A Unique Social Crisis Stabilization Program Flourishes in Southwest Virginia

Following the Virginia Tech tragedy in 2007, the Virginia General Assembly began crafting legislation to mandate involuntary out-patient treatment. A regional workgroup decided to invite Recovery Innovations of Arizona to provide training to transform expected involuntary orders into “no force first” recovery-oriented welcoming services that still offered choices. This resulted in the design of a social crisis stabilization program at Highlands Community Services, focused on helping people in crisis reduce stressors and increase supports. Paying particular attention to “what’s strong, not what’s wrong” inspires hope as well as an immediate shift in the consumer’s perspective of their recovery opportunities for the future.

Eligible individuals are men and women with a serious mental illness. Those who enter the Home Recovery program are often surprised to encounter a warm environment with comfortable, homey furniture, walls painted a creamy butter, soft fragrances, and CD players providing music or the sounds of water breaking on the shore. An assessment helps guests to focus on their assets, abilities, and cultural attitudes toward health and wellness rather than their diagnosis. These factors help guests build relationships and identify hopes and dreams for new roles in the future. Living and family rooms are used for group activities such as guided imagery and relaxation techniques. There is also a relaxation room that doubles as a dressing room that is available for more peaceful moments when group activities become too intense. Comfort meals are served by a Recovery Hostess whose sole purpose is to cater to the nutritional needs of our guests. All meals are served family style which allows true fellowship and therapeutic social discussion among staff and guests.

In addition to focusing on our guests’ symptoms in crisis, we are also able to offer physical makeovers. We provide a private shower with a multifunction shower head that can simulate a rain shower with an endless supply of hot water. Many of our guests live in assisted living facilities in which privacy is not easily accommodated and hot water is in short supply. The ability to bathe privately and access everything needed for a makeover can dramatically improve the degree of hope our guests feel during our service while also boosting their self esteem.

Once all of the comforts of a true home are met, we work with each guest to help them prioritize goals for new roles in the future. This person-directed service is then coordinated with case managers and other referral agencies that can continue teaching supportive skills that reduce stressors. Guests can access the service for up to fifteen days at a time and from one to six hours daily. This allows each person to get the services they need to divert potential hospitalizations. While medication needs are not the first choice for diminishing our guests’ acute distress, we work side-by-side with doctors to ensure appropriate attention when necessary.

Ninety-seven men and women were served in Home Recovery in FY 2012, with only seven hospitalized within two weeks of discharge. Average length of service was nine days and the referral reasons included avoiding hospitalization, step down from in-patient services, and loss of housing. Satisfaction surveys revealed the following results:

• Help with stress - 89%
• Focus on personal strengths - 89%
• Inspired with hope - 92%
• Person centered/individual approach - 97%
• Increase in confidence - 94.5%
• Best of Home Recovery - groups, listening, food

The program was presented at the 2011 PRA Annual Conference in Boston, MA, resulting in several inquiries about employment at HCS and an invitation to start a similar program in Israel.