The need for asylum for the chronically mentally ill

Our society highly values autonomy, independence, and freedom. In our model programs for the chronically mentally ill (CMI), we aim for these values and, in the process, may be doing a disservice to those people who cannot attain them. This article proposes that even the best in community care is not enough protection for many CMI. We need to do a better job of discriminating between who can and who cannot benefit from model community programs. We also need to develop a whole continuum of care that accepts the dependency of CMI people, and their various levels of functioning, as well as the progress, deterioration, and inevitable fluctuations that occur. Emphasis is placed on the need for sanctuary and asylum for many that only permanent housing of some kind can provide.