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Housing First In Theory and In Practice 

Pathways Vermont has been delivering our Housing First program in communities around Vermont since 2009. As funding has been available, we have added teams to serve additional communities, most recently adding a team in Bennington County in 2022.

This year, we have proposed to the Vermont State Legislature that they consider making Pathways Vermont Housing First a statewide program, as the need is undoubtedly in every community in our state. Vermont now has the nation’s second-highest rate of persons experiencing homelessness. The 2023 Point-In-Time count identified 3,295 individuals experiencing homelessness in Vermont. Vermont has also seen the highest percent increase in persons experiencing homelessness – a 197% increase between 2020 and 2023.

Last year, Housing First Vermont, a coalition of organizations and individuals, was formed. Pathways is a member. We’re sharing their op-ed piece published in January 2024 in various outlets.

Op-Ed Piece:

Housing First Vermont is a coalition of organizations and individuals, including Vermonters with lived experiences of homelessness, working to advance evidence-based policies and best practices to solve homelessness.

Signing organizations and individuals of this opinion piece are as follows:

  • Disability Rights Vermont
  • End Homelessness Vermont
  • Pathways Vermont
  • ACLU of Vermont
  • Vermont Center for Independent Living
  • Vermont Legal Aid
  • Michael Ruggles
  • Brenda Siegel
  • Anne Sosin

Housing First: Evidence-Based Solutions to Homelessness
All Vermonters deserve a safe and affordable place to live, yet rising rents, low rental vacancy, and mounting evictions are pushing an unprecedented number of Vermonters into streets, cars, and dangerous living situations. Children, Vermonters with disabilities and severe medical conditions, veterans, youth exiting foster care and elder Vermonters are some of the many faces of a crisis that has catapulted Vermont into the second highest per capita rate of homelessness in the United States for the second year running and garnered national attention.

Vermonters do not need to accept this. Homelessness is a housing problem, and Vermont’s policy choices have led to skyrocketing rates of homelessness. Many decades of research have shown that the vast majority of people experiencing chronic homelessness can be successfully housed using an evidence-based Housing First approach. Housing First is a federally backed strategy of supporting unhoused individuals and families into housing before addressing other challenges. Cities and institutions employing these proven practices at scale have made dramatic progress in solving homelessness. This is why a diverse group of organizations and individuals, including Vermonters with lived experience of homelessness, came together to create Housing First Vermont. We know that Vermont too can make headway by adopting evidence-based policies and best practices to solve homelessness.

First, we should make a decision as a state that every Vermonter deserves a safe and stable place to live. To achieve this goal, the state should adopt a common framework accompanied by ambitious state targets. Data-driven targets should include the number of Vermonters to rehouse, new non-congregate shelter units utilizing Housing First principles, and new housing units dedicated to Vermonters exiting homelessness. Policymakers should also build on the work of the Legislature in 2023 and require that 30% of all housing units created with state funding be dedicated to Vermonters exiting homelessness.

Second, Vermont should embrace the data-proven practice of Housing First. Robust evidence shows that Housing First is more effective at ending homelessness than conventional approaches. The state can begin this system-wide transformation by investing to bring the infrastructure for Housing First permanent supportive housing to every community in Vermont. In parallel, policymakers should begin to require Vermont state housing and service investments to follow the evidence-based Housing First components outlined by the US Department of Housing and Urban Development.

Third, we must accelerate efforts to house people experiencing chronic homelessness and Vermonters with disabilities, including psychiatric disabilities and substance use disorders. Individuals with disabilities are significantly overrepresented among people experiencing homelessness, face steep barriers to exiting homelessness, and may be more likely to face eviction as a result of their disability status. Many studies have demonstrated that most people, including those with psychiatric disability and substance use disorder, can be successfully housed and stabilized in housing. As an immediate priority, Vermont policymakers must ensure all homelessness policies, implementation, and investments use the Americans with Disabilities Act (ADA) definition of disability.

Under the Olmstead decision, people with disabilities have the right to equal access to emergency housing and to receive care, including for psychiatric disability, in the least restrictive setting. Policies to rehouse vulnerable Vermonters must be accompanied by eviction prevention policies and practices consistent with Housing First and the Americans with Disabilities Act. Evicting people struggling with substance use disorder and psychiatric disability only fuels the dual crises of overdoses and unsheltered homelessness in communities across Vermont.

