Loneliness and isolation

Bowen

A large part of mental illness is battling loneliness and isolation. The residual stigma involved with the illness has resulted in most people in society innocently identifying more with what makes someone with a psychiatric illness different, rather than being able to see what they might have in common.

Mental illness is a very unique and terrible disease. It requires those who suffer from it to admit that they are going to need a lot of help—to admit that they are going to have to rely on others. This disease requires a team of family, therapists, doctors, and friends. At Caramore, everyone is in the same situation.

Battling stigma can be as simple as ending the secrecy of the illness and saying to others “hey look, my friend here has some problems, and we need your compassion and help.” Most people, when asked directly like this, rise to the occasion. People want to help.

The community aspect of Caramore asks our clients to not only be dedicated to their own improvement, but to serve all the others in the group. We realize that our success is interconnected here; and we have to find a way to get there together. We don’t want to fix defects—we want to find unique talents and celebrate them and use them to help others with the illness.

Individuals with mental illness are people who are lonely, want relationships, and want some success in life. They want to feel needed and appreciated and loved. Success in battling this illness demands directly getting others involved, both for themselves and for others.

D. Cooley

Deinstitutionalization

When you read story after story in the News & Observer chronically pining about deinstitutionalization and the lack of services in the community for the mentally ill, what they’re complaining about is the lack of comprehensive care.

One in four of us will experience some form of psychiatric illness in our lifetime. This statistic alone communicates how widespread and common it is for any of us to fall prey to depression, an eating disorder, anxiety, substance abuse, or a psychotic disorder.

For one in seventeen of us, mental illness will be severe. Severe psychotic illness most frequently comes early in life—in youth, when individuals are their most productive. Not only is the productivity impaired, but the nature of the brain disease also damages insight, cognition, and behavior.

A young person discharged from a hospital after being temporarily stabilized, gets released into the community with no plan, no job skills (never got a chance to learn them with the illness hitting so young), and no rehabilitation focusing on their illness and behavior, is destined to fail.

For all of the limitations of a hospital, it did provide comprehensive care. Caramore provides comprehensive care. Caramore is the community service that people wish existed for the mentally ill.

Caramore attempts to provide comprehensive assistance for as long as it takes. We centralize medication, shelter, food, therapy, and rehabilitation in one place and we do it for the length of time necessary, and to the degree necessary.

There is no cure, but almost all brain diseases can be treated, and part of the treatment requires (along with the traditional model of drugs and doctors) comprehensive and intensive support and rehabilitation. The beauty of Caramore is that it is not a hospital—it’s essentially the real world, with real jobs, real friends, and real apartments. But it provides that underling helpful and watchful guidance. We find that our clients want to be independent—not dependant, and when they gain the maturity and perspective regarding managing their illness, they rise to the occasion, attempting to achieve all that they can, while remaining aware of their illness.

Our model is worth copying in all communities.

D. Cooley

What Caramore is not

Caramore is not a group home.

Caramore has two homes that serve as the first stop for incoming clients. These homes house all new incoming residents and are designed to provide a stable and structured environment where all that goes into “living” (chores, social interaction, nutrition, cooking, hygiene, etc.) can be gradually addressed. But within weeks, many of our clients find themselves in a large two bedroom apartment that we manage. No one lives in our homes for long, they're just the first step.

Caramore is not a clubhouse.

Caramore has two in-house businesses that are actually for-profit competitive services in Chapel Hill and Carrboro. All of our incoming clients begin working on these jobs to gradually address stamina, work-place etiquette, and employment soft skills. But these jobs are temporary and exist to prepare our clients for a more permanent job in the community. Besides, these guys down the street do the clubhouse thing better than anyone else.

Caramore is not for everybody.

All potential clients visit Caramore for at least a week prior to coming in officially. Many individuals, in various states and severities of their illnesses, are simply not ready to try and work in the Caramore environment. That’s why we are a small program and why visits are essential. But just visiting can be valuable—it demonstrates, through our feedback, exactly what is needed to improve, and what should be worked on, to eventually gain admission.

Caramore is not an easy program.

The real work begins after getting admitted. Our clients must be willing to work exceptionally hard to manage their illness, their work, and life. Nothing is guaranteed. Entrance into program offerings like Tier 3 are not automatic, but are contingent upon consistent effort and a motivated attitude. Most find though that genuine effort brings great rewards at Caramore.

Caramore is…

A highly supportive environment and a loving group of people that strive to provide just the right help to each client we serve; to gradually, in stages, and to the extent that each individual needs and desires, promote progress, wellness, rehabilitation, and independence.

D.Cooley

Creative, flexible, and adaptive

Caramore has the honor or serving extremely unique and rare individuals. Illness is experienced and manifests itself very differently in each individual, making meeting people who come to Caramore a new adventure each time.

Experiences of mood disorders and psychotic diseases are traumatic and tragic—but they also can be fascinating, unimaginable, and humbling. The struggle to overcome illness is heroic and inspirational to be a part of.

It truly takes a team to take on this illness—and time. Treating it requires being creative, flexible, and adaptive. No one approach is always appropriate—each individual is frustratingly one-of-a-kind; but that’s also the challenge and source of satisfaction. Each individual necessitates being known within the context of who they are and what they need, and getting to know them is part of the fun.

How do you re-teach someone every little messy and complicated life-circumstance that the rest of us take for granted? It’s no science, and it begins simply enough with being kind and listening. It takes an open mind and a willingness to approach each person as needing something wildly different from the last one—and the reward for that openness is gaining a new friend.

D. Cooley

Police Crisis Intervention Teams

NAMI has been doing a wonderful job advocating for Police Crisis Intervention Teams (CIT) to be adopted in all communities.

What is a CIT program?

-CIT is a partnership between the police, the mental health system, family members and individuals suffering from mental illness.
Certain officers within a force who have an interest and insight into psychiatric illnesses, receive specialized training from mental health professionals and advocates .

-They are taught to recognize psychiatric distress and symptoms that accompany the disease, and the types of techniques and responses that best work to de-escalate the situation rather than compound it.
The goal, through recognizing psychotic symptoms and dealing with them appropriately, is to get the individual into the proper mental health treatment rather than arresting them or anyone getting hurt.

-Implemented in communities (Memphis, Durham, and many more), the program greatly reduces the rates of arrests and injuries for those with mental illness; and it improves the understanding and compassion and satisfaction for officers working within those communities.

The existence of this program is an encouraging example of the gradual progression of societal awareness concerning psychiatric brain diseases, its symptoms, and how best to help someone suffering from them.

D. Cooley