Respite Houses: The Future of Mental Health

This is a guest blog written by Alishia D, a peer staff member at Second Story Respite House in Santa Cruz, CA.

In early 2016, during my undergraduate studies in psychology, my usual paranoia got the best of me. I felt co-workers and fellow students were framing me and controlling my body and thoughts. At night, I could hear, feel, and see demons leaking from their world into this world with the intention of following me, convincing me I was dead, or at the very least disillusioned to the reality around me.

I remember clearly when I learned about Second Story Respite, a 6-bed program staffed with individuals who have lived through some form of “psychiatric distress,” meaning panic attacks, general anxiety, depression, voices, paranoia, mania, and anything beyond. Armed with my knowledge as a psychology student and the idea I was meant to “help” people, I arrived for my interview at a two-story house in a pretty nice neighborhood. Did I have the right address? I wasn’t sure. Even after watching the YouTube videos about them, I had the term “facility” locked in my head and expected that environment.
We’re not a facility. We are not locked: guests can come and go as they please; all we ask is for a courtesy call if someone plans on staying out late. We are voluntary and self-referred: this means you must want to stay with us, and call for an interview yourself. With us, the stay is generally two weeks, with exceptions at times based on age and your involvement with the activities and general vibe in the house. We are currently working beneath a non-profit program and with our County Mental Health system. We get training ranging from Motivational Interviewing to Trauma Informed Care to Mindfulness. We have groups led by staff members ranging from music and art to “Seeking Safety” and “Hearing Voices.” Attendance isn’t mandatory, but it is encouraged.

My first (and still on-going) training started before I was officially hired: a week of Intentional Peer Support (IPS). This type of support was founded by Shery Mead to create a partnership and a connection between the peer worker and the peer needing support. In the traditional world of psychology, there is the therapist and the client, the psychiatrist and the patient, and there’s an unspoken hierarchy there: the psychiatrist is “educated,” the patient is “ill” and essentially helpless in their behavior. We respect the psychiatrist for the rigorous courses they took, for all that medical knowledge stuffed in their little brain, so often we feel compelled to trust them over ourselves because they know best.

In IPS, this hierarchy is broken down as much as possible. As peer workers, we don’t claim to know any better than the person we’re connecting with. We don’t claim to know them or their struggles better than they do. We may still have opinions, and I’m certainly not one to say I’ve never had the urge to say “well, if you just do this . . .”, but we separate ourselves from our worldview to get a deeper understanding of their worldview first. The trust between the peer worker and the peer struggling isn’t built on a hierarchy of knowledge, it’s built on a willingness to be honest and open, even in uncomfortable moments.

For these reasons, we consider those who stay with us “guests.” They’re part of the community of the house. They have the option to participate in making dinner and everyone is encouraged to eat together. We have a full pantry and two refrigerators.  We have a backyard and a washer and dryer, all open to anyone’s use at any time. We have DVDs, a few television channels, a cat who everyone adores. We sometimes take trips in our van to the beach, for a hike, whatever. We’re running 24/7 with overnight staff (my main position at the moment) and an open “WarmLine.”

We don’t have “assessments,” just a few interview questions about what someone wishes to work on while they’re with us. We don’t keep track record of diagnoses: we focus on the experiences rather than the labels. I never know what someone’s been diagnosed unless they decide to tell me, or they mention it in casual conversation, and rightly so, as diagnosis isn’t a necessity. Now, you could sit down with someone and listen to their beliefs and views and go ahead and puzzle it all together, but then you’ve missed an entire story, an entire life, because your focus went to what you think they should be called. That focus, in this kind of work, turns into too common of questions: “What medication are you on?”; “Is it working?”; “It isn’t?”; “You should switch to something else, talk to your doctor, it’ll help.”

There’s more to the process of recovering than the straight and narrow path we’re taught as psychology students. There’s more to the process of recovery than those of us who have been struggling to recover have been taught from traditional medicine, from hospitalizations, from traditional therapists.

The foundation of the spirit of Second Story, as I’ve seen it, lies within the uniqueness of each staff member and each guest. The compassion is genuine in part because we’ve been there, as cliché as it sounds. We don’t care because it’s our job to care. It’s no one’s job to care. People don’t care about work they do all the time, and most of those people don’t get paid enough to even fake-care. We care—at least, I care because we’re all part of the same community and a community is only as strong as the member thriving the least. It’s not about me, or any single guest or staff, it’s about us as a whole. To find out why the others care, you’ll have to ask them.

I’ve let go of my obsession of “helping” others. People are capable of helping themselves. I’m here as a support force, as tangible proof things get better. The mental health system will make a place for the peer movement, and my future will inevitably be involved in that movement. After I finish my studies, I will use my degree to help peers and peer programs dominate the upper levels of the mental health system: hospital treatment programs, psychiatry, and psychotherapy. The industry, I think, could learn a few lessons from the people they treat.

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