Fourth, Vermont must reimagine its approach to supporting Vermonters experiencing homelessness as it invests in permanent solutions. Many studies on the use of motel-based shelter have added to evidence that non-congregate shelter is superior to conventional congregate shelter. The state should expand its supply of non-congregate shelter in line with this growing body of data. Interim housing, or shelter, should be designed as a shuttle to permanent housing, versus a revolving door that leaves far too many cycling through dangerous living arrangements, emergency rooms, and the criminal justice system at great risk to themselves and cost to the public.

Finally, Vermont must reject harmful and ineffective practices that are not supported by evidence or consistent with the Americans with Disabilities Act. Research does not support the use of encampment sweeps, camping and panhandling bans, asylums, forced institutionalization and treatment, use of congregate shelters, or conditioning housing or shelter on participation in required services. Many of these practices not only fail to solve homelessness but also impose significant costs and impacts on communities. Policies and practices for shelter, permanent housing, and supportive services must use evidence-based practices grounded in dignity and choice.

Vermont’s emergency of homelessness is not inevitable. Our community members and neighbors should not have to suffer any longer without safe and stable housing. We know that we can make progress on this crisis if we follow the science on best practices to solve homelessness. Choosing to solve homelessness makes our communities stronger for all Vermonters.

Vermont Judiciary Commission on Mental Health and the Courts First Annual Summit

*This blog post is an adaptation of a speech given by Alexander Ferguson, Training Specialist at Pathways Vermont, during the Summit.

I am grateful for this opportunity to be here today and have the privilege to speak with this group of leaders. I have worked in peer support for the past decade. I come here as someone with raw life experiences which I have found to be my greatest asset when it comes to this work.

I’ve learned through my practice of peer support that this work is truly about shifting narratives, so I want to begin there: there is a widely held belief that when someone does something harmful, disruptive, or destructive, this is the result of some “problem” that’s organic to the person. Thus, the person is defined by this “problem.” When a person is convicted of a crime and labeled a criminal, that has an impact on how they understand themself, how their community members interact with them, and how they move through the world from that moment forward. We have an opportunity to change the approach, to shift this way of thinking and instead recognize that when someone does something harmful, disruptive, or destructive, this is actually a symptom of a social problem. People, their choices, and their actions cannot be decontextualized from what’s happened to and around them. When someone is in crisis, we have a choice: we can control and label them, or we can support them to navigate their experience, take accountability for their actions and any harm they’ve caused, and figure out sustainable ways to be in community.

Within the context of individuals who are experiencing mental health challenges or crises, it is sometimes the response of providers to require treatment, which may include risk assessments, institutionalization, incarceration, medication, and therapy. The goal of these interventions is typically to “stabilize” or “normalize” someone’s behavior based on social norms. This process is often lacking empathy, validation, curiosity, and cultural awareness. It is unreasonable to expect every human being to respond gracefully to traumatic events. We can’t expect everyone to fit into the mold of what we believe a “normal” human being should look like, think like, or behave like, especially when these ideas of “normal” can often exclude many of us. Have you ever experienced a crisis or had a tough time and expressed yourself in ways that just didn’t make sense to those around you? Have you ever had a loved one express themself in ways that didn’t make sense to others?

It’s not as simple as “this person has done something harmful, disruptive, or destructive and we need to control them” – we have to ask, why has this person done something harmful, disruptive, or destructive? What happened to them? What is their cultural context? How did they learn to move through the world? What of their needs aren’t being met?

James Baldwin said, “Any real change implies the breakup of the world as one has always known it, the loss of all that gave one an identity, the end of safety.”

When someone’s own conception of safety has been so thoroughly broken, we inadvertently do them harm and an injustice if we impose our conception of safety onto them. While it’s important to prioritize community safety, it is also important for us to remember and recognize the impacts of collective trauma on marginalized communities. Important to question the narrative that we are telling and that is being told to us. We need to become more conscious of when biases, judgments, and assumptions play into our discomfort with the way in which someone is expressing themselves. The way in which an upper class middle aged white person experiences grief or loss could look different than a lower class black youth. Not everyone’s definition of trauma looks or feels the same.

I would like to share with you a story from my life. I was 19 years old, living in New Jersey and working at a liquor store. I had some struggles with substance abuse and had a group of friends who weren’t the best influences. My family struggled to communicate with me. I began to get into the party scene and started hanging out with some rough characters. Long story short, I found myself with a fractured jaw and concussion after getting into a fight at a party. My bosses and family questioned my injuries. My story was that I fell down the stairs – nobody really believed me. My friends were pushing me to get revenge, even offering to help me do it. Meanwhile my family pushed me to tell them what really happened and then gave me some ultimatums in terms of changes that needed to be made in my life. A few local police officers also started to question me. I really didn’t find any of these approaches helpful, but I knew something had to change. My mind was in a dark place and I wanted revenge on the people who hurt me.

