Summary

The mentally disabled occupy about 9 percent of the public housing units for the elderly that GAO studied, and the number of such individuals housed among the elderly appears to be on the rise. Public housing authorities report that people in almost one-third of those households cause serious problems like threatening other tenants and having disruptive visitors. Although about 78 percent of public housing authorities say that mental health services are provided in their communities, the extent to which public housing residents avail themselves of such services is unclear. Agreements between public housing authorities and local mental health services, however, have helped to deliver needed mental health care to public housing residents with disabilities. The rights of the mentally disabled to live in federally subsidized housing primarily serving the elderly vary by federal program. Excluding the nonelderly mentally ill from public housing for the elderly or from section 8 rental housing would violate the antidiscrimination requirements of the Fair Housing Act and the Rehabilitation Act of 1973.

GAO found that: (1) nonelderly, mentally disabled persons (NMDP) are a small percentage of the population occupying subsidized housing for the elderly, although the percentage is significantly greater in larger public housing agency (PHA) projects; (2) NMDP cause a disproportionate share of problems, and those problems take longer to resolve because PHA staff do not have mental health training; (3) the incidence of problems is increasing and varies by PHA size; (4) the numbers of NMDP in subsidized housing for the elderly may be increasing, due in part to lack of affordable housing and recent antidiscrimination regulations; (5) PHA determine applicants' eligibility and suitability for public housing subject to HUD regulations, particularly antidiscrimination rules; and (6) revised HUD guidance gives PHA more freedom in the screening process, but PHA are still unsure whether their actions violate antidiscrimination laws. GAO also found that: (1) states are required to provide case management services to mentally ill individuals who also receive substantial amounts of public funds or services; (2) information on mental health and other community-based support services or the sufficiency of funding is not available; (3) community support services and case management can prevent or lessen NMDP behavioral problems; (4) cooperative agreements between PHA and local mental health service providers help in case management by coordinating delivery of housing and support services; and (5) NMDP eligibility for subsidized housing for the elderly varies, but the issue is not specifically addressed in any program authorizing legislation.