The restorative power of being involved

Hanging out at Weaver Street, Carrboro

The simple secret to Caramore is that we get people who are mentally ill, involved. We believe in the restorative power of being involved—in something, anything.

Being involved may mean having a job, or interacting with people, or solving problems. It may mean taking an art class or being in a book club or exercising, or even just eating a meal with others. It means facing issues and completing tasks and accomplishing goals—whether or not you’re fully successful. It means changing habits and maybe a lifestyle from doing almost nothing to doing a lot.

Moving around, keeping busy, and getting involved is living life. That’s about all there is to it. It’s the difference between remaining vital or decaying. Our brains and body desperately crave—and indeed require—new experiences and challenges; experiences and challenges that stimulate all of our senses, breaking the deadlock of inaction, inactivity, and monotony.

Getting out there and experiencing and living—with all the risk that that involves—is living, and can only broaden, better, and restore your health and improve your life.

D. Cooley

What if I already have a place to live?

Franklin Street, Chapel Hill

You don’t necessarily have to live at Caramore to receive our services. We actually serve clients who already have a place to live—we call them “Voc-Only” (vocational only).

However, in general, we do feel that our recovery and illness management methods work far better, when you stay in our facilities—at least for a period of time. New routines for work and socialization and medication management are better learned and retained when you are under the direction of our staff.

Each situation can be different and yours will be evaluated separately. It may very well be that you are solid in a residential sense and only need help with a job. We can still help you.

D. Cooley

Faison Sloan

Faison Sloan is a former client who now works for us as an apartment manager, and because of that he’s unique in really understanding the seemingly mundane element of adding structure and routine and purpose to a day—and then spreading those days into months and years. No one better understands this simple long-haul approach to rebuilding behavior—and how all of this can pay off big time later when you start to realize how much stronger you’ve become; when you find you can handle those things that used to put you over the edge.

And that’s Faison’s strength. He really knows himself and can pinpoint the exact things that he can’t handle. It took him a long time to do that and it is frustrating for him to attempt to articulate that to our current clients who can only see the present and don’t understand the cumulative power of time. But that’s another quality Faison has: patience.

Faison even claims to be the originator—at least in spirit—of our current Tier 3 Project. You see, years ago, after he completed our program, he sensed he needed more. He kept coming over to see our apartment manager at that time, Eric Goldman. Faison new it was beneficial to stay in touch but he felt awkward. Goldman said “just tell them you’re coming to get meds everyday,” and the Tier 3 Project was born.

D. Cooley

Justin: our photographer

The photos you’re now seeing up on these pages are coming from one of current guys—Justin. You’re not seeing a photo of him here because he prefers to stay behind the camera—as a lot of artists do.

Justin has a bachelor’s degree in multi-media (web, video production, etc.), has shot a lot of photos for local newspapers, and is a short film director (he’s made 3 films). Currently he is experimenting with spoken-word art and has completed a few performances around town during open-mike night

He’s been given an old low-grade Sony Cybershot—probably inadequate—but he considers it a challenge.

D. Cooley

The tragedy of having a mental illness affects an entire family

I was reminded of this today from a nice phone call from a parent who tells of her own struggle with her son’s illness. The experience and emotions run the entire spectrum, from shock, and disappointment, to sometimes shame, and denial. The slow and time-dependant craw through all of this then is not only experienced by the individual, but often also by the family, who become de facto caregivers.

This particular parent called it a “grieving” process, which appropriately communicates the mammoth sense of loss and sadness that must be confronted. This, again, takes time—often a long time.

This process of coming to grips with a horrifying life long illness then get complicated by two more factors: the illness is still shrouded in stigma and myth, and almost no societal plan exists to inform and help people on what to do next.

Years of recovery time are sometimes lost in utter confusion about the path and treatment of the illness. Parents must connect themselves with others who are going through this—NAMI is a nice first start.

Ironically, at Caramore, we sometimes have to remind ourselves of the lack of knowledge out there on mental illness. We see so many similar stories and histories, that it becomes almost routine.

Personally, we at Caramore feel we have some nice methods to begin recovery for a person with a mental illness. We also feel that we can begin to alleviate a small portion of the suffering a family feels. We offer some hope amid the loss, for a life that wasn’t expected, but not too bad either.

