Latest / Brain Stories / Episode 20 - Brain Stories Connections: Peer Healing in Just 7 Days
Transcript
- 0:00SPEAKER_02: Welcome to Brainstories Connections, a show about how all of us can do mental health so much better.
- 0:05SPEAKER_02: Today we're going to do a second episode on peer-based programs.
- 0:09SPEAKER_02: Peer-based support offers a very different approach to mental health care.
- 0:13SPEAKER_02: Because at its foundation is a principle that has always struck me as pure common sense.
- 0:18SPEAKER_02: The staff of peer support are people with personal experience in living with serious mental health issues.
- 0:24SPEAKER_02: In the business world, it's standard practice to hire people with the most experience.
- 0:28SPEAKER_02: And we expect them to draw on that experience and share it with others.
- 0:32SPEAKER_02: Not in mental health.
- 0:34SPEAKER_02: Clinicians are traditionally trained not to share their experience, and having their own mental health issues is usually considered a liability, not an asset.
- 0:43SPEAKER_02: Today we're going to talk with Lindsay Mesa, who's part of an organization changing that.
- 0:48SPEAKER_02: She oversees a program in Vermont called the Rosewood Cottage Peer Respite.
- 0:53SPEAKER_02: We're going to talk about what that actually is and some astonishing early results they're already seeing.
- 0:59SPEAKER_02: But this conversation takes a turn to something even more surprising.
- 1:03SPEAKER_02: Seizing the bull by the horns with empathy to talk about one of the hardest subjects I know.
- 1:09SPEAKER_02: Here's that conversation.
- 1:10SPEAKER_02: Hi, Lindsay, and welcome to Brain Stories Connections.
- 1:13SPEAKER_02: I want to jump in to start talking about Rosewood Cottage.
- 1:17SPEAKER_02: It's offered by Pathways Vermont, the organization you work for, and it's a peer respite program.
- 1:23SPEAKER_02: What does that mean?
- 1:24SPEAKER_00: Peer respites are voluntary, home-like environments where people can spend a short amount of time outside of their regular environment when they're in self-identified distress, mental health distress.
- 1:38SPEAKER_00: And they're staffed by a team of trained professionals who are trained in the modality of care that's called peer support.
- 1:45SPEAKER_00: Voluntary means it is completely up to the person when they show up, how they show up, if they show up, and we're really invested in it being a resource that feels like the right thing for the person who's seeking care.
- 2:00SPEAKER_02: You talked about staff being uh trained in intentional peer support.
- 2:04SPEAKER_02: What is what is what is intentional peer support?
- 2:08SPEAKER_00: Intentional peer support is a professionalized way of showing up in mental health peer support.
- 2:13SPEAKER_00: It was developed by an amazing woman named Sherry Mead about 30 years ago now.
- 2:19SPEAKER_00: Um and it is uh a way of creating relationships where both people in the relationship show up uh to provide support uh to each other in a in a mutual way, right?
- 2:35SPEAKER_00: So both people both receive and give help.
- 2:38SPEAKER_02: And you also said short-term.
- 2:40SPEAKER_02: What does short-term mean?
- 2:41SPEAKER_00: For Rosewood Cottage, right now that means up to seven nights.
- 2:44SPEAKER_00: Uh, and typically a pure respite model of care would be seven to fourteen nights kind of maximum stay.
- 2:50SPEAKER_02: Aaron Powell This is what might be called relational care.
- 2:52SPEAKER_02: It's person to person.
- 2:54SPEAKER_02: It's um the goal is to not get somebody out as quickly as you can, it's to make a relationship.
- 2:58SPEAKER_02: Is that is that accurate?
- 3:00SPEAKER_00: That's the foundation of everything.
- 3:01SPEAKER_00: And it's um it's very different.
- 3:04SPEAKER_00: Oftentimes, folks who are uh experiencing mental health distress are met with support that is uh you know, they they seek out an expert, right?
- 3:13SPEAKER_00: They seek out somebody who can help them understand what's going on.
- 3:17SPEAKER_00: I've definitely been there myself, right?
- 3:19SPEAKER_00: Um, and the focus uh from that expert is all on the individual.
