By next year, Gainesville will be home to one of the few respite houses in the United States, reflecting the city’s increasing access to alternative mental health care.

Illustrations by Sydney Martin.

By the time Rusti Poulette moved to Gainesville, they had run out of options. Since middle school, when they began feeling severe anxiety and depression, they had sought treatment only to find each doctor explain that there was nothing they could do. The experimental drugs, the endless different psychiatrists and psychologists — nothing helped for long.

This changed when Poulette began to hang around the Civic Media Center and the former Wayward Council, a nonprofit, volunteer-run record store. They were places, Poulette said, where they found a sense of purpose.

“People were giving me responsibilities and creative outlets,” they said. “I found this sense of community and people that could support me.”

Within a year of being engaged in these communities, Poulette said they threw out all of his medication. They stopped going to the doctor.

“I haven’t had a problem since,” they said. “Gainesville has kind of been like a healing ground for me.”

Poulette is a self-described psychiatric survivor, someone who has rejected what they felt were disorienting and disempowering mental health services — some of which can exacerbate a person’s trauma — and now seeks alternate forms of therapy that embrace self-determination.

Having survived, Poulette said, they wanted to help others experience the same. In 2011, they and other survivors began to meet regularly, sharing their stories and providing support to one another. They conducted their meetings using the framework and language of peer support, a larger international mental health movement that aims to empower mental health care consumers to help and advocate for each other. Sometimes this can supplement traditional mental health services; sometimes it can supplant them.

Within a year of being engaged in these communities, Poulette said he threw out all of his medication. He stopped going to the doctor.

The peer support movement has been percolating through Gainesville for a long time, but it has hit its stride over the past five years as groups popped up at the University of Florida and around the city. And a culminating point is soon to come: By January, Gainesville will have its own peer respite center, a house staffed and operated by people who have personally experienced mental illness, operated under a philosophy of community-based healing.

The goal, said respite director Phil Schulman, is to create a community of peers who can be there for one another in times of distress.

“When you are in distress, when you’re having extreme states, or if you’re having them and you’re looking to prevent them from growing, you don’t have to do it alone,” he said. “There’s a community, there’s a place to reach out.”

The idea of peer-support came out of the mental health consumer movement in the ‘70s, a drive among mental health consumers advocating for fair treatment. Peer support as a process is grounded in the belief that those who have experienced mental illness themselves can, through compassion, openness and encouragement, create an environment that helps those in crisis find relief. By doing this — what Poulette said is called “holding space” — people can help themselves find the route to their own recovery.

As with Poulette, this kind of process can happen without being sought. Gainesville resident Ali Brody, for example, also found open dialogue, support and encouragement from people already in her life. She had experienced depression and anxiety in the past, but in the past year she started waking up feeling defeated, finding it difficult to leave the comfort of her own space. The feelings would linger until she was overwhelmed by anxiety, shame and uncertainty. For days, then weeks, she would wake up like this, distressed by the idea of interacting with others. She had seen therapists before for depression, but to little effect, so she coped through destructive behaviors, including unhealthy drinking habits and deceit, until this May her friends intervened.

Brody said that her friends and other members of the community held space for her, letting her express the fear and shame she felt. They encouraged her to seek treatment with a therapist at the local branch of Meridian Behavioral Healthcare Inc., a statewide mental health facility.

“These resources have been very helpful for me, but I think what has been most helpful was how available others were to me,” Ali wrote in an email. “They sat with me, they heard me, and they believed in me. I think that without them, I would not be where I am now.”

menthealth1Brody said she falls into the same patterns sometimes, but that through the help of the community and other resources she began to recognize her behaviors and felt empowered to change them. She said she now feels more able to engage in healthy relationships; she feels calmer, happier and more present, and that she is in a place where she can grow with intention and self determination.

Alexis Henderson, who in 2014 founded local peer support group Peer Connect, said that any time she feels sick, she finds herself pulling away from others, retreating into isolation. Since she was 15, and for the past 15 years, doctors have offered various diagnoses — everything from bipolar disorder to obsessive compulsive disorder — and medication. She’s been in and out of psychiatric hospitals. But she said what helps her, despite experiencing intense social anxiety, is sharing with other people.