D. Cooley

Practical reasons for choosing Caramore

Caramore is a unique and valuable model for people trying to get back on their feet. We’re unmatched in the comprehensiveness of services we provide and the extent to which we provide them.

Four practical services:

1. Transportation: for the duration of the program, we make sure you get to wherever you need to go—whether it be employment, medical visits, or personal. You will never miss an appointment, interview, or day of work because of lack of transportation.

However, this pledge does not mean you are chauffeured the whole time; although we do have many company vehicles, you will also be expected to ride the free Carrboro/Chapel Hill buses, occasionally pay for transportation (off-hours bus trips, taxis if necessary) and—if it is one of your goals—be saving for your own car. We help you become self-reliant and a specialist in getting yourself around.

2. Housing: We have two group homes, numerous supervised apartments, and a growing number of our Tier 3 Project apartments. You will have an affordable place to live. If you chose to live away from us, we’ll counsel you on Section 8 and the rental market in the area. We help you set up utilities and move your things.

3. Money: We help you become aware of your budget. We help you save. We make you aware of how your Social Security benefits are impacted by your income. We help you get back on your feet financially and help you stay on course for saving goals (for cars, debt repayments, etc.), and paying for rent and utilities.

4. Employment: One of the most frustrating parts of trying to get a job is not knowing anyone and not having any connections or not even knowing where to start. Jobs are about connections—knowing somebody. Our Job Counselors already have years-long relationships with employers. We are trusted and respected. We operate like an employment service. When you come to Caramore, and are job-ready, you immediately are vouched for—you’re connected and trusted and have one foot in the door to a job.

We also will prepare you for the job and assist you in getting what you need to do the job and we’ll be around to help you keep the job. Minor problems that could lead to being fired may be easily solved by consulting with us—we’re your advocate all the time.

Not only do we provide support for these four essential and practical elements life, the reason we are unmatched in providing these services to the mentally ill, is our level of dedication to your success. We don’t think you’ll find many agencies doing as much, and to the extent, that we do it. You cannot lose and your life will improve while at Caramore.

D. Cooley

Tier 3

Tier 3 was created in 2003 to provide a more stable and long-term approach to appropriately treating chronic and episodic mood and psychotic disorders. Tire 3 provides insurance against the unpredictable and often reoccurring symptoms of brain diseases. It aims to simplify and monitor complex medication regimen and provide affordable housing. It aims to provide strong support when an individual needs it and very little interference when an individual does not need it.

Tier 3 was created to:

1. insure that symptoms are managed
2. drastically diminish the need for hospitalizations
3. level the playing field to allow someone with a mental illness to transcend the limitations of the illness

Tier 3 Project’s aim is to insure that no ground is lost after initial rehabilitation. Here’s how we do it:

• We hold leases to spacious, affordable, and newly renovated two bedroom apartments, which provide a comfortable and private living experience.
• All of the units are located close together complete with a separate on-site office where medication is housed.
• We evaluate the renewal of individual leases each year—some of our clients have been with us for years.
• We monitor medication daily with all Tier 3 clients.
• We communicate as needed with doctors, therapists, parents, and employers.
• We attempt to limit isolation and spot problems and solve them before they become big problems—e.g. saving the job, not losing the apartment, making wise money decisions, monitoring healthcare and benefits, avoiding costly hospitalizations, etc.
• We attempt to challenge clients to continue to set goals for themselves—to continue to set in motion plans for their future. We want to avoid dependency and we like to see progress and improvement.

We have attempted to create a vibrant, social environment of self-sufficiency and independence that our clients crave, while at the same time providing an underlying solid support structure.

Without these types of safeguards and supports, the re-emergence of even minor symptoms for an individual with a brain disease can sometimes plunge them into a situation where a job is lost or bills can’t be paid or the apartment is at risk—an exponentially worsening set of circumstances.

Tier 3 protects safety, progress, assets, and employment. It nurtures, encourages, and better positions individuals for long-term success.

D. Cooley

Four reasons to return to work sooner rather than later:

1. Working (even part-time) can help you get better and is vital to your recovery by giving you something to wake up for, possibly take your mind off yourself, and feel good about. Some studies suggest that it can reduce your illness symptoms.