- 3:23SPEAKER_00: In this model, in a Rust bit model of care, uh the focus is on the relationship.
- 3:28SPEAKER_00: And what that allows us to do is it allows us to draw out the individual person, um, to see themselves, right, as the experts of their own experience and to kind of return to that sense of knowing or intuition about who we are, what we need, um, that can get stripped away, right, when life just gets complicated and hard.
- 3:51SPEAKER_02: Yeah.
- 3:52SPEAKER_02: I wonder if so I want to focus on the short-term part of it though.
- 3:54SPEAKER_02: So I think of relational work as taking a long time.
- 3:58SPEAKER_02: I love the idea of building a great relationship with seven days.
- 4:00SPEAKER_02: Can it actually what will you know, what difference can seven to 14 days really make?
- 4:04SPEAKER_00: A remarkable difference.
- 4:06SPEAKER_00: Right now, it's a two-bed respite, and it's the second respite in our small state, Vermont.
- 4:11SPEAKER_00: There's there's a benefit to it being as small as it is because it does allow for that intimacy and that building of quick relationships.
- 4:18SPEAKER_00: And, you know, again, I think that the folks that staff the program, my my wonderful colleagues are all folks who come to the work with their own lived experiences, with their, you know, their own experiences that may have or have in the past brought them to seek out pure respite care.
- 4:34SPEAKER_00: And that is does so much work as well to the building of those strong relationships.
- 4:41SPEAKER_00: When you've been in that hard place yourself, you can show up with the kind of empathy, right, that allows for really deep listening to another person's story.
- 4:52SPEAKER_01: How did Rosewood Cottage get started?
- 4:56SPEAKER_00: Rosewood Cottage is uh funded by a generous grant from Four Pines Fund.
- 5:01SPEAKER_00: Uh Four Pines Fund is a philanthropic organization working to provide more effective suicide care.
- 5:07SPEAKER_00: And Rosewood Cottage in our state in Vermont, it's the second pure respite in the state.
- 5:12SPEAKER_00: Uh, our a partner or organization of ours, Alissum, has been operating a pure respite as well for over a decade now in our in our communities.
- 5:23SPEAKER_00: The idea behind Rosewood Cottage was both to expand access to this care that was really working well but minimally available in our state, while also expanding the research and evidence around this model of care.
- 5:38SPEAKER_00: And so one of the really exciting parts about our peer respite project, Rosewood Cottage, is that it's funded to be evaluated.
- 5:47SPEAKER_00: And we're we've just recently finished year one of what will be a three-year evaluation with a wonderful external evaluator, human services research institute.
- 5:57SPEAKER_02: And they're specifically interested, I think you said in in suicide and care for suicide.
- 6:02SPEAKER_02: Um, how much is that a factor in what's happening at Rosewood Cottage?
- 6:06SPEAKER_00: About one in four people that we've served to date are coming to the respite in active suicidal distress.
- 6:13SPEAKER_00: So um, you know, endorsing or strongly endorsing that statement of like, you know, I want to take my own life.
- 6:20SPEAKER_02: Yeah, that's a lot.
- 6:21SPEAKER_02: One in four is a lot.
- 6:22SPEAKER_02: And you mentioned the study that's happening that in this the the first evaluation of the first year was just out in September 2026.
- 6:30SPEAKER_02: What else have you found beside in addition to one in four people are actively suicidal when they enter?
- 6:36SPEAKER_00: Well, one in four are coming into the respite in active suicidal distress.
- 6:41SPEAKER_00: Only one in eight are leaving the respite um in active suicidal distress.
- 6:46SPEAKER_00: But that we're seeing that 50% reduction um in you know active suicidal distress for only a seven-day stay is really remarkable.
- 6:57SPEAKER_02: That is really returning.
- 6:58SPEAKER_02: Yeah.
- 6:59SPEAKER_00: Wow.
- 7:00SPEAKER_00: One of the questions that uh the evaluators ask is um, if not for the peer respite, if not for Rosewood Cottage, right?
- 7:08SPEAKER_00: What would you have done?
- 7:09SPEAKER_00: What kind of care would you have accessed?
- 7:11SPEAKER_00: And 63% of people that we've served to date said that if not for the respite, they would have um made an attempt on their own life, which is really yeah, really, really powerful.
