AT FRIENDLY HARBOR, PEER MENTORS ARE KEY TO MENTAL HEALTH
Jamie Siebrase, Westword–
The devil had taken over his grandmother’s body, pulling out her soul. Thinking he was Jesus, Joe Bowers decided to put an end to the battle of good versus evil.
He waited for his grandmother, the woman who’d raised him, to go to bed. “I gave her time, and then I went to the kitchen cabinet, took out a 16 gauge shotgun, loaded it and walked upstairs,” Bowers recalls. His grandmother’s bedroom was at the top of the stairway. The door was cracked open, and as Bowers reached the landing, he saw his grandmother kneeling by her bed in prayer. Confused, he tiptoed to the end of the hallway, contemplating why, exactly, the devil would be praying.
“I decided that the devil was trying to confuse me,” Bowers says. So he crept back to his grandmother’s bedroom, cocked his shotgun, and aimed it at her chest.
That was Bowers’s first psychotic episode, back in early 1964, when he was just sixteen. It took him more than fifty years to find the help he needed.
A few minutes past noon, 71-year-old Joe Bowers strolls through the back door of the Friendly Harbor Community Center, a two-story brick building on the north side of Pueblo.
The joint has been open since 11 a.m., and there’s coffee brewing in a breakfast nook off the kitchen. Bowers pours himself a mug before joining a few of the “old-timers” who are listening to ’60s and ’70s classic rock on a radio in the living room. “The place is homey; the atmosphere is good,” he says.
At 1 p.m., a peer specialist will shuffle Bowers and his buddies into a conference room for an hour-long support-group session that’s available, free of cost, to any community center member interested in chatting. “There might be five or ten people on a given day, and there’s always at least one person who has a lot to talk about,” Bowers explains. “The thing about Friendly Harbor that’s different is it’s always an equal speaking to another equal. There’s no judgment.”
Bowers volunteers at Friendly Harbor three to four days a week. When he isn’t participating in support groups or hanging out with members, he might be at the store buying supplies for the organization or outside mowing the front yard, checking on a few of the trees he planted last fall.
Bowers only learned of Friendly Harbor in 2014 — but it’s been a safe harbor for him ever since.
Friendly Harbor had been founded in Pueblo almost two decades earlier, in 1996, by three people with severe mental illnesses: Chris Hart, Mike Mihalas and boardmember emeritus Robin Hill. Initially, the nonprofit was designed as a drop-in center aiming “to restore hope, dignity, and a sense of purpose to Pueblo Citizens who happened to have a mental illness,” according to Friendly Harbor’s original bylaws.
After operating on a shoestring out of a small rental building with no running water, Friendly Harbor relocated to a two-bedroom house in 2003, when it updated its bylaws to expand its mission to help all adults with mental illness.
Over time, Friendly Harbor became a gathering place for Pueblo’s homeless population, who often came in for the coffee rather than the services. Two of the founders left, and Hill himself got sick in 2010. “It became kind of a scary place for our members,” says Elissa Ball, a psychiatrist and boardmember who’s also living with depression.
That’s around the time that Bowers found the drop-in center. Shortly after relocating to Colorado from Wyoming, he needed to find a doctor to fill his prescription for Haldol, so he’d made an appointment with a psychiatrist at Health Solutions, a nonprofit behavioral health-care organization in Pueblo.
Bowers had been diagnosed with paranoid schizophrenia in 1964, shortly after he attempted to murder his grandmother. “I was always skeptical about my diagnosis, because I have never heard voices, though I have been very delusional,” he says.
He was right to be leery. When his condition was re-evaluated for the first time in fifty years at Health Solutions, Bowers learned that he was “classic Bipolar I,” not schizophrenic.
Schizophrenia is defined as a psychotic disorder, whereas bipolar disorder is a mood disorder that can involve psychosis. Because they share some similar symptoms, differentiating between the two can be almost as difficult as making an appointment with a psychiatrist in Colorado.
Bowers had to visit Health Solutions several times before he saw a psychiatrist who finally gave him a correct diagnosis. While he was waiting to be evaluated, a counselor there told him all about the Friendly Harbor Community Center. He was eager to check it out.
At the time, Friendly Harbor operated out of “a dingy, rundown building,” he remembers. “I wasn’t impressed with the place.” But the people inside affected him, especially boardmember Patrick Hurley, a retired minister with his own mental illness.
In September 2016, with help from Health Solutions and Mental Health America, a national community-based nonprofit for people with mental illness, Friendly Harbor purchased its current property at 2713 North Grand Avenue, a former orphanage for black children known as the Lincoln House, and reopened as a full-on community center.