2. Regardless of what your future career might be, working now keeps your work-place skills alive and establishes references and connections. Think of it as networking for the next job. The longer you're absent from the work world, the harder it will be to return.

3. Making your own money can reduce the burden of your family or free you from whomever you may be dependant on—increasing your freedom and independence.

4. You can keep your benefits while you work—we have a benefits counselor that can help you understand the incentives out there to actually increase your income.

Caramore can help you immediately return to work and counsel you on how to get on a career path. Currently, we have some clients who are employed in jobs that they consider to be "a first step." Others are studying for their GED, taking college classes, and some are currently working in their chosen careers—but they all recognized the value of getting back into the workforce as soon as they were able.

D. Cooley

Getting better takes time

Ray is currently one of our rising stars; he’s participating in our Tier 3 Project in his own apartment, works full time for UNC Animal Lab, is a connoisseur of restaurants and dining, and just got his Ford Probe back on the road. He’s a young guy with ambition and interests and plans.

He’s also a great example of how feeling and getting better takes time.

Ray first got sick and diagnosed in 2000, which pretty much derailed his life. In 2001, he came to Caramore and lasted just days. He felt he wasn’t ready and chose to leave and went to an assisted living facility where he stayed until July of 2005—returning to Caramore.

So what happened? Why could he pull off in 2005 what he could not in 2001? Was it a psychopharmacological miracle, a gradually developed new prospective, physical healing, or just natural maturation? It is likely some of all of those things, with the thread that unites them all being time. Ray needed time to heal and rest and sort things out and desire for more.

Battling a mental illness is a struggle and Ray deserves a tremendous amount of credit for adapting to it, living with it, and transcending it—with patience. His plans for 2007 are even more ambitious…

D. Cooley

Meet the folks at Caramore: Eric Goldman

Eric, right, with family

One of the folks that you immediately come in contact with at Caramore is Eric Goldman. Stationed strategically in the center of our administrative office (“headquarters”)—for full symbolic and literal reasons—he’s responsible for the day-to-day operations of the office and our group homes.

His exact title is “Operations and Group Home Coordinator” and is the only employee to use both front and back of his business card to get all that on there.

He’s a high-level management guy now, but his longevity—he’s worked at Caramore for over 15 years—is a result of his love of working directly with clients (he has supervised our group homes and has run our supervised apartments for many years). He’s built a career on working with, living with, interacting with, serving as a role model, and just plain bettering the lives of the mentally ill—with true passion.

Although his current talents and skills have turned him into an office-type-guy, his highly social persona and love of people continues. In fact, his new role inspires him to entertain staff and clients daily with a seemingly unending supply of jokes—not to mention keeping us off guard with his pranks and shenanigans.

If it pertains to smooth functioning of our office and group homes, or laughing during the day, it’s because Eric Goldman is manning the controls—and he’ll be one of the first people you meet when you enter Caramore. Like countless others who he has befriended and mentored, you’ll remember him for a long time after too.

D. Cooley

Working in the community and living in our supervised apartments

After living a number of weeks in our homes, and working on our lawn crew or cleaning crew—and depending on the person, the illness, progress, and attitude—clients are approached by our employment counselors about working in the community.

Where our clients work in the community depends on where they want to work. Where have they worked before? What experience do they have? What are their limitations and strengths? A whole slew of practical factors are considered, potential jobs are searched for, applications are filled out—sometimes resumes—and job interviews are conducted, all with the guidance of Caramore staff.

Beginning the job, transportation issues, and even possible on-the-job-coaching, are provided by Caramore. In fact, one of Caramore’s main objectives is to make sure you have everything you need to keep the job.

Landing that first job in the community is a big step at Caramore. It can be stressful but also exhilarating, leading to new confidence and feelings of self mastery. It can often be the first time that our clients can imagine a new life for themselves.

Clients at this time move from our family homes into our spacious supervised apartments, shared with one roommate. All of Caramore’s services continue—like psychiatric visits and coordination, medication monitoring, counsel, everything. What is new is the elemental shift to a bit more independence and responsibility. But the level of Caramore support remains safe and strong.