Although still in shock and recovering from a fractured jaw and concussion, I decided to get my haircut at the local barber. While I was in the chair he began his usual routine and asked if I wanted a different style or just a regular shape up. We had an interesting conversation about music, life, and education. He asked me what my goals were for the next year. Where did I see myself one year from now? I told him I was interested in going to college in New York City. While he was trimming the back of my head he then asked me about the bruise behind my ear. “Look like you took a pretty hard hit kid?” I admitted that I had gotten into a fight a few days prior. I said I wasn’t worried about it and that it would be taken care of soon enough. The barber told me he grew up in this neighborhood and had been in some tough situations before. He said that the same guys that jumped me most likely were sitting in the same chair I was earlier this week. He gave me some perspective that most likely these guys were going to end up in jail or dead. He said it sounded like I had other options in front of me and I had to make a decision for myself.

That conversation with the barber supported me towards making the decision to go to college. He wasn’t a counselor or therapist, just another human being sharing his experiences with me. Shortly after that I went to admissions at The Institute of Audio Research & Technology, applied, and got accepted. Next I quit my job at the liquor store and cut ties with my old friends. Looking back, that conversation with the barber changed my life. His non-judgemental approach and the connection he forged with me is what I needed to make the necessary changes in my life that brought me to where I am now.

When thinking about ways in which people cope with trauma and try to meet their needs, we must understand that people will sometimes make choices that don’t make sense to us, that feel dangerous or unsafe to us. It’s not upon us to control people or change their choice. For example, we must understand and accept that licit and illicit drug use is a part of our world. People use drugs for a variety of reasons: to manage or numb emotional or physical pain, to facilitate connection to self and others, to survive a world that doesn’t feel survivable, to feel joy, to feel love, to feel alive. Rather than condemn, criminalize, or ignore drug use, we can choose instead to minimize the harmful effects by practicing peer support. We can meet people where they are, acknowledge their pain and trauma, engage in open and honest conversations about the risks and benefits of drug use, and not seek control or deny their autonomy. That’s what peer support is about at its core, which brings me to an important point:

I believe a crucial part of our conversation today should be about who’s version of peer support are we providing? Which communities are we serving? I often look around at whose voices are at the table and think about who we are missing. The version of peer support that I continue to learn, practice, and teach is based on recognizing each person as the expert of their own experience – meaning that we still preserve someone’s autonomy and choice in what type of support they are looking for. This incorporates a process of us building relationships that look and feel different. Exploring the stories and narratives we tell ourselves and have been told. Shifting that narrative from “what’s wrong with you?” to “what happened to you?”

So often within systems we are given labels and then forced to fit in these boxes. It’s time for us to think outside the box. Let us remember that many of these systems were originally designed and created in order to oppress marginalized communities. I want to give credit and recognition to all peer support workers in Vermont doing radical and amazing work. A lot of this work in general goes unheard and unseen. I feel it is also important to bring attention to the privilege within treatment and access to services. One person might get a bed at peer respite while another will end up being arrested, then forced to be hospitalized. There are so many people who continue to struggle without any support at all. We need to find ways to break down the barriers and walls together so that mental health services in general can be more accessible.

We can do this by creating more options and opportunities such as peer respites, peer support warmlines, community centers, and peer support groups. These alternatives provide options to individuals like myself who would not otherwise seek out traditional services. This will help fill those gaps within our system after someone is released from incarceration or on a waiting list for therapy or getting stuck in emergency departments because there’s nowhere else to go when experiencing a mental health crisis. These alternatives allow people to remain in their communities while receiving meaningful services and support rather than losing their community connections and autonomy. These alternatives are also less expensive than institutionalization or incarceration – they strengthen communities while decreasing financial burdens.

At Pathways Vermont, we offer alternative mental health services through which we seek to minimize coercion and foster connections through our shared experiences. We operate the Vermont Support Line, a statewide warmline for Vermonters seeking connection and understanding. In Burlington, we have the Pathways Vermont Community Center, where staff connect with community members via drop-in hours, peer support groups, and community engagement. We also have Soteria House, a 5-bed alternative residential program for people experiencing extreme states or first-episode psychosis.