“There’s a sense that I lose myself every time I start feeling sick,” she said. “When I do finally reach out to other people, I turn around much faster. I start doing more, being more active. I find that I need a shift in perspective, and being confident and happy and my true self.”

Reid Schreiber, another member of Peer Connect, said that engaging in peer support helped him as well — but the process was slow. When he started going to the group meetings, he simply said, “My name is Reid, and I’m still alive.”

“But after volunteering a second time, I actually took the risk and opened up,” he said. “And each time you open up to somebody else about what’s going on with you, I feel like you can heal a little bit more.”

The respite, still unnamed, will be run entirely by a small staff of trained peer specialists, with help from other peers in the community who can lead support groups and programs. Schulman and Poulette said it will have a home-like environment with moments of activity and opportunities for solitude–and all of it will be available for free.

The respite aims to be a place where people can go to get away from stressors, said Jim Probert, psychologist at UF’s Counseling and Wellness Center and vice president of the board for the respite. There would be a few rooms available for short-term stays, as well as programming throughout the day. Any services provided at the respite would depend entirely on a person’s needs.

“It’s up to them completely,” said Poulette, who was recently hired as the respite’s first peer specialist. “If they need to sleep for 72 hours and not get up, cool. If they need to just sit in their room and have someone make them food for a couple of days, then that’s cool too.”

According to Phil Schulman, director of the respite, only 15 peer-run crisis respites exist across the country. In 1998 he helped start and run one of the first of these in Essex County in New York, and he said the coming house will be more explicitly community-oriented.

Respites are also created as an alternative to the way some police officers, doctors and others handle those in crisis. For example, involuntary commitment to psychiatric hospitals can be a traumatic experience.

“Police are called, people are put into handcuffs, they’re taken into a hospital,” Schulman said. “And if they resist, they might be tackled, they might be forcibly injected with drugs.”

Frank Blankenship, a local liaison for MindFreedom International, a nonprofit grassroots organization that advocates for the rights of those affected by the mental health system, said in his experience with psychiatric hospitalization, even voluntary commitment is not always truly voluntary. He said once when he was taken to a hospital he was told that if he did not commit himself voluntarily, he would be involuntarily committed.

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“It wasn’t pleasant,” he said. “I didn’t understand what was going on. It wasn’t very grounding. You end up on the third floor of the building, and it was like landing on another planet.”

During a person’s first commitment, Schulman said, doctors will often break the news: the condition, mental illness, is chronic, probably requiring a lifetime of medication and therapy.

“Police are called, people are put into handcuffs, they’re taken into a hospital,” Schulman said. “And if they resist, they might be tackled, they might be forcibly injected with drugs.”

Schulman argues that framing mental illness this way, and in such an environment, could be potentially harmful: The experience can make a person feel less confident about navigating the world and more susceptible to becoming overwhelmed.

For Schreiber, the idea of suicide was deeply preoccupying. He couldn’t stop thinking about it; the compulsion would get stuck in his head. Sometimes, he said, everything he knew about himself, his whole sense of self, would become eclipsed by darkness, and in these moments he felt inescapably alone. It felt, he said, like falling into a hole. In his senior year of high school, he was checked into the psychiatric hospital for the first time.

“You have to ask for basically everything,” he said. “It’s kind of like being a small child again, in a way.”

The respite would offer an alternative to this kind of treatment, Schulman said, providing support that is not violent or coercive, in an environment developed to build trust and compassion.

“I like to use the metaphor of the steering wheel,” he said. “When you take the steering wheel away from people, that’s disempowering. So as much as possible we want to keep the steering wheel in people’s hands and ask them, ‘What kind of supports are you looking for? What kind of support have you found has helped you when you’ve been overwhelmed in the past? And what kind of things do you not want?’”

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In the print version of this story, Poulette was misidentified using the pronouns “he/him/his,” which has been corrected to “they/them/theirs.” 

Read our update on the progress of Florida’s first peer respite center.