During this second Tier, clients are encouraged and mentored to pursue not just keeping their job, but some of the other things they love in life, like family, passions, interests, hobbies, and friends.

The vast majority of people that come to Caramore, end up working part time. They are working jobs that suit them at this particular time, providing them with meaningful and engaging duties that give them a sense of accomplishment and connection with the world. Other people depend on them and what they do. The hourly wages are climbing in Chapel Hill and our low-cost-housing allows them (along with SSA) to live comfortably and save. Because of the part time hours they have time and are encouraged to do the things they love.

There is great diversity in backgrounds and interests and current after-work pursuits. Right now, there are clients…

• Pursuing a masters in library science
• Pursuing an associates degree at a community college
• Painting and showing works in galleries
• Continuing work in film and photography
• Attempting to get back into event planning
• Getting a GED
• Encouraging and leading in AA
• Doing on-the-side home-improvement projects
• Creating and recording music
• DJing
• Swimming, walking, running, lifting weights at the YMCA (free for all clients)
• Attending English as a Second Language classes
• Coordinating and leading a book-discussion club
• Saving for a car
• Dog-sitting for the weekend
• Defeating video games
• Modifying (tricking out?) a car
• Leading a support group for depression
• Discussing ACC sports
• Hanging out and smoking
• Attending movies, concerts, and coffee shops in Chapel Hill and Carrboro
• Attending martial arts classes

D. Cooley

What will Caramore cost me?

The entire cost of Caramore is covered for you by our funding. It’s free!

Caramore does not bill Medicaid or any other healthcare provider for services.

We are continuously seeking additional funding such as grants and donations to provide and improve essential services for you.

We do require you to save 50% of your SSA money each month. This is your money, being set aside in a bank account to accumulate each month. This allows you to see how quickly money can grow, and get you in the habit of saving monthly. It also serves as your future “moving money” when it comes time to move through the program. This money gives you the power to make great choices with what you want to do and where you want to go. Caramore’s financial counselor will explain and guide you thorough our savings program.

When you arrive at Caramore, you will immediately have a job with us while you prepare for a job in the community. The job will pay you wages of about $158 (net) a week, and in the group homes, it will pay for your rent ($115 a week). All food is included in the $115 rent.

Working on our lawn crew and cleaning crew requires you to purchase five uniform shirts for $20 ($5 is deducted form your first five paychecks). If you’re on the lawn crew, we give you up to $30 for the purchase of steel toe boots. Uniform pants are also provided.

Here in Chapel Hill and Carrboro, the buses are free. Non-routine rides (off the bus line, at off-hours) do have a cost of $14.50 for twenty rides.

When you move to our supervised apartments, the rent becomes $385 a month total. This includes power and phone but not food or cable. The addition cost for food should be covered however with the higher wages from the new community job you’ll have at that point.

Tier 3 apartments (the third and optional part of our program) are currently (it varies with the market) going for around $615 (for a two bedroom, two bath), plus all utilities (power, phone, cable). With a roommate, the total cost should fall around $400 or so; a nice affordable price for this high-employment-opportunity area.

Your financial situation will be unique, with maybe debt, a car, or current credit card bills, and will be evaluated with our financial counselor for an appropriate plan. Getting financially stable is a major part of the Caramore experience. You will be challenged and encouraged to become more aware of your money, to gain control over it, and to save it.

D. Cooley

What is success?

Christopher Morley writes, “There is only one success—to be able to spend your life in your own way.”

Mental illness is simply vicious and tragic. Sadder still are young individuals who get sick with the illness and cannot accept it. They think it just can’t be—not now, not to them. They are in denial, which typically leads to more suffering.

Accepting that one is ill and gaining “insight” can take a very long time. The life that had been planned and the visions that accompany that plan seem ruined, and a grueling frustration sets in.

Most tragic illnesses require a completely new lifestyle and a reconfiguring of thought—mental illness is no exception. Everything changes, and individuals need time to sort all of this out mentally and physically. It’s a fierce challenge, especially for the very young.

The above quote suggests success as having a vision of what one wants to do coupled with the mature realization that one is enjoying both the process and the results—a balance of ambition to get there (and maybe always getting there), and the wisdom to be happy with what is achieved.

