Are you a health care worker? We’d love to hear from you. Email editor at northcarolinahealthnews.org
By Rose Hoban
While a classical guitarist played Mozart, a half dozen people milled about, eating cookies and salads at a community center south of downtown Winston-Salem on a recent Friday.
It doesn’t sound much like what most people would think of as the scene at a mental health center, but that’s what it was: an open house to celebrate the opening of a new drop-in center for people recovering from serious mental illness.
“There’s got to be come connecting place, a social nexus offering resources and peer support,” said center founder Laurie Coker, a former nurse who’s been dealing with bipolar disorder for decades, who inaugurated the center this month.
Coker plans to run programs at the drop-in center to help participants take care of their physical health needs, have sessions on managing personal finances, hold exercise classes and provide a place for some fun. She wanted to create a place where peers could gather in a non-judgmental atmosphere.
“It’s a place to start and end the week with friends,” she said.
For many unaffected by mental illness, the picture of someone with a “serious mental illness” is of an unkempt person who walks down the street talking to him or herself or someone who is belligerent, who acts strange, abuses drugs or alcohol, and is chronically dependent on public services.
But that’s not the norm for the vast majority of people with mental health issues, who mostly live average lives, Coker said. She said people with mental health disabilities are more aggressively combating the stereotypes of people with intractable mental health disabilities. And, like her, they’re building resources to help others with mental illnesses recover and enter fully back into mainstream life, like the new center.
But few models exist in North Carolina, and currently there’s no way to pay for it.
Got to be starting something
Coker said the idea had been forming in her head, and in discussions with others, but when she finally moved on it, the center came together fast. It was only a few months ago that she was driving around Winston-Salem looking for a cheap, or preferably free, space that would allow for folks in recovery to meet once or twice a week.
That’s when Coker passed GreenTree Community Church, a small Baptist congregation located on South Broad Street south of Business 40 and thought it looked like a winner.
The pastor there, Tim Gross, jumped on the idea immediately.
“it seemed like a good thing,” Rev. Gross said. “It agreed some of my thoughts about mainstreaming people with mental illness and just loving them instead of marginalizing them.”
Gross said Coker and her group could use the space free twice a week, and the center was born.
“People in recovery want some place that feels like their own,” Coker said. She also said it’s important the center not be funded by any money from the state’s Division of Mental Health, Developmental Disabilities and Substance Abuse Services. “This is part of people’s social health needs… and when it feels like it’s part of the system, people put it mentally into a different basket.
“People don’t feel like they’re full citizens because they don’t have autonomy and decision-making ability when the system is involved,” she said. “We didn’t want it to be another place where people are ‘making decisions about me without me.’”
Building recovery one person at a time
According to Coker, and others, a paradigm shift has been quietly building in the mental health community, moving the focus of treatment away from cookie cutter ways to fix symptoms of people with mental illnesses, to finding individualized ways for people with mental health problems to succeed on their own terms.
“We don’t talk about illness and symptoms,” said Larry Fricks, who is a leader in the recovery community. Fricks opened one of the country’s the first peer support facilities in Georgia more than 20 years ago, after being hospitalized with bipolar disorder. “When i was hospitalized in the 80s, all you was focused on was the symptoms, but there are other things that will disable you, the stigma, the damage to your self image.”
“We talk about strengths and supports. We focus on what’s strong, not what’s wrong,” Fricks said.
“There’s no single definition of recovery,” said Mary Seymour who works at the Mental Health Association in Greensboro. Seymour was diagnosed with bipolar disease in 1995 and struggled for years, including spending time in a psychiatric institution, as she described in an essay she published in 2002.
Seymour admits the term “recovery” is squishy, and that there’s no one definition. And that’s part of the problem, because there’s no one path, no one pill for people to take, no one way to get from being ill to being “recovered.”
“It’s not following a one-size-fits-all traditional medical model,” Seymour said. “In the old model it was easier to quantify. There were people who were successes and others failed and it was like, ‘oh well.’”
“It’s very individualized,” she said. “Everyone will have their own recovery path.”
That very individualization has also made recovery hard to study and to find quantifiable evidence to back up the approach.
But that’s changing, according to Fricks, especially when it comes to peer support, the practice of people with mental health problems providing guidance to others with similar issues.
“There’s research that people have more resiliency if they have certain things, one is having a social network. That’s part of why peer support works,” Fricks said. “Alcoholics Anonymous is a great example.”
Now Fricks works at a national level, helping states develop peer support trainings and programs. Even still, only about half of states’ Medicaid programs cover peer support.
North Carolina’s new Medicaid mental health program arrangement would allow local mental health agencies to pay for peer support. But widespread acceptance of the model is slow.
“They say there’s a 15-year lag time between the time a service is shown to be effective and when it’s operationalized on a large scale,” Coker said.
Embraced in the community
A connection with peers is what drew David Cray, 39, who volunteered to play his classical guitar for the open house. He related his struggle with schizoaffective disorder, and how it derailed a promising career that took him from the NC School for the Arts to the Berklee School of Music in Boston.
“The way of treating people with mental illness used to be very generalized, but everyone is unique,” said Cray, who wants to become a music therapist. His recovery began when he went back to music, and he is trying to rebuild a life around it. He said he also takes medications. “Everyone has a different definition of recovery, it’s learning to start over and not focus on the past.”
“When Laurie told me about (the center), I had to come over and see what’s going on,” he said. “I know this peer support idea is a new thing for the mental health system, people who have had illness helping others. But I think this will be something that will really help.”
Louis Armour, 41, also came out to the open house and made his way around the room, talking to everyone. He described the center as a place to “receive entertainment and consolation.”
“Just having a cup of coffee with someone else who gets it can help you find a way,” said Armour, who has both schizoaffective and bipolar disorders and has spent time in and out of state hospitals.
“If you have specific issues, it can help to get one-on-one with someone,” Armour said. “Places like this help you feel like a person, part of a community.”
Correction: The article originally identified Mary Seymour’s organization as Mental Health America – Greensboro. It is the Mental Health Association in Greensboro.