We also firmly believe that housing is a human right. We know that stable housing makes it more possible for people to move through times of crisis. For the past thirteen years we have been working to end homelessness in Vermont through our Housing First program. Since we began providing services in 2010, Pathways has housed nearly 1400 Vermonters across the state. Through our partnership with the Department of Corrections, we’ve housed 340 people leaving incarceration. The majority of people we’ve housed self-report a history of trauma.

Across all of our programs, we practice peer support and harm reduction through our principles of humanity, authenticity, collaboration, humility, curiosity, and hope. We honor individual choice and self-determination and regard each person as the expert of their own experience. We resist biases, judgments, and assumptions. Here’s an example: when someone is experiencing substance use challenges, a widely-held assumption is that their substance use is the “problem” and that sobriety is the answer and must be the focus of their “treatment.” However, this approach sometimes ignores why someone is using substances in the first place.

We understand that substance use is often the solution to a problem or challenge, so our approach focuses on understanding a person’s experience and the way they’ve learned to make meaning. We get curious about their life, their journey, and how they’ve learned to survive. We empathize with their struggles and talk openly about our own. We build collaborative, trusting relationships where we can have open and honest conversations about their self-defined goals and desires for their life. We ask about what’s working for them and what’s not working for them. We celebrate their wins and support them through their challenges. Through these conversations, we make space for possibilities – opportunities for growth, change, and transformation.

We practice this approach because many of us at Pathways know what it’s like to be disregarded as the expert of our own experience, to be denied opportunities for growth and transformation. We employ people with lived experience across the agency in service roles, admin roles, and leadership roles, including our Executive Director and several members of our agency leadership team. These lived experiences include trauma, intense emotional distress, suicidality, psychiatric oppression, challenges with substance use, incarceration, justice-involvement, food insecurity, and homelessness. Many of us have endured various types of trauma including marginalization and systemic oppression. Some of us have been denied our autonomy and the right to make our own choices, to make our own meaning.

I’ve worked alongside case workers, clinicians, psychiatrists and law enforcement while supporting community members during challenging moments. Providing basic yet fundamental human connection, building trust and understanding with each other. I have found that while building these connections there are still so many individuals that fall through the cracks of our systems. Being in community with people and building rapport is how we develop and maintain relationships. Peer support is a way of learning, exploring, and making meaning out of life’s challenges. Times of crisis are crucial points in someone’s life, opportunities to grow and transform. I have experienced and seen other services quickly make judgements and assumptions during these crucial moments – they label or lock up or shoot first and ask questions later.

At a time in my life where I was struggling to find hope, a friend shared this poem by Hafez with me that I wish to share with you all here today:

The Heart is right to cry.
Even when the smallest drop of light, of love, is taken away.
Perhaps you may kick, moan, scream in a dignified silence.
But you are so right to do so in any fashion,
until God returns to you.

There are moments in life where we struggle to make sense of what happened to us. Moments where things change and have an impact on how we see the world, like recent events where flooding wiped out thousands of homes and businesses. We need to make more time and hold space in order to be able to process these traumatic events. Perhaps that means kicking, moaning, and screaming in the middle of this room right now? Through this process we might find ways to rebuild which might look different than the way it did before. Just as we are coming out of those hard years of the pandemic and attempting to return to what normal life looked like, we are seeing that some things may never be as they were. Now is the time for us to find new ways of thinking and being.

Motels and Homelessness: How Does Pathways Vermont Weigh In?

People ask my opinion on the motel situation in Vermont. For those not familiar, during the pandemic, Vermont sheltered folks experiencing homelessness in local motels. Federal funds made this possible. As federal funds dwindle, the question of what to do about the motel program has been the focus of many.

Since I am in the business of ending homelessness, it makes sense that people would ask me what I think. I am not, however, an expert on shelters or transitional housing. 

What I am an expert on is permanently ending homelessness for individuals and families. 

Vermont also has expertise in permanently ending homelessness. In 2009, the Vermont Department of Mental Health collaborated on a five-year federal grant to bring the evidence-based practice of Housing First to Vermont. Since then, my organization, Pathways Vermont, has been ending homelessness for individuals and families non-stop. Well, at least as much as we are funded to do so. 

Pathways cannot end poverty, racism, or the housing crisis. We cannot obliterate the opioid epidemic or mental health challenges. What we can do, person by person, family by family, is end their bout with homelessness and provide them with wrap-around services tailored to their individual needs. 

Pathways has an 85% retention rate– meaning 85% of folks stay housed and don’t return to homelessness. For those not familiar with retention rates, that is an incredibly high percentage.

