More than just a place to drop in: a community mental health center creates a dynamic environment for people with mental illness to learn life skills and have fun.

Reduced funding and restrictions imposed by managed care are forcing nonprofit community mental health agencies to reassess their programs, and in some situations this reevaluation is an opportunity for improving treatment. At Suncoast Center for Community Mental Health, Inc., in St. Petersburg, Florida, the new Wellness and Recovery Center changes an old model of day care and support to a dynamic system involving clients in their own recovery and finding ways to help them function at their highest level. Suncoast Center is turning "as good as it gets" into "as good as it can be."

Until recently Suncoast Center operated an adult Drop-In Center, providing a place where adults diagnosed with mental illnesses could spend time, eat lunch, and perhaps play pool. Yet Renee Kilroy, the agency's clinical services director, notes that over the years the Drop-In Center had become a hangout where there was "not a real incentive to get involved. Too many people were just smoking and watching TV. That's not a healthy environment." So the program was moved to a new, refurbished location and the entire focus changed. Instead of having lunch on-site, for example, clients are taught how to go into the community and buy lunch in a "normal" setting.

Clients at the Wellness and Recovery Center now participate in a wide range of activities, and some have been hired as peer counselors to run groups assisting others. The Wellness and Recovery Center is open to anyone over 18 years old recovering from a mental illness. It is a client-driven, client-supported program actively promoting recovery and resiliency by helping participants learn how to manage their daily lives, deal with their illness, and be involved in the community and even "give back" to it.

Libby Hopkins, coordinator of the Wellness and Recovery Center, says that the program's most important element is the combination of a strong treatment focus with the attitude that keeps it going: being positive about recovery. As part of eliminating the stigma of mental illness, group sessions may be run by a staff member or one of the six peer coaches--everyone is together in the recovery effort. She says recognizing that recovery is a process is essential in order to "provide an environment that is positive and stimulating so that the healing process commences" when an individual arrives. "Even for the people who are most debilitated," Hopkins explains, "that positive environment is critical to their healing."

In addition to Hopkins and the peer coaches, the Wellness and Recovery Center's staff includes counselor Mike Leggat; one full-time and one half-time employment specialists to help participants find full-time, part-time, or volunteer employment, according to their abilities; a supportive housing specialist assisting clients in finding or keeping places to live; and full-time and half-time community integration specialists.

The schedule for group sessions fluctuates as needed, and most groups meet in the morning (the clients' preference). There are 50 active participants, with daily attendance at about 20. The Wellness and Recovery Center is open Monday through Friday from 8 a.m. until 3 p.m., and on Saturdays from 10 a.m. until 2 p.m. Hopkins says the schedule can change to include Sundays during football season if people want to watch games together in a healthy environment.

The groups cover a wide spectrum of individual interests and needs, such as:

* Anger management

* Arts and crafts

* Basic aerobics

* Individual life planning

* Life coaching

* Life skills

* Meditation and relaxation

* Men's issues

* Music

* Overcoming adversity

* Self-esteem

* Socialization

* Stress management

* Wellness and weight loss (which includes group walks)

* Women's issues

* Values clarification

Groups closely addressing clients' illnesses include sessions on schizophrenia, mental illness education, recovery considerations, and depression. GED classes with a teacher from the local public school system include learning basic computer skills, and clients regularly have holiday parties that they plan themselves. Clients work to help each other through a "warm line," a phone number they can call for peer-to-peer support. Since individual clients' levels of illness and abilities to function vary widely, staff must adjust every group and activity to include everyone attending a particular session as much as is possible.

Every Friday morning begins with a general forum on preparation for the weekend, and every other Wednesday there is a special community awareness outreach effort, which often is a beach cleanup event near the offices of Tampa Bay Watch, a nonprofit that works to clean and preserve the Bay whose offices are adjacent to a county-owned beach park (see sidebar). In addition, a bimonthly newsletter written by program participants for program participants began in June.

All of these activities combine into an overall treatment goal of helping clients learn to cope with their illnesses and to live as independently as they can by adopting basic skills, such as using a schedule to buy bus passes each month or setting up a system for appointments. At the same time, clients are learning how to rely on available support systems and how to build their own networks of people to assist them, including their peers at the Wellness and Recovery Center.

The Wellness and Recovery Center also employs WRAP, Wellness Recovery Action Plan. In WRAP sessions, clients help design their own treatment plans over a span of six to eight group sessions. Hopkins hopes to involve more clients in WRAP. She hopes that clients will take WRAP into the community and form their own support groups, functioning much the same way that AA or NA groups do. If that happens, each client's independence will have the potential to change the lives of others in a ripple effect through the community.

Melissa Metcalfe is Development and Community Relations Manager for Suncoast Center for Community Mental Health in St. Petersburg, Florida. For more information about the Wellness and Recovery Center, contact Libby Hopkins, LCSW, at lhopkins@sccmh.org or (727) 327-7656, ext. 3243. Suncoast Center is a member of the Mental Health Corporations of America.

RELATED ARTICLE: Outreach

On a community outing to help clean up a beach, counselor Mike Leggat drives the van and chats with clients near him to find out how they are doing. Anthony is delighted to tell Mike that he has been helping "the nice lady" at the assisted living facility where he lives by making beds and handling some cleaning chores. Mike probes a little: "Is she paying you?"

Anthony hesitates, wondering if that would be wrong, but says, "Yeah. Is that okay?"

"Yes, yes--it's fine," Mike assures him. "I just want to make sure no one is taking advantage of you." When there is no answer, he asks gently, "Is she taking advantage of you? You know what that means, don't you?"

Anthony laughs and says, "Oh, no. She's not. I'm getting paid. I know to watch out for that!"

After the van arrives at the Tampa Bay Watch building, everyone puts on latex gloves, and they divide tasks. Vincent volunteers to carry one of the two trash bags because his back hurts and he cannot bend over. Another member of the group is concerned that he may have a seizure coming on, so he stays behind with another staff member. Then everyone heads down a familiar path to look for trash and clean the area.

Mike repeats the instructions, and members of the group repeat them to each other: Do not pick up any glass. Look for fishing line; it is very important to pick it up to protect birds from getting caught in it. Stay away from uneven areas where you could slip. Stay back from the road and, even then, watch the traffic.

[ILLUSTRATION OMITTED]

Crossing the bridge from Tampa Bay Watch's land to Fort DeSoto Park, Mark looks over and says, "There are our friends. They're having lunch!" Mike looks at the water and sees a fishing boat moored. "Those fishermen? I guess they are our friends."

"No," Mark corrects him, "them!" pointing at several pelicans floating near the boat, begging for handouts--or an opportunity to snatch a fish. Mark has made a connection with Mike's explanation about the need to pick up any fishing line left on the bridge.

"That's right," Mike tells him, "we are the birds' friends, and it sure does look like they are having lunch."

--Melissa Metcalfe