Providing a place where behavioral health patients feel at home is the strength of Winston-Salem’s Greentree Peer Center.
By Thomas Goldsmith
Kerry Johnson always had trouble understanding how the kids in his elementary and middle years seemed so together, so ready “to take on the whole school.”
Talking this week at Winston-Salem’s Greentree Peer Center, Johnson, 21, said he was only able to handle his sense of dislocation, along with bullying by other students, for one day into high school. Living at home with his mom in Winston-Salem, he comes to Greentree three times a week to find a place of acceptance among other clients with behavioral health diagnoses.
“I came here one day and I liked it and I came back,” Johnson said. “I have a fear of being around a lot of people. I don’t know how to maneuver.”
Greentree, located in a storefront church not far from downtown, is a project of Laurie Coker, a nurse, advocate and familiar voice in North Carolina’s discussions about care for people with mental illness. It would be an overstatement to say that Greentree runs on a shoestring: It operates rent-free thanks to the Greentree Community Church and employs certified peer specialists including Coker herself as volunteers.
The federal Substance Abuse and Mental Health Services Administration, known as SAMHSA, defines a peer provider such as Coker as someone who uses his or her own experience of recovering from mental illness or addiction, as well as formal training, to work with people in behavioral health settings with a goal of promoting recovery in mind and body.
In a mental health environment awash in money for residential care, Greentree exists to help people such as Johnson, who calls it one of the positives in his life, without resorting to inpatient care.
“Before this, there was really not any place I could feel accepted,” he said.
Easy atmosphere
Greentree has a front room with a counter and diner-like tables where visitors can enjoy drinks and snacks. A larger back room is the place for group discussions, films and training sessions.
People, some with children, come and go — greeting, ragging and teasing each other in what’s clearly a familiar environment. One client who chose not be identified entertained the room by reeling off exact statistics for long-dead Major League Baseball stars.
Another talked of his days encountering well-known writers at the Winston-Salem publishing company where he worked. And yet another gets a ride from Mount Airy with his stepfather two days a week, just to be at Greentree.
“I’ve been coming here for about four years; this place will help you if you let it help you,” said James, a former West Virginia coal miner who didn’t want to give his last name.
“I’ve seen people that come in here that have problems and I mean problems. After a while, after they get to talk in the group meetings, it helps them a lot.”
Greentree hasn’t rid James of every problem that bothers him, he said: “Sometimes I get to feeling suicidal and I don’t want to be around you. You get depressed and hear voices in your head and you try to ignore them.”
Successful model
Peer centers are gaining acceptance in a number of states, with Georgia viewed as a leader in the movement.
The authors of a 2010 study in the journal Issues in Mental Health Nursing found that “…peer support is a thoughtful process that involves observing, reflecting, taking action, and evaluating outcomes. Supportive actions include helping with activities of daily living such as bathing, dressing and shopping, sharing material goods, providing information and advice, sharing a social life, and offering emotional support. This leads to various positive outcomes for providers and recipients of peer support, such as improved mental health outcomes and quality of life.”
On a recent Monday, Coker was at the center with Terry Cox, another certified peer specialist. In addition to taking those roles, both find themselves helping clients in a myriad of ways.
“There was young man who needed glasses,” Cox said. “We were able to get him covered with Care Med. “It can be so overwhelming, they would rather not be able to see than to deal with the system.”
Clients such as Terry Johnson and others would likely stay home all day, watching television, if not for the three days a week (M-W-F) that Greentree is open from 1-6 p.m. Now, Johnson is going to be working on his GED.
“Once he had a starting place, he was able to structure his activities,” Coker said.
[pullquote_left]The University of North Carolina at Chapel Hill has a certification program for peer specialists, developed with the Department of Health and Human Services. More than 2,000 people have been certified as peer specialists in North Carolina.[/pullquote_left]For James, it was providing the help he needed to get a fishing license, even without a government ID.Clients with strong personalities can get “edgy” and quarrelsome with each other, but almost always respond to being diverted to another activity, the peer specialists said. Staff have had to call police a couple of times, with good results.
For Beverly Hamel, 25, time at Greentree has helped her to move toward her goal of becoming a veterinary technician through training at Forsyth Tech. Chicago native Hamel has had a tough time — neglect and undernourishment as a child and more than two dozen misdemeanor arrests.
But now she lives with her grandparents, whom she calls “mom and dad,” in Winston-Salem.
“I try to have happy thoughts,” she said.
Coker has sought funding from various sources, only netting a couple of $500 grants from a community organization. But she’s leery of getting too far into the behavioral health infrastructure.
“This is where healing seems to be happening,” she said. “MCOs would take this place and put two clinicians in charge.”
[box style=”3″]As part of an integrated care team, peer providers bring assets including:
• Personal experience with recovery, in body and mind.
• Knowledge of stigma that comes from within, including means of fighting it.
• Compassion and commitment to others.
• Means to counter responses from clients who say others lack awareness of the nature of behavioral health problems.
• Experience of a transition to hope from hopelessness.
• A better basis on which to build a relationship of trust.
Source: SAMHSA-HRSA Center for Integrated Health Solutions
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To clarify, the two times when police have been called were times that we should have been able to call mobile crisis teams. However, our MCO would not allow them to come. So we had to resort to the police. Crisis circumstances are very rare at GreenTree in our four years of experience.
I’m a PRSS in Va, where there are no jobs available. Peer Specialists need to eat too.