- 7:24SPEAKER_00: That's been another really striking finding in our evaluation data to date is that we are supporting, you know, people who would have and have accessed higher levels of care, more costly care, um, if not for the respite.
- 7:39SPEAKER_00: Uh, about almost 40% of the people that we've served to date have um, you know, report that they've been psychiatrically hospitalized in the past two years.
- 7:50SPEAKER_00: 80% of those people who have had that psychiatric care experience say that they prefer the respite uh over their hospital stay.
- 7:58SPEAKER_02: Holy cow.
- 7:59SPEAKER_02: That's pretty incredible.
- 8:02SPEAKER_02: Why do you think that is?
- 8:03SPEAKER_00: The centering of peer support values, of autonomy, of it being voluntary and accessible, right?
- 8:10SPEAKER_00: Um, if it not requiring people to be removed from their home communities to access it, those are all factors in what's making it easier for people to say yes to something like this and want to say yes to a service like this.
- 8:26SPEAKER_02: I want to circle back to the study piece of it.
- 8:28SPEAKER_02: So the study is, you said I think it was going to be a three-year study.
- 8:31SPEAKER_02: Is that correct?
- 8:32SPEAKER_00: That's right.
- 8:32SPEAKER_00: Yeah.
- 8:33SPEAKER_02: Studies are expensive to do.
- 8:34SPEAKER_02: How come?
- 8:35SPEAKER_02: Why is it important?
- 8:36SPEAKER_02: What's it gonna what do you hope to learn from that?
- 8:38SPEAKER_00: I think it's so important to do a study like this for this particular model of care because what is out there so far is so minimal.
- 8:48SPEAKER_00: And that's not because it's not something that works or it's not something that's worth investing in.
- 8:53SPEAKER_00: It just is oftentimes the case that alternative models of care don't get the benefit of the big investment, right?
- 9:01SPEAKER_00: And the benefit of the research lens of evaluation.
- 9:05SPEAKER_00: And so our hope is to be able to continue to tell what is so far a compelling story about the efficacy of uh this kind of support.
- 9:18SPEAKER_00: But it is actually also true that peer respites are less expensive than psychiatric hospitalizations are.
- 9:26SPEAKER_00: Our respite is about two to three times less expensive than um a psychiatric bed night stay.
- 9:34SPEAKER_02: I would imagine if you know, word really got out about the respite center.
- 9:40SPEAKER_02: There would be um, you know, a line from Burlington down to Boston to get in.
- 9:45SPEAKER_02: Have you been able to meet demand?
- 9:46SPEAKER_00: We are able to get everybody in um who has sought uh the service so far.
- 9:51SPEAKER_00: So Vermont's a small state, right?
- 9:53SPEAKER_00: But it's a pretty long state.
- 9:54SPEAKER_00: And we've served people in 12 of our 14 counties um across our state to date, which just goes to show for me that it's a service that people really desire, right?
- 10:05SPEAKER_00: That it's worth traveling for.
- 10:07SPEAKER_00: Um and I think we would have served people outside of the state as well, but right now our criteria is Vermont residents and Vermont adults.
- 10:16SPEAKER_02: What has drawn you to this work?
- 10:18SPEAKER_02: I mean, you've been with Pathways Vermont for a while now.
- 10:22SPEAKER_02: And I know you uh you wrote in a blog for Pathways Vermont about your own experience with your dad and an intense battle he had with suicidal thoughts.
- 10:33SPEAKER_02: Is that part of what got you in that?
- 10:35SPEAKER_02: Or what happened with your dad?
- 10:37SPEAKER_00: I've been working for Pathways for uh nearly 15 years, which is almost the life of the organization.
- 10:41SPEAKER_00: Pathways is a 16-year-old organization.
- 10:44SPEAKER_00: Um, and when I first came to work for Pathways, I did not know what I was getting into.
- 10:50SPEAKER_00: I'm a person with my own lived experience of mental health challenges uh and my own involvement in the psychiatric system.
- 10:58SPEAKER_00: Um, I lost my dad to suicide 16 years ago.
- 11:03SPEAKER_00: So right before I began working for Pathways, actually.