We are experts at permanently ending homelessness for individuals and families.

We want to do more. 

The 2023 Point-in-Time Count, a report released in June by the Chittenden County Homeless Alliance and the Vermont Coalition to End Homelessness, showed that, statewide, this year’s count registered 3,295 people experiencing homelessness, an 18.5% increase over the prior year.

When the Vermont Agency of Human Services put out a call for funding ideas, we submitted this letter. We asked for more money to expand our Housing First teams around the state.

We offered a few options, including the one that makes the most sense to me — an expansion of Pathways’ permanent supportive housing into every Agency of Human Services District in the state, as well as strategically expanded capacity in existing communities to address unmet needs. This would cost just under six million dollars. 

I am going to answer the top three questions I invariably get, in case you may have them, too:

  • Since the housing market is so bad, how will you be able to find units?

It is true that the housing market is awful, and it is taking us longer to find units for the folks we work with, but we do find units. We have a network of over 150 landlords around the state that partner with us, as well as partnerships with local housing trusts and housing authorities. In the past year, we housed 138 people in our Housing First program. 

  •  There are so many open positions in human services; how could you expand services? 

Pathways has also struggled with staff shortages, but our shortages are not nearly as bad as most other agencies. We have a highly dedicated, mission-driven team that is laser-focused on ending homelessness. Once you have witnessed a person who has experienced homelessness take their new key and open the door to their new apartment — there is no greater joy and relief for both the new tenant and the staff involved in manifesting that particular miracle. 

  • If your program is so good, why is there still homelessness?

Ending homelessness (and keeping folks housed) is a three-legged stool. One leg is apartments, one leg is a rental subsidy, and the third leg is the support services needed to assist people with a variety of complicated life challenges. We are very good at ending homelessness on an individual level. We need to scale the resources in the 3 legged stool to meet the need.

What do I think about the motel situation? I think we need to invest our state dollars in permanent solutions: affordable housing, and bring Pathways Housing First permanent supported housing services to scale for Vermont. 

Why I Am Marching at Mad Pride This Saturday

I am out in the open about my experiences with mental health challenges. I think that is why so many people tell me about their own experiences of mental health challenges. This past year I have lost count of how many people have told me in hushed tones that they have, or have had, mental health challenges but that they cannot talk about it in public, and they definitely cannot talk about it at work.

These are adults in 2023. People who work in offices, corporations, hospitals, schools, tech firms, social service agencies, non-profits, therapy, real estate, and in state jobs.

What kind of culture do we live in that we shame people into concealing a part of their life? A culture where people feel if they are open about their experiences of mental health challenges, that they will be seen differently, treated differently, and discriminated against.

What kind of message are we sending our children about experiences they may have in their lifetimes? Shame is one of the most potent negative emotions, with sometimes lethal consequences.

I am not saying people should feel bad about not sharing their experiences or should do anything that makes them uncomfortable. They are merely reading the room. They are making a sound choice based on observation and experience.

What I am saying is that we need to change our culture. Those of us who are able need to stand up and say it is ok to acknowledge our mental health challenges as part of our life journeys. If we don’t have mental health challenges, we must stand up for our siblings, parents, children, neighbors, and co-workers.

We need to stop using language about experiences of mental health challenges like “crazy,” “mad,” and “insane” as slurs. Using that language negatively adds to our culture of shame.

Those of us who have experienced discrimination, bullying, shame, coercion, human rights violations, and being silenced because of our human experience of mental health challenges are reclaiming the word “mad” as a symbol of pride and are publically proclaiming it.

I am marching at Mad Pride this Saturday because I want to live in a world where our human experiences are not categorized as “worthy,” or “unworthy,” “normal,” or “abnormal.”

I am marching in Mad Pride because people with lived experiences of mental health challenges currently have very little political power. We are tokenized at best and often excluded from decision-making tables. Our opinions about where state and federal dollars should be spent to support our community are met with patronizing nods and ultimately ignored.

I am marching at Mad Pride this Saturday because I want children to know that experiences of mental health challenges are a part of many, many people’s lives and may be part of theirs too. Those experiences can be difficult and scary. And they can also be transformative, take you in new directions, make you more empathic and more resilient, and you may see the world in new and more interesting ways. And you will not be alone. You will belong to an amazing collective community of artists, scientists, philosophers, teachers, students, social workers, lawyers, mothers, fathers, siblings, athletes, technicians, musicians, dancers, doctors, and so much more.

