live on the higher functioning levels of their condition and can keep their condition stable is not a problem. However, those who are moderate and low functioning face a variety of challenges.
One of the most familiar challenges comes when the mental health of an individual becomes seriously unstable he/she goes into residential care for 10 to 14 days and stabilized. Once they are stabilized they are released back into the community, without a natural support network the road towards destabilization starts all over again.
One might think that at some point the state would open the purse strings and provide for the development of more resources for moderate and low functioning individuals, but this is not going to happen. It can be very overwhelming challenge to develop natural supports for them.

Over the last few years I have walked the streets and have seen the growing number of high and low functioning individuals with developmental and psychological disabilities living under highway bridges and in abandoned buildings because they have no place to call home and no natural support network. So I think the time has come to make some serious decisions about how the disabled are cared for and supported.

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Written by Dave Pflueger May 2016 (c) copyrighted by Pflueger. Dave is a former Correctional Chaplain of the Pierce County Sheriff’s Department and certified for mental health peer counseling.

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