- 11:06SPEAKER_00: It's not why I showed up to the work, but it's definitely why I'm still here.
- 11:12SPEAKER_00: Um, I did not know that I would have this opportunity to work in a program like Rosewood, right?
- 11:19SPEAKER_00: To work with a community of people like those folks that are working out of Fort Pines Fund to contribute to this broader story about what um it means to provide support to people in suicidal distress.
- 11:34SPEAKER_02: How how old were you when your dad took his life?
- 11:37SPEAKER_00: Gosh, it was a couple days before my uh 22nd birthday.
- 11:43SPEAKER_02: Well, that's a tough time.
- 11:45SPEAKER_02: I I think any time is a tough time to lose someone to suicide.
- 11:49SPEAKER_02: But that's really, you know, you're an adult and yet you're you're really just beginning adulthood.
- 11:55SPEAKER_02: But what was the impact on you emotionally?
- 11:57SPEAKER_02: What were you thinking?
- 11:59SPEAKER_00: It was just so complicated.
- 12:01SPEAKER_00: And I and I know everyone's right, like all of our that's one of the beauties of peer support work is that I get the opportunity to be part of and listen into other people's stories.
- 12:11SPEAKER_00: And just it's always complicated, right?
- 12:14SPEAKER_00: Um, but for me, the losing my dad to suicide came at this point in my life where I was grappling also um with who I am, how do I show up in this world, having my own mental health experiences.
- 12:29SPEAKER_00: And so it shook everything, right?
- 12:31SPEAKER_00: Um, and I didn't really know how I was gonna continue in what direction I would continue.
- 12:39SPEAKER_00: Um, and those were the circumstances by which I found my way to pathways um into this kind of work.
- 12:45SPEAKER_00: At the time, um, my family was, you know, calling my dad's death an accident.
- 12:50SPEAKER_00: Suicide is lots of things, and it is just definitely not an accident.
- 12:54SPEAKER_00: And as much as, you know, my family loved and cared for my dad, and we didn't, you know, publicly feel any way other than just like, you know, we didn't feel anything but love for him, right?
- 13:04SPEAKER_00: And again, it's it's really only been through my work um at Pathways and you know, and also through time that I've been able to share in in a way that is more authentic and honest and true and recognize.
- 13:18SPEAKER_00: And I I hope, right, that in sharing, it offers people a little bit of something, right, that they might grab onto themselves.
- 13:26SPEAKER_00: It all becomes a little bit more survivable because it's not it's not swept under the rug, you know, it's not clouded in shame.
- 13:35SPEAKER_00: And that's part of of storytelling for me, for sure.
- 13:40SPEAKER_02: Yeah.
- 13:42SPEAKER_02: Knowing what you know today, if you were to go back and have a conversation with your dad, what would you say to him?
- 13:48SPEAKER_00: One thing I guess I'll say about my experience with my dad is that I knew he was having thoughts of suicide.
- 13:53SPEAKER_00: I just didn't know how to talk to him about it, you know?
- 13:56SPEAKER_00: Um, and it it wasn't that I didn't want to or didn't care.
- 13:59SPEAKER_00: And I I knew I know he knew I cared as well, but I didn't know how.
- 14:04SPEAKER_00: And I think part of that was that the messaging I had gotten about that topic for my life to date was that I'm not an expert.
- 14:14SPEAKER_00: I can't save someone's life, right?
- 14:16SPEAKER_00: Like, how am I gonna possibly start a conversation?
- 14:19SPEAKER_00: What I know now uh through my work in in peer support pathways, right?
- 14:26SPEAKER_00: What I see modeled with my colleagues at Rosewood Cottage is that a conversation about suicide is is it is a conversation.
- 14:35SPEAKER_00: Um, and if somebody's coming to you and they're taking that vulnerable risk of saying it's something that they're grappling with, they're doing it for a reason.
- 14:45SPEAKER_00: They're sharing it with you for a reason.
- 14:47SPEAKER_00: Um, and so now I feel like I could have sat in conversation with him, sought not to fix because I can't fix it, um, but at least to understand.
- 15:00SPEAKER_00: And I think that when we show up to relationships like that, when we give each other the opportunity to be seen, while it doesn't fix everything in the moment, it is a part of a story of long-term healing to stay present, to stay in the conversation.