I am marching in Mad Pride this Saturday for me, for you, and for all of us. I hope you will join me.

___________________________________________________________

LOGISTICS:
The march begins at 1 PM from the Hood Plant parking lot in Burlington, Vermont. Marchers will walk down Church Street, through the Church Street Marketplace, to Pearl Street, and into Battery Park.
There’s a formal program scheduled from 2 PM to 4 PM at the Battery Park bandshell, including music, spoken word, and speeches. Lunch will be provided, and the first 100 participants will receive free commemorative t-shirts.
Confirmed speakers to date include Robert Whitaker, author of Anatomy of an Epidemic and Mad in America; Sera Davidow, Director of the Wildflower Alliance in western Massachusetts; Wilda White, founder of MadFreedom, Inc.; Spoken Word poet Rajnii Eddins.

Why Our Board Supports Pathways Vermont!

Wright Cronin:

“I wholeheartedly believe Pathways is one of the most exciting, innovative and effective organizations working to end homelessness and improve mental health care in the country. I am so grateful Vermont has a resource like Pathways throughout its counties and it brings a lot of meaning and joy to my life to be able to directly support their work to care for our community. Getting involved and learning more about their approach, practices and results in Vermont has changed my outlook on the future too, giving me real hope that our society can develop and implement empathic and effective solutions to address chronic problems.”

 

John Rogers: 

“I give of my time, talent, and treasure to Pathways Vermont because their Housing First model is making a powerful difference in the lives of Vermonters.  I’ve seen firsthand Pathways make a difference with friends I know that have been extremely hard to house.” 

 

Maura Collins:  

“I run the state’s largest affordable housing funding agency and so volunteering and donating to Pathways Vermont felt like the “right” thing to do. But this all became much more personal when my family member was diagnosed with a severe mental illness and began to detach and deteriorate before my eyes. I developed a new appreciation for the critical value of Pathways. The team at Pathways Vermont can connect with people in ways few others can. I give my time, energy, and money to Pathways because I watch them save lives – including family members like mine – across the state.”

 

Tim Wall:

“Since joining the board of Pathways Vermont in 2018, I have seen firsthand the incredible impact this organization has in providing support to individuals struggling with mental health and homelessness. Every day, we encounter people from all walks of life who are facing these challenges. Whether it’s a close friend, family member, or even a stranger, we are all affected by the toll that these struggles take on our communities and loved ones. That’s why I believe supporting organizations like Pathways isn’t just the right thing to do, but a necessary step towards creating a more compassionate and equitable society for all.”

 

Peter Toshev:

“I volunteer for Pathways to support the team at Soteria who provide state-of-the-art care for people in extreme states and who I know execute with great discipline, and little recognition, on their mission. Few Vermonters know of the innovation in mental health services championed at Soteria and so I push for broader awareness and adoption of the program’s practices. Many of the current approaches in psychiatric care are very narrow and crude and in the work at Soteria we are seeing new steps taken to increase the flourishing of the human mind!”

 

Sara Mahon:

“I volunteer and support Pathways because when some of our community members are struggling more than others, it is important to take care and support our people, especially with basic human needs. Letting people have choices is so important to healing and helping. I can’t quit Pathways because it is a part of who I am now.” 

 

Thank you to our board for your unwavering dedication and passion for Pathways Vermont! Your support has been instrumental in helping us advance our mission of ending homelessness and providing innovative mental health alternatives.

Peer Respites: A Vital Community Resource

In early 2018, I was in the midst of a deep darkness and struggling significantly to move through the day-to-day experience of being alive. Pretty much everything felt like a chore: I was angry about having to brush my teeth. Getting dressed for winter and having to deal with snow made me want to scream and break things. Holding a conversation for any amount of time felt absolutely torturous. I didn’t want to feel any emotions and I didn’t want to talk about emotions, mine or anyone else’s. In short, I was mutinous about being alive and I wanted very badly to stop existing. 

Back then I worked as a peer support advocate at a community mental health agency and spent the majority of my days supporting people in emotional distress. You can probably understand why my work didn’t feel restorative, energizing, or particularly possible during that time (though it had certainly felt that way before and did again after). Outside of work, I struggled to maintain my relationships with friends and family; I couldn’t keep up with communication and when I did communicate, it wasn’t authentic to my actual experience. Most importantly, I’d fallen short in my relationship with myself: I’d become so focused on trudging through the muck of each day that I’d lost myself. I saw a stranger in the mirror. 