In its new space, Friendly Harbor was also able to launch a peer-based mentorship program, Mentor2Success. This therapeutic service has quickly become one of Friendly Harbor’s signature offerings.
Friendly Harbor is not a treatment facility — “We’re very clear about that,” says Bowers — but rather a gathering place that promotes long-term healing through community events and bottom-up peer mentorship. It’s staffed and run by “consumers,” a word used to describe people living with mental illness.
“The term for somebody with a mental illness has been an object of controversy for a long time,” says Bowers. “As for myself, just call me crazy.”
Joe Bowers was raised by his grandparents in upstate New York, near the Catskills. He seemed a pretty typical boy who loved baseball, football, and track and field: “a total jock,” as he puts it.
So his grandparents were surprised when a middle-school teacher called to say that the boy’s grades had slipped, and he’d become withdrawn. The teacher recommended that he see a psychologist, and “I just hoped my classmates didn’t find out I was seeing a shrink,” Bowers recalls.
Despite the prevalence of mental illness, that stigma Bowers felt in the early ‘60s is still present today. One in five Americans — over 40 million people — has a mental health condition. While the most common mental illnesses are depression and anxiety, one in seventeen Americans suffers from a more serious disease: schizophrenia, bipolar disorder or extreme paranoia.
For four years, from 1961 to 1964, Bowers had weekly therapy sessions with a psychologist. “He did his best to help me out,” Bowers recalls. “I was already at the point where I couldn’t have avoided what came next without medication.”
What came next was his grandfather died, and the grief he felt triggered “an episode,” Bowers says. “I got very psychotic and delusional.”
Those delusions led him to his grandmother’s bedroom door with a loaded gun. There, for a split-second, he lost confidence in his delusion. “When you’re psychotic, sometimes you have these short moments of lucidity,” Bowers explains. “I released the shotgun, and I told my grandmother that I was trying to kill her.”
Bowers and his grandmother walked downstairs and called his uncle, who drove Bowers to the now defunct Middletown State Homeopathic Hospital, a mental institution where he would spend the next two and a half months. Doctors there determined that Bowers suffered from paranoid schizophrenia, but nobody told him that diagnosis. In fact, it would be fifteen years before he learned what condition he might have…and even then, the diagnosis was wrong.
At Middletown, he recalls, “My treatment consisted of therapy sessions with a psychiatrist, but those were infrequent. They weren’t big on medication. I was treated with electric shocks.”
He received fifteen shock treatments during his first stint at the hospital, and “I became lucid after a while,” Bowers says. He was released from the hospital in May and graduated high school the following year with his class.
Bowers had been prescribed Thorazine, but only took it sporadically because he didn’t like how the medication impacted his physical performance. “I’d been hoping for an athletic scholarship to college,” he explains.
Bowers didn’t get that scholarship, but he did get into Sullivan County Community College. Everything was going fine until his third year, when Bowers had his second psychotic episode, this one involving a czar and the fall of Russia. Over the next two decades, Bowers fantasized he was King Solomon, Leonardo da Vinci, William Shakespeare and James Bond, among many other historic and fictional figures. During these episodes, he was arrested for crimes such as trespassing and arson. From New York to Arizona to Wyoming, he bounced between solitary confinement in jail cells and state mental hospitals, where he was medicated with Thorazine and Stelazine. At one point, he learned he’d been diagnosed as a paranoid schizophrenic.
In spite of all this, Bowers somehow managed to complete a bachelor’s degree in fisheries science at the University of Arizona, and then continue to hold down jobs, initially as a hotshot wildland firefighter before taking a position as a lab technician with a Wyoming power company.
Sometimes it seemed like his wife, Molly, was the only thing keeping Bowers together. “She’s the most important part of my support system,” he says, noting that he even started taking his medication as prescribed because it was easier than arguing with his wife.
The medication wasn’t working in 1986, when Bowers started contemplated killing Molly during a bad episode that led him to sign himself into Holy Cross Hospital in Salt Lake City. Bowers was prescribed Haldol at Holy Cross. He’s been taking the antipsychotic since then, and has been “mostly symptom free,” he says.
Back in Wyoming, therapists emphasized the importance of ongoing counseling, and one doctor gave Molly signs to watch for, such as pacing, that would alert her it was time to tweak the dosage of his medication. “A lot of people with mental illness lack awareness,” Bowers says. “Over time, I came to trust Molly if she would say, ‘You’re acting strangely.’”
