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My son is a resident of the Sonoma Developmental Center. The center is closing as the residents are “integrated” into community homes. While a number of the center’s residents will be able to blend into community settings, in part because many are so medically compromised they are unable to be a real focus of neighborhoods, my son isn’t like that. He is active and strong. He is also mentally ill, and at times his mental illness can take over.

Private community providers are able to eject those who cause problems or are difficult to manage from community home settings. In the past, the developmental centers have taken in those who were not successful in community homes.

When my son’s mental illness escalated, and he was ejected from private community settings, the centers were a safe haven for him and others like him. Unfortunately, the state has blown a hole in the safety net for folks like my son.

Currently, in addition to the risks of losing the safety net of the Sonoma Developmental Center to fall back on, Santa Rosa neighborhoods have been organizing to protest the placement of community homes for center residents in their neighborhoods. Their discomfort further increases the chances of developmental center residents’ failure in community settings. For those not able to make it in private community settings, the alternatives are few and increasingly restrictive. Jail, acute psychiatric settings, which are not geared for the developmentally disabled, and emergency rooms will be the fall back.

All of the many issues facing those with serious mental illness are very real. Imagine what it is like for those who also face a serious developmental disability and are unable to understand what is happening to them or why it is happening.

In a recent meeting with local mental health officials, a number of issues were identified that affect the care of dual-diagnosis clients in acute psychiatric settings including. These include the lack of acute psychiatric beds, especially for Medi-Cal clients, poor communication among care providers and medical care providers and inpatient settings and the lack of knowledge by many inpatient psychiatric staff of clients who have both a mental illness and are autistic or developmentally disabled. Special training for inpatient staff in working with dual-diagnosis clients is needed.

There are major issues for individuals with mental illness, and there are added complications with dual-diagnosis individuals. For example, they can take longer to stabilize, and once stable, depending on whether their former provider is willing to take them back, they may no longer have anywhere to return to, and they are challenging to medicate because many react to antipsychotic medications with serious side-effect reactions related to their co-morbid conditions.

My own son has ended up in intensive care with seizures on more than one occasion from side effects of the medications he was given to try to control his mental illness.

The bottom line is that while integration of the developmental center population may work out well for many people, there is a small population of dual-diagnosis individuals for whom closure presents real risks. Look for dual-diagnosis individuals to join the general mentally ill population in a system that simply isn’t equipped to deal with them.

Kathleen Miller, a resident of Santa Rosa, is a retired social worker whose 50-year-old son has been at the Sonoma Developmental Center for 17 years. She is president of the Parent Hospital Association.