|‘Work, it’s what we do;’ Cirrus House helps mentally ill transition to independence|
|March 18, 2016 Frank Marquez|
Photo by Frank Marquez Shanelle Williams and Darryl Keller work on volunteer agendas for other club members. We're like a family, where we help each other, she said.
Think of a clubhouse and a kids’ tree fort may come to mind, with high enough rope ladders or wooden pegs to keep most parents at bay. After all, kid talk is kid talk, and the environment gives them a chance to let their hair down, and maybe air their grievances about authority.
The Cirrus House is a little like that. There’s no pressure.
Using the clubhouse concept, Cirrus gives people living with the effects of mental illness a chance to try things out based on their strengths, maybe like those tree fort kids who daydream about their futures. Cirrus got started based on a clubhouse system, which started in New York City as the Fountain House, taking its name from a fountain in its front courtyard.
“Our primary objective, when we were founded in 1984, was to provide a clubhouse to support people living with mental illness,” said Brent Anderson, Director of Cirrus House. Subsequent objectives “provide services to people with a proven propensity for mental illness, which would include homeless persons, veterans, and at-risk youth,” for example.
Anderson said research has shown the clubhouse model works. Founded in 1948, Fountain House, which has served more than 16,000 men and women, provides a basis for more than 400 similar programs (including Cirrus House) in 32 countries around the world that help 50,000 people.
In the Panhandle, statistics indicate there were 314 homeless from Jan 1, 2015, to Dec. 31, 2015, with the majority in Scotts Bluff County, though the exact number of mentally ill was unverified.
Back in the early days of psychology, mentally ill people were institutionalized, given little chance to get better. They were literally locked away.
Today, care has improved by leaps and bounds. Organizations like Cirrus House provide an innovative self-help program, which aims for members to regain their productivity and self-confidence, resume their lives, and re-enter society. The clubhouse environment also allows its members to learn self-advocacy, and fight the stigma that often separates them from their neighbors.
There are horror stories, Anderson said. “Some folks in NYC who had been institutionalized in the 1940s met and created friendships. When they got back out on the street, they formed a close-knit group. They said, ‘we don’t want to go back into that place. It’s a place we do not feel is helpful to us.’ ” The first clubhouse members began regularly meeting at the New York Public Library.
The clubhouse model is strengths focused. It addresses these questions: What are you able to do? What are you capable of doing? What are you good at? The idea is to develop peoples’ skills – looking at them as people first. Anderson said, in the past decade, social services research on strengths or assets focused programs have far superior outcomes than other programs.
Cirrus also applies a housing first model, which was considered a bold move when it was first tried. Dr. Sam Tsemberis founded Pathways to Housing in 1992, with the creation of the Housing First model to address homelessness among people with psychiatric disabilities and addiction disorders. According to Anderson, Tsemberis took drug addicted, mentally ill straight off the street and put them in an apartment, giving them the key, and telling them, ‘here’s your home.’ People said that’s insane.
However, Housing First has shown far superior outcomes than other prevalent housing models that demand the afflicted to prove themselves before receiving help. Research has shown that many of these people who were being cycled through the system were thriving after being given the tools to succeed.
At Cirrus House, getting a roof over someone’s head can go a few directions with either permanent housing or permanent supported housing. The latter allows them time to get their routines, responsibilities and medications in check. “We work with people to make those transitions,” Anderson said.
Another powerful factor in the support at Cirrus House is the community support worker who addresses practical matters such as housekeeping, pursuing benefits like getting food stamps, or going to the courthouse for copies of official records (social security cards, driver’s license, etc.), which can at times present barriers to housing or employment.
“Community support workers at Cirrus House help club members achieve their goals of being independent in the community,” said Denasha Ricketts, who has served as a community support person for a year and a half and is also a registered nurse.
“We go about that by working in conjunction with other community agencies, such as the Housing Authority, CAPWN, Panhandle Mental Health and Potter’s Wheel. These are just some of agencies we work though.”
Community support persons also act as an advocate. Having been in their position too, at one time or another, they can see things the member can’t, show them how to communicate in stressful situations, and provide ways to deal with difficult circumstances that might cause a barrier to their success.
“We let them know, ‘you don’t need to do this alone.’ We don’t do it for them,” Anderson said. “We do it with them.”
With regard to identifying strengths, the program looks at the whole person, and not necessarily the illness. For example, a teen girl might be contending with multiple issues. Aside from her psychiatric condition, she could be a gang member, pregnant and addicted to drugs, which poses the question: In the realm of social services, where does she go? The traditional medical model approach would assign a specific solution to each problem or deficit. Drug prevention class one day, pregnancy prevention group another day, gang prevention another day and so on.