I knew that I needed to create a break from my life in order to keep living: the only way I could reconnect with myself and rebuild my resilience was to take an actual and intentional pause. 

In communities across our state (and the country), when people want to take this particular kind of break or pause, there aren’t a whole lot of options. Many people who are in crisis end up in psychiatric institutions where they’re made to surrender their cellphones, their shoelaces, and, quite often, their dignity in the name of “getting better.” While some people do benefit from their experiences in psychiatric institutions, by and large psychiatric institutions don’t truly meet the diverse needs of community members in crisis. A psychiatric institution is a place to go when there’s nowhere else to go and, sometimes, a place that people are forced to go by service providers. 

Community members in crisis need and deserve community resources that afford them the space to create their own pause, to build their own respite, to facilitate their own healing, growth, and transformation in self-designed ways, and to authentically connect with others. This is what I needed. To truly take a pause from the stressors in my life and reconnect with myself, it was imperative that I maintain autonomy and choice and that I receive support from people who knew what it was like to navigate darkness. 

One such community resource is a peer respite. Peer respites utilize a holistic, person-centered, peer approach to supporting people who are experiencing intense emotional distress. Peer respites are homelike environments, non-institutional by design. 

In Vermont, we currently have one peer respite, Alyssum. Located in the middle of the state in Rochester, Alyssum is a two-bed residential crisis respite and hospital diversion service funded by the Vermont Department of Mental Health; it’s peer run and staffed by peer support workers with lived experience. Luckily I knew about Alyssum. I reached out to them and they said they’d take me as soon as they had an opening. I was fortunate to have plenty of paid time off and an understanding supervisor who supported my decision to care for myself. Within a week, Alyssum had an opening and I took it. 

I drove myself from Brattleboro (my home at the time) to Rochester on a Tuesday afternoon in late February. After completing the intake process, which was mostly just a conversation about my current despair and what I hoped to get out of my time at Alyssum, I settled into my private, cozy room, put my clothes away in the armoire, plugged in my phone charger, arranged my journal and a couple books I’d brought on the nightstand. That evening a staff person made a very tasty dinner that we ate together, and, after considering our options, we watched a movie on a comfy couch in the spacious living room. I wasn’t yet ready to talk at length about how I was feeling and no one pressed. They simply were there with me, being with me while giving me space. That night I felt more present and connected to myself than I had in a very long time. 

In the 11 days that I stayed at Alyssum, I unpacked why I’d ended up needing a pause from my life, why I’d been feeling so deeply disconnected from myself and the world around me. Each staff person I connected with supported me in ways that we mutually agreed upon: someone took me to breakfast in a nearby town and made multiple delicious meals that we shared together; a couple people smashed plates and bowls with me at a quarry while we screamed into the pit together, releasing anger; one person helped me pick the font for a new tattoo (lyrics from a meaningful song); one person supported my creation of a vision board, highlighting the areas of my life where I wanted to dedicate my energy (this particular activity is, in part, how I ended up several years later becoming Director of Training & Advocacy at Pathways Vermont); one person made me a grilled cheese sandwich that I still think about sometimes (I love sandwiches); several people laughed with me, cried with me, meditated with me, hugged me, watched movies with me, and sat with me in quietude. 

While at Alyssum, I also supported myself in many of the ways that I know work for me. I spent several afternoons at a local café/bookstore down the road. I wrote so much that I filled a small journal. I read. I painted in the basement. I drove to Montpelier and got a new tattoo. I cooked. I rested without interruption. I screamed and threw rocks into a river. I connected with other guests. Though I kept texting to a minimum (my own limitation for myself, not anyone else’s), I had my phone on hand to maintain connection with my community and loved ones. 

I sought a respite because I’d found myself in a deep crisis of meaning. I needed space to rediscover myself, to figure out a way forward, to focus my energies on building a life that felt livable and sustainable to me. I needed to feel held and loved by others, to get reacquainted with holding and loving myself. And, most importantly, I needed to be the captain of my own ship, the designer of my own experience of rest and healing. Alyssum gave me this. Peer respites can and do give this space to our community members when they need it. 

Peer respites are a vital component of our system of care and in Vermont we only have one two-bed respite – this isn’t enough to meet the diverse needs of our communities or community members in crisis. Additionally, peer respites relieve pressure on emergency departments and emergency services by diverting community members who are experiencing mental or emotional distress, considering suicide, or struggling with substance use. 