Bowers retired from his job in 2013, and he and Molly were eager to move to Colorado. Their two sons were living in Denver at the time, but they preferred the small-town charm — and the lower cost of living — in Pueblo.
Despite consistently ranking among the nation’s physically healthiest states, Colorado comes in 43rd nationally in behavioral wellness, indicating a high prevalence of mental illness and low access to care, according to a 2017 report issued by Mental Health America. Of the Coloradans polled, 11.8 percent reported poor mental health, up from 9.9 percent in 2015.
It costs money to treat mental illness, but not treating it can be far more expensive. Funding for mental health services in Colorado comes from a combination of state and federal funds, including Medicaid. The state’s budget to care for patients without insurance was $40.7 million in 2017. But in 2010, behavioral health cost Colorado at least $887 million, according to a report issued by the Colorado Health Foundation.
The criminal justice system often picks up the slack. Colorado’s state prison system and county jails spent $93 million on mental health services in 2010.
One of Friendly Harbor’s eleven board members has a daughter with mental illness. “We were told by professionals that in order for our daughter to get the help she needed, she’d have to commit a felony so she could be placed in a hospital for the criminally insane,” the boardmember says.
“Using our criminal justice system as a warehouse for people with mental illness is probably the most expensive decision we can make — and the least therapeutic,” adds Andrew Romanoff, president and CEO of Mental Health Colorado and former four-term state representative and two-term Speaker of the House. His group is holding a gubernatorial debate focusing on the issue of mental illness on March 23.
Mental health professionals know more about mental health care today than they did when Bowers was receiving electric shock therapy more that fifty years ago. They know, for example, that early intervention has been very beneficial for people with mental illnesses.
“When people come in early for treatment, 80 percent will get better — and those who don’t ‘get better’ usually still benefit from the treatment,” says Dr. Carl Clark, president and CEO of the Mental Health Center of Denver.
And yet, Romanoff notes, “about half a million people in Colorado are not getting the mental health care they need.”
Stigma is one obstacle. Nearly 40 percent of Coloradans polled for the 2017 Colorado Health Institute’s Health Access Survey said they were uncomfortable talking about their problems or concerned that somebody would find out. “But the single biggest barrier is cost,” says Romanoff.
Under the Mental Health Parity and Addiction Equity Act of 2008, which was amended by the Affordable Care Act to include individual health-insurance coverage, many insurance plans require equal benefits for mental and physical health care. These laws often go unenforced, though, and mental health professionals in Colorado are reimbursed at a rate that is 40 percent lower than that of some other providers. That helps explain why 35 percent of Coloradans polled in 2017 said they had trouble booking mental health appointments.
“For people with private insurance who have behavioral health coverage, only two out of every five who need treatment actually receive it,” Clark says. “People will look at their provider list, start calling providers, and oftentimes they’ll get an answering machine that says the provider is not currently taking new patients.”
Frustrated, many people simply give up.
During an early stint at a state mental hospital, Bowers remembers telling an orderly that when he got better, he wanted to get a degree so that he could work with people with mental illness. “The orderly told me that wasn’t possible with my history,” Bowers says.
But in 2017, Bowers proved naysayers wrong by completing a sixty-hour training program with Peer Coach Academy, a Denver-based nonprofit specializing in peer recovery training. The academy provides small-group training sessions at First Presbyterian Church of Pueblo for Friendly Harbor’s peer specialists, covering topics ranging from motivational interviewing to ethics and professional boundaries. Bowers has also received training through the National Association for the Mentally Ill, and is now well equipped to serve as a Friendly Harbor volunteer peer specialist.
Bowers has also written an ebook, Life Under a Cloud: The Story of a Schizophrenic, with which he hopes to dispel some of the fear and ignorance — and to make a point. “People with mental illness are sometimes treated with discrimination and prejudice,” he observes. “I felt like the system was all wrong, when somebody who is sick ends up spending half their life in jail or a hospital.”
On the days when he volunteers at Friendly Harbor, Bowers usually heads out around 5 p.m., but some nights he’ll stick around for one of the organization’s events or classes, such as the Wednesday night “Creative Arts” club.
Weekly support groups are augmented by recurring monthly activities, including movie night, poetry night and game night, as well as “Haircut Day,” when members can come in for free cuts. Gatherings are usually lighthearted and fun, and family members are encouraged to participate, especially in bi-monthly family support-group sessions.
For long-term mental health care, “a supportive community is key,” says Romanoff. “Most mental health disorders are chronic conditions, and a lot of folks will need support for the rest of their lives.”