“The strengths focused model flips that on its head,” Anderson said. “People have problems embracing this method because it’s more of a philosophical approach as opposed to a step-by-step design. In the girl’s case, “we might find she has an interest in gardening and art. I’ll mention that I have a friend who works at a green house, and maybe she’d like to visit there someday. If she likes it, then I’ll ask my friend if there are volunteer jobs there. It’s the same with artwork. We might look at activities at the arts center. That’s where I focus my efforts.”
Anderson added, “Once the person starts developing their strengths, all the ailments start to take a backseat. She’s engaged in positive things, rather than being focused on fixing a problem, her positive strengths start to outweigh the negatives in her life. She has less time and energy to give to the gang or the drugs.”
Cirrus House does not ignore struggles or deficits, they acknowledge that every human being has struggles –it’s just not their primary focus. Instead of “prescribing” solutions from a perspective of authority – asset focused models put emphasis on building mutually beneficial relationships where program participants know their active participation is needed, wanted and expected.
When someone comes to the clubhouse, they go through intake. The staff verifies their mental illness, and enrolls them in one of three programs which are funded by the State of Nebraska: Day Rehabilitation, Day Support, and Adult Daycare. According to Anderson, a person could potentially land in each one of these categories. They may not have scripted a plan, or goals for improvement, yet Cirrus House can bill the state under Adult Daycare. Someone who has socialization goals or wants to investigate getting a job, represents a step up, and they might qualify for Day Support. Day Rehab involves serious commitments – goals, outcomes, writing a plan with a staff member, which could involve developing job skills, getting into an employment program which gets members out to worksites, more health-conscious eating – all flow back into the ultimate goal of improving their mental health – or, more simply stated, feeling better.
“Everything is based on the real work of the agency, that absolutely has to be done in order for the organization to float,” Anderson said.
The Numbers and Navigation Unit at Cirrus House writes checks and processes all the Medicaid and grant billing. One is a paid staffer and the other five are clubhouse members. This type of rehabilitation program aims to get them re-engaged in the community, through employment, building skills, and working relationships. “Otherwise, the full-time staff has a tough time getting things done,” Anderson said. “They come and work here because they’re building sincere friendships – true buy-in to the program. They know it’s not busywork.”
Other members are involved in a driver program. “We provide about 11,000 rides per year,” Anderson said. “We pick people up in the morning, take people to and from appointments, and weekly grocery shopping. There’s nothing that the staff can do, that a member can’t.”
In the Better Living Unit, members oversee 80 housing units. Like for any other housing complex, the staff manages collecting rents and money from washers and dryers; taking in and processing housing applications; and providing renter education. At the Mega Bites Unit they run a restaurant, the staff serves lunch five days a week, 52 weeks a year, and is open on all holidays, including Thanksgiving and Christmas. Mega Bites also oversee basic computer and I.T. issues, a monthly newsletter and new member orientation.
“We’re like a family here,” Anderson said. “And sometimes we are the only place someone has to celebrate Christmas.”
The clubhouse employs a manager and four others –overall, Cirrus House, Inc. has about 30 full and part-time employees. Since its inception the Clubhouse has had 643 members. Currently there are 73 active members with an average daily attendance of 35 to 40 at the Clubhouse while 26 members are enrolled in the employment programs. Community Support currently serves 68 individuals and the Cirrus homeless prevention/intervention programs served 314 people last year. Cirrus also offers youth programs and counseling services; all together they positively impact hundreds of lives every year.
Once members are working, Cirrus House provides support to the employer, sometimes handling human resource matters. We’ll help them get their foot in the door,” Anderson said. “We have agreements with the Main Street Market and Walmart in Scottsbluff, and vouch for our members. Employers discover that our members are so eager to prove themselves that they often tell us that we sent some of the best workers they’ve ever hired, and ask, ‘Do you know anyone else who is looking for a job?’ ”
Anderson added, “Once you’re a member, you’re always a member.”
Some aspects of providing a total package of social services remain open-ended. Alcoholics and drug addicts cycle through jails, emergency rooms, and other support systems. Reports say the homeless are costing taxpayers from $55-65K a year. It’s cheaper to get them stabilized with housing and subsistence aid, and help them set work program goals. The other side is guessing what might happen – in other words, the cost of higher-level care.
Two programs at Cirrus House, include Youth Transition (people from 16-24), represent young adults who are close to making decisions for themselves, but may be teetering on the brink of being homeless. Then there are members in the TAP program and can live in an apartment for up to two years while learning a skill or trade.
Nebraska Behavioral Health Director Sherry Dawson says the state is working toward serving co-occurring disorders. In other words, someone who may be recovering from drug abuse or alcoholism could someday be helped at Cirrus House, but that hasn’t occurred, yet. Currently, a person has to be labeled as “primary, mental illness” to be served at Cirrus House.
Photo by Frank Marquez Club member Denise Manuel and Cirrus House Executive Director Brent Anderson relax outside of Cirrus House.