Consumers Can Be Great Service Providers

By Kurt Sass

Peers have a special way of establishing trust with clients

There is a growing trend for the better in the mental health field to hire more mental health consumers, especially in direct care positions. As little as 15-20 years ago, this practice was relatively non-existent. During my most major depression 12 years ago I did not run into a single mental health “professional” who ever identified him or herself as a fellow consumer. Not a single doctor, therapist, clinician, or anyone else. I spent 2 years getting advice from people (though good-intentioned for the most part) who had no real first hand experience of what I was going through.

The closest I came was when I was already on the road to recovery, and my new therapist recommended that I start going to support groups in addition to seeing her. It was the way she explained it that really hit home with me: “Now I know we’ve made a lot of progress in the few weeks since we’ve met, but I feel you really need to talk to others that have gone through exactly what you have. To be honest, Kurt, I myself have never had Major Depressive Disorder or Bi-Polar Disorder, so I can’t honestly tell you that I know how you feel.”

And she was so correct. How would most therapists or psychiatrists be able to relate to lying in bed helpless for months at a time, or having constant suicidal thoughts, or not being able to sleep for days on end due to non-stop, rapid, racing thoughts? With insight like that, no wonder she stayed my therapist many years.

Once well enough to work, I was fortunate enough to find employment with Community Access, an organization that helps individuals with psychiatric disabilities. They also are dedicated to hiring at least 51% consumer staff, destroying the myth that mental health consumers are bad hiring risks. (Don’t worry, if you don’t have a psychiatric disability you can still apply—they don’t discriminate!)

My first position at Community Access was as a Service Coordinator, and I can’t begin to tell you how many times being a mental health consumer myself helped my “clients” (we actually use the term tenants as they each hold their own lease in many of our housing programs) through a difficult situation. I can’t tell you how many times, but I’m going to tell you of two right now.

Tenant AB (HIPAA privacy regulations) came to the office one day (which is located in the same building he lives) and he looked awful. In fact, he had progressively looked worse over the previous few weeks. He kept saying his stomach hurt him very bad, but had no idea why. I brought up the possibility of side effects from his medications as a possible cause. He did not want to discuss his medications at all. I then mentioned to him that once I had very similar side effects when I took Lithium. “You took Lithium?” he asked in utter surprised. Why? He inquired. After explaining briefly my mental health history, I told him about the side effects I had experienced with Lithium, but that I had talked to the psychiatrist, who made a change to the medication whose end result was the disappearance of these side effects.

Once AB knew my story, he really started opening up to me. He told me all the medications he was taking and about the recent changes in these meds, which seemed to coincide with his severe abdominal pain. I was able to convince him to see his psychiatrist, who ended up adjusting his medications to a level his system could tolerate. Without AB’s trust in me as a fellow consumer, he probably would have never revealed the information needed to get him the help he needed.

Tenant CD came into the office one day completely distraught. She felt that she needed to go the psychiatric emergency room (ER), but was afraid of what would happen if she was admitted, as she had never been there before. Having been in numerous psychiatric wards myself, I was able to tell CD both the good and the bad experiences I had there. CD said she felt very relieved after speaking to me, as she thought they simply tied most people to their beds, but felt much better about her decision to go to the hospital knowing someone who had actually experienced it as a patient. I was able to escort CD to the psychiatric ER and help ease and comfort her through the experience.

The bottom line is that clients (for lack of a better term) feel much more comfortable and empowered when at least some of the staff they encounter are their peers. Fortunately there are organizations such as Community Access out there that actually go out of their way to hire people with psychiatric disabilities, not just to give them an opportunity, but also because they realize what a valuable asset their experiences bring to their organizations.