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In Canada and Scotland, the transitional discharge model (Forchuk, Reynolds, Sharkey, Martin, & Jensen, 2007) has proved successful. Patients who were discharged to the community after long hospitalizations received intensive services to facilitate their transition to successful commu-nity living and functioning. Two essential components of this model are peer support and bridging staff. Peer sup-port is provided by a consumer now living successfully in the community. Bridging staff refers to an overlap between hospital and community care—hospital staff do not termi-nate their therapeutic relationship with the client until a therapeutic relationship has been established with the community care provider. This model requires collabora-tion, administrative support, and adequate funding to effectively promote the patient’s health and well-being and prevent relapse and rehospitalization.
Poverty among people with mental illness is a signifi-cant barrier to maintaining housing. Residents often rely on government entitlements, such as Social Security Insur-ance or Social Security Disability Insurance, for their income, which averages $400 to $450 per month. Although many clients express the desire to work, many cannot do so consistently. Even with vocational services, the jobs available tend to be unskilled and part-time, resulting in income that is inadequate to maintain independent living. In addition, the Social Security Insurance system is often a disincentive to making the transition to paid employment: the client would have to trade a reliable source of income and much-needed health insurance for a poorly paying, relatively insecure job that is unlikely to include fringe benefits. Both psychiatric rehabilitation programs and society must address poverty among people with mental illness to remove this barrier to independent living and self-sufficiency (Perese, 2007).
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