“This type of support is scarce,” adds Michael George, Friendly Harbor’s volunteer executive director, a consumer who is in recovery from alcohol and drug addiction. George learned about Friendly Harbor during his tenure at Colorado Mental Health Institute Pueblo, a 449-bed inpatient hospital where he worked as a licensed clinical social worker until retiring in 2014. (CMHIP is one of two state mental hospitals in Colorado; the other is Colorado Mental Health Institute Fort Logan, in southwest Denver.) The peer-specialist program made Friendly Harbor particularly appealing to George.
A peer specialist is a person with “lived experience,” boardmember Ball says. “They have experienced mental illness or substance-abuse problems and are in recovery.” In addition to going through training, peer specialists must pass a written exam. Last October, Friendly Harbor received a $15,000 grant from Casey Family Programs, covering the cost of training and the exam. “We’re currently training three more peer specialists,” Ball notes.
Friendly Harbor is open six days a week, Monday through Saturday, and one of its five peer specialists is always on site during operating hours, from 11 a.m. to 5 p.m. In addition to manning the front desk at the center, peer specialists provide members with resources and lead daily support groups. Some groups are labeled by diagnostic set — there’s an anxiety and depression meet-up on Mondays, for example — but most are geared more generally toward mental wellness. “People can come to any group anytime to talk,” Ball notes. “We are not a treatment center, but we are beneficial to treatment.”
Bottom-up peer-leadership programs, such as Friendly Harbor’s Mentor2Success, have also been shown to be effective for people with mental illness. “A lot of research shows that involving peer specialists improves the outcome beyond what other specialists can do for people with mental illness,” says Ball. Demonstrated benefits of peer mentorship include symptom improvement, increased enjoyment of life, and decreased hospitalization and emergency-room visits.
“A peer specialist has that extra ability to empathize with what it is like to think crazy thoughts, and they can sympathize about the side effects of medication,” she continues. “Peer mentorship works because people with mental illness get hope from seeing somebody like them functioning at a high level.”
While a robust peer-mentorship program might be Friendly Harbor’s hallmark, one of the most extraordinary aspects of the organization is its leadership. Friendly Harbor doesn’t just serve consumers; it’s managed by them, too. “People with a lived experience of being in recovery from mental illness or substance abuse have a unique contribution to make,” George says. Under its bylaws, at least half of Friendly Harbor’s boardmembers must be consumers.
Friendly Harbor currently has about 300 active members. “We get 5,000 visits a year, mostly from local and regional members,” George says. “Important work happens here.”
Even so, Friendly Harbor is still “a nonprofit that’s limping along, trying to stay funded with grants and individual donors,” says Jill Wodiuk, the board secretary. The organization’s only paid employees are peer specialists; otherwise, it depends on the work of volunteers.
While the organization has morphed over the years, it has always worked to promote mental wellness by providing a spirit of connection among consumers, family members, advocates and organizations such as the Pueblo Chieftain, Colorado Mental Health Institute Pueblo, the Jackson Foundation, Mental Health America and Health Solutions. Now it’s in the process of formulating one-year and five-year visions. By 2019, Ball says, she’d like to increase Friendly Harbor’s annual operating budget from $60,000 to $120,000 in order to hire a three-quarter-time CEO and add more staff peer specialists. Such growth would allow the nonprofit to broaden its membership base and engage in outreach with more mental health organizations and private practitioners.
“We want to have longer hours, including Sunday,” Ball adds, noting that another goal is to provide off-site services to organizations such as churches. And within five years, Friendly Harbor would like to buy a van to take members on outings. The anticipated moves are modest, but critical.
“Nonprofits have a tendency to shrivel up and die,”Wodiuk says, “but this is too important for that.”
Dealing with mental illness requires courage and hope. The people at Friendly Harbor show that every day, and now they’re putting it on display with an art exhibition, Courage and Hope, that opens with a reception March 14 at the Sangre de Cristo Arts Center in Pueblo. The exhibit includes over sixty pieces in mediums ranging from painting and sculpture to music and artistic narratives created by people with mental illness and substance-use disorders.
“We advertised to our mental health community, and we also have a few local artists who learned about the exhibition and wanted to participate,” says Ball, who came up with the idea for Courage and Hope.
Bowers has three blogs in the exhibit. One, “A Rose by Any Other Name,” discusses “the proper terms for referring to people with mental illness,” he says.
But don’t worry, he adds. You can still just call him crazy.
Article originally appeared in Westword.