- 15:18SPEAKER_02: You had mentioned in an email uh an analogy about how to approach that in the iceberg, I think was the term you used.
- 15:25SPEAKER_02: What what is that?
- 15:27SPEAKER_00: So there's an analogy that gets used in peer support trainings pretty often of an iceberg, right?
- 15:33SPEAKER_00: Which is that what is above the surface of the water in an iceberg is only a small portion, right, of that actual total iceberg mass.
- 15:44SPEAKER_00: And so we can use this analogy to talk about lots of concepts, but if I'm talking about suicide, I'll say that what sits oftentimes above the surface of the water is that statement.
- 15:55SPEAKER_00: I want to die, right?
- 15:56SPEAKER_00: Or some version of that statement.
- 15:58SPEAKER_00: What sits below the surface of the water are all the reasons why we're thinking about dying.
- 16:05SPEAKER_00: Their grief, their despair, their, you know, their basic needs got not getting met, loneliness, shame, isolation, right?
- 16:13SPEAKER_00: The whole gamut of things that sits below the surface of the water.
- 16:18SPEAKER_00: Something I've learned and something that's helped me to stay present in these really hard and often very scary conversations, right?
- 16:26SPEAKER_00: Is that most of the time when somebody says I want to die, our conversation with that person becomes about not dying, right?
- 16:35SPEAKER_00: Like how are we gonna make a plan for you?
- 16:37SPEAKER_00: How are we gonna keep you safe?
- 16:38SPEAKER_00: What do you have access to that we might need to take away from you?
- 16:42SPEAKER_00: I want to die, and the response is about not dying.
- 16:46SPEAKER_00: And that conversation sits above the surface of the water.
- 16:49SPEAKER_00: Instead of getting stuck there, I start asking about what's going on in underneath.
- 16:55SPEAKER_00: I wonder under I want to understand the why.
- 16:58SPEAKER_00: And once I'm there, gosh, there's so much to talk about, right?
- 17:03SPEAKER_00: Because even though maybe I can't identify with wanting to die right now, I can identify with grief.
- 17:10SPEAKER_00: I could talk about isolation.
- 17:12SPEAKER_00: I know what shame looks like.
- 17:14SPEAKER_00: And so when we open up the conversation, when we explore what's underneath the iceberg, so many times I've found myself in a very different conversation.
- 17:26SPEAKER_02: Yeah, that makes a lot of sense.
- 17:27SPEAKER_02: That's really, really powerful.
- 17:28SPEAKER_02: I think so many of us experience where we sense somebody else's pain or we hear it about it directly and we don't know what to do.
- 17:36SPEAKER_00: It's scary.
- 17:38SPEAKER_00: Um, you know, and it's it's really reasonable to hear someone's pain and to want it to end, right?
- 17:45SPEAKER_00: Or to want to avoid it.
- 17:46SPEAKER_00: And I think what I love about a peer support model is it is that relational frame.
- 17:51SPEAKER_00: And so if I were to give it you a sense of it in practice, right, is when I have that thought, right?
- 17:55SPEAKER_00: When when you show me your pain and I say, uh, right, like that's a lot, or I'm scared of it, or I don't know what to do with it, right?
- 18:04SPEAKER_00: This relational frame doesn't say I have to ignore that.
- 18:08SPEAKER_00: It just says I have to notice, I have to own it as my thing.
- 18:12SPEAKER_00: And then I've got to bring it to the relationship in a way that we both figure out what to do next together.
- 18:19SPEAKER_00: That's really, really different than me saying, I'm gonna use my fear, my own pain, my own discomfort to drive what happens in relationships, which sometimes, right, when you're the provider, that looks like taking control.
- 18:33SPEAKER_00: This is the antithesis of the that, right?
- 18:35SPEAKER_00: This is, I'm not gonna use this to take control.
- 18:38SPEAKER_00: I'm gonna talk, we're gonna talk about it, right?
- 18:40SPEAKER_00: And we're gonna figure out a way forward together.
- 18:43SPEAKER_00: And so often that way forward is so different than what I could have come up with if it was just my own head.
