LEADING THE WAY: CONARD HOUSE
IN SUPPORTIVE HOUSING
At the time Elaine Mikels founded Conard House in 1960, she was no stranger to the stigma and discrimination associated with "different." It was her personal struggle, life experience and social work training that led her to create the first psychiatric halfway house in San Francisco. As an "early adopter" of psychosocial rehabilitation (aka psychiatric rehabilitation outside of California), Mikels sought to create an "atmosphere of normal expectation," including one of recovery, as defined by the individual. This fierce champion of civil rights and social justice led the way.
Today, 50 years later, Conard House is the first organization to introduce the well-established, evidence-based, principles and practices of chronic illness self-management to a unique population--the 500+ residents in our supportive housing. Elaine's pioneering spirit continues to sustain us--clients and staff alike--and to guide our mission--to develop resources to help people self-manage mental illness.
According to some studies, within the decade more than half of American adults will be living with and needing to self-manage at least one health condition. How does it feel to be chronically ill? It makes you dependent, powerless--vulnerable to and fearful of becoming marginalized, isolated and ignored. It can be, in a word, terrifying.
The challenge is to lead a healthy life, a life not defined by chronic illness. Within our large and aging supportive housing population (average age is 52), many struggle with chronic mental illness, as well as physical health conditions and co-occurring substance disorders. Accordingly, our attention has increasingly turned to helping our residents expand their personal capacities for both the prevention and self-management of chronic health conditions. To that end, we developed our Health Education Project (HEP).
Every week, for six weeks, a small group (10-15) of our clients and staff spend two and a half (2.5) hours together--in a classroom. Professional hats are left at the door. Yet everyone is an expert. And clients are the experts on living with chronic mental illness. The group is attending a Chronic Disease Self-Management Program (CDSMP) workshop , developed over 30 years ago by Stanford University for people living with chronic medical conditions, e.g., diabetes, arthritis, heart disease etc. Under the direction of two co-leaders (at least one of whom has a chronic condition), participants are there to educate themselves about the process and practice of self-management, to learn from and support each other's positive efforts to become better self-managers. That's the goal and the measure of success--increased capacity to self-manage chronic illness, from the point of view of the expert who matters, the client.
What does self-management mean? It means developing regular use of the CDSMP's essential building blocks: action planning and problem-solving. It means the ability to make informed choices, to adapt new perspectives, to acquire and use generic skills that can be applied to new problems as they arise, to practice new health behaviors, and to regain and maintain stability.
To date a total of 73 people--equally divided between clients and staff--have completed the six-week basic workshop. Prompted and informed by feedback from workshop graduates, we are now working on an advanced training workshop. The advanced workshop will offer supplementary training for solving problems in areas that our residents described as particularly challenging.
In an era of unprecedented reductions in our public system of care, Conard House use of CDSMP is an effective way to develop personal resources for mental health including, most importantly, hope.
Former board member
"Acceptance respects their illness.
Expectations respect their strength."
Elaine Mikels, 1962
The Conard House Health Education Project (HEP) began in 2008. It is funded in part by a grant from the Mount Zion Health Fund of the Jewish Community Endowment Fund. Additional support is provided by The San Francisco Foundation, the Margoes Foundation and the Michelson Foundation.