All of our clients are working for their future—to spend their life in their own way—and if they can set up as many positive and healthy trends now, they eventually begin to enjoy the present.

D. Cooley

Employers who really make a difference

Caramore’s expertise is getting an individual who may have come right out of a long hospital stay, or some other similar situation of not working for a long period, and returning them to work in the community.

We do this by immersing them in our own “work adjustment” program for a couple of months where they can relearn and really get down as routine those “soft skills” like an appropriate personality, how to act socially, what to say, being friendly and optimistic, taking instruction and supervision, &c.

Once these soft skills are down an individual is ready for a job in the community.

Our job counselors work with our clients every step of the way, on all components of pre and post job placement. The counselors do a lot of counseling, but it is the client who does the job day-in and day-out.

If it weren’t for the help of some wonderful employers in our community, Caramore simply could not exist. Caramore and clients work extremely hard to maintain great relationships with our employers. We function as an employment agency! Our faith and commitment to our clients as workers, our ability to provide competent employees on short notice, our being on call to assist in any problems, all work to benefit employer and employee.

Here are some of the businesses who provide Caramore participants with the opportunities to be successful:

Lowe's Home Improvement Warehouse
Everything you need for your home and customer service with a smile.

McLaurin Parking
Serving the parking needs of UNC Hospital and campus

UNC at Chapel Hill
One of the oldest and best universities in the country

Carol Woods and Carolina Meadows Retirement Communities
Taking care of all the needs of their senior residents

Marshall's Department Store
Fashion and furnishings at great prices

Harris Teeter Supermarkets
Great food and service

D. Cooley

To smoke or not to smoke?

The other day one of our best employers of our clients—Carol Woods Retirement Home—banned smoking entirely from their grounds (they also offer a lot of help to quit). Lowe's Home Improvement enacted the same rule some time ago and this follows a societal trend that can be witnessed frequently in the newspaper. Smoking, more and more, is not being tolerated in our society.

No one can reasonably argue for smoking—certainly not in any realm where health is considered, but when it comes to mental illness and smoking, the issue becomes a bit complex.

For a person with a mental illness, smoking may enhance concentration, encourage relaxation, stimulate dopamine production in the brain, reduce symptoms, and just be plain fun as something to do.

However, it is far unhealthier to smoke than not to, for the now obvious known impact it has on the lungs and hart. But for the mentally ill, nicotine may also negatively effect the role of prescribed medication in the body.

Caramore does not ban smoking from our grounds. We allow our clients to smoke, outside, at all of our facilities. We believe that recovery takes time—sometimes years—and we believe in attending to various issues regarding healthier living in due time, as the individual becomes ready to conquer them.

We believe that an inquiry into quitting is a first step toward quitting and we attempt to respond to individuals who want to quit by hooking them into plans to do just that. So although we do allow smoking, we are always looking for the right person at the right time to help them attempt to quit. We want to promote the healthiest lifestyle and environment possible while battling a mental illness.

D. Cooley

Illness management, recovery, and a great place to live

The portion of our program known as “Tier 3” (long-term housing and illness management) expanded again today. Two of our clients, Paul and Richard, moved into their new spacious two bath apartment where they will live for the next year and enjoy the full services we offer (job counsel, financial counsel, medication supervision, psychiatric and hospital coordination, etc.).

Tier 3 was created to fight the recidivism many mentally ill experience as a natural consequence owing to the episodic nature of the disease. If we can monitor the prescribed medication and communicate with doctors, and if we can stay in frequent contact with a client and stay attuned to their health—then we stand a better chance at keeping the job and the apartment (we’re the landlord after all) when the illness takes an inevitable turn for the worse.

Our Tier 3 apartments are bundled together and provide a campus-like feel. Medication is stored and taken at an office right on site. The context of the living arrangement is one of like-minded individuals living, working and struggling to get healthier and improve their lives. We believe that the supportive and social environment works to change behavior—to lessen symptoms and minimize setbacks. Environment is everything!

Paul works at Carol Woods Retirement complex and Richard drives for UNC. Both guys will use the next year to attempt to achieve more goals they have for themselves like taking classes and paying off their vehicle loans.

D. Cooley