- 18:52SPEAKER_00: And that's how I know I'm really doing the work of peer support, is that I'm surprised, continuously surprised by where I end up.
- 19:00SPEAKER_02: What's the conversation that begins to happen at Rosewood around that?
- 19:04SPEAKER_00: There's this expectation that you're not alone in it.
- 19:06SPEAKER_00: And you're really, really not, right?
- 19:08SPEAKER_00: It's a 24-7 staffed environment.
- 19:11SPEAKER_00: So you're really, really not alone, right?
- 19:13SPEAKER_00: So if you're coming in and you're like, I'm not sure that I'm, you know, what I'm gonna do next, okay.
- 19:20SPEAKER_00: You know, like then let's create a plan that acknowledges that you're not sure what you're gonna do next.
- 19:25SPEAKER_00: I think for so many people, the thing that has been missing is the time, the time to really actually feel whatever you're experiencing.
- 19:37SPEAKER_00: And gosh, like I say that, like that's easy.
- 19:40SPEAKER_00: I spend, you know, most of my adult life avoiding my feelings, you know, right?
- 19:45SPEAKER_00: Like it's uh it's way right, like it's for me at least, it's a lot easier to not feel my feelings.
- 19:52SPEAKER_00: But once you get that that chance, right, to do it again, then the shape of it starts to come into play, right?
- 19:59SPEAKER_00: Like if I'm doing that iceberg metaphor again, right?
- 20:02SPEAKER_00: Like the sh that shape of what neat is underneath starts to form.
- 20:05SPEAKER_00: And then you can start to see what you want to do with it.
- 20:08SPEAKER_00: That's I think an opportunity uh that can happen at a place like Rosewood is it's that time to find the shape of a thing so that you can start to think about how you'd want to shift it or move it.
- 20:19SPEAKER_02: So there are two peer respite programs in Vermont, give or take, 80 or so in the entire country.
- 20:26SPEAKER_02: Fewer than half the states have one.
- 20:28SPEAKER_02: How many in an ideal world do you think they would be?
- 20:31SPEAKER_00: If I were to envision my perfect world, there's a place 20 minutes for me that I can go and I can receive that kind of support.
- 20:39SPEAKER_00: And that's what I wish for everyone across our country.
- 20:42SPEAKER_02: What's sort of the next steps for Rosewood Cottage and Pathways Vermont to s to begin to scale up?
- 20:48SPEAKER_00: Rosewood itself is pilot funded.
- 20:50SPEAKER_00: Uh, and part of my my work and my agency's work over the next couple year period is to figure out what are the you know long-term mechanisms, right, for for funding a project like this.
- 21:02SPEAKER_00: What would it look like to create a network of this kind of care um across our communities?
- 21:07SPEAKER_00: And so that everybody, not just me, right, but everybody can say I've got one, you know, 20, 30 minutes um away from me.
- 21:15SPEAKER_02: The 20-minute rule.
- 21:17SPEAKER_02: Yeah.
- 21:18SPEAKER_02: Yeah.
- 21:18SPEAKER_02: I like that.
- 21:19SPEAKER_02: Pathways just put out the this for the first year preliminary results.
- 21:24SPEAKER_02: And we will put a link to that in our show notes if somebody wants to see that.
- 21:27SPEAKER_02: But for people who would like to find out more about Rosewood Cottage and Peer Respite, where would you send them?
- 21:33SPEAKER_00: Yeah, you're welcome to come straight to our website, pathwaysremont spelled out.org.
- 21:37SPEAKER_00: There's inquiry farms if you're a person who might be interested in staying at the respite, and as well as our phone number if you wanted to talk to somebody on our team about what it might be like to stay there.
- 21:47SPEAKER_00: Information about this model of care, what's happening in our community, lots more to learn about what's happening here.
- 21:55SPEAKER_02: Lindsay, thank you so much for coming on Brainstories Connections and telling us about this.
- 21:59SPEAKER_02: It was absolutely fascinating.
- 22:00SPEAKER_00: Yeah, absolutely.
- 22:01SPEAKER_00: Thank you so much for having me and thanks for the work that you're doing and trying to get these stories out there.
- 22:07SPEAKER_00: So appreciative.