Pathways Vermont is currently working to establish more peer respites across the state of Vermont, starting with a pilot of a 5-bed respite in Burlington. We believe deeply in the power of peer support and utilize this approach across our existing programming: Housing First, Supportive Services for Veterans & Families, FACT (Forensic Assertive Community Treatment), Soteria, Vermont Support Line, and Pathways Vermont Community Center. As a statewide peer-led peer support agency, we feel that we are uniquely positioned to establish and sustain multiple peer respites. To learn more about our proposal and plans, you can review this presentation or reach out to the following Pathways Vermont staff:

Hilary Melton (she/her), Executive Director: [email protected]

Lindsay Mesa (she/her), Assistant Director: [email protected]

Maria Moore (she/her), Director of Development & Communications: [email protected] 

J Helms (they/them), Director of Training & Advocacy: [email protected]

 

What Does It Take To Change?

What does it take to change?

I’ve thought a lot about change, why it matters, and how it happens.

Take running. I was never a runner. I never played team sports in school and didn’t consider myself particularly athletic. For years I believed I couldn’t run; well-meaning doctors told me my particular set of chronic conditions would be aggravated by the repetitive movement.

I started running in my early twenties after I lost my dad to suicide. My dad was a runner, and I thought maybe in the experience, I could find a way to connect with him. At first, it did not work. For a long time, really, I was breathless, pushing too hard, too fast. I had to slow down. It felt infuriating to see a future state but have to accept how long it would take to get there. But eventually, painstakingly, step by aching step, and only in hindsight, I realized running had become a permanent part of who I am.

So, what does it take to change a system?

In 2010, Pathways Vermont partnered with the Vermont Department of Corrections to pilot a Housing First program for people exiting incarceration in our state. It made sense. People who have been incarcerated are far more likely to experience homelessness than people who have not been, cited in In Focus. Incarceration and Homelessness: A Revolving Door of Risk.

In turn, people experiencing chronic homelessness are often caught in what we call the “institutional circuit,” cycling between our most expensive social systems, including psychiatric institutionalization, emergency care, and incarceration.

In Vermont, it costs $260 a day for a bed in prison. Our Housing First program – for both services and housing subsidy – runs around $53 a day. When we piloted this program, we had a growing percentage of people in our communities being held in prison past their release date for lack of housing: people who had served their time but lacked the resources to return to their communities. This partnership seemed like the right thing to do.

We asked: what would it look like to in-reach? To connect with people while incarcerated, rather than waiting for outreach to happen once they likely entered homelessness. Could we adapt Housing First to meet the needs of folks involved with Corrections?

We started with a small pilot program: 10 people, one community. We found independent apartments for folks in our communities, and we leased them ourselves, subletting to our program participants. This gave landlords some added confidence, and it allowed our tenants to navigate returning to the community, knowing their housing would remain secure should they temporarily need to be away. We built a community-based support team using a modified Assertive Community Treatment model. We saw people frequently and worked to meet them where they were holistically and comprehensively.

Like anything, it was beautiful and messy, and we learned a lot. But overall, people came out of incarceration, and they stayed out – and they stayed housed.

One of the most confounding and interesting parts of the project was our funder and partner: the Department of Corrections. At the outset, it seemed like an unlikely match. Pathways and Housing First are so deeply entrenched in the values of individual choice and autonomy we often ran the risk of being viewed as too permissive or ‘giving something, asking nothing.’ How was DOC viewed? Well, pretty much the opposite.

But for the program to work, it required we work closely together – probation and parole officers, caseworkers in facilities – they became our partners. We met frequently: joining our participants at their meetings with their probation officers, holding interagency team meetings, and providing cross-training about how each entity operates and our respective best practices.

And slowly, step by aching step, things began to change.

For our part, we realized quickly that to support people to live in community well, we had to think broadly about what that asks of us. There are social contracts and rules to living in community for ALL of us. For folks working with DOC and under conditions of release, there are undoubtedly more rules, though framing it in that way for folks we served made it more tangible.

As we worked to honor personal autonomy, restore dignity, and reduce shame, we encouraged DOC to learn more about harm reduction and to rethink their understanding of risk and safety. Through conversations and shared experiences – we engaged endlessly about how to best support each other. Together, we grew our muscles for tolerating discomfort and envisioned differently what it looks like to stick with people in a truly restorative way.

In 2021 DOC engaged in justice reinvestment work to restructure elements of community supervision and housing support with the following vision: All Vermonters under supervision have the housing resources and relationships they need to thrive and keep themselves and communities safe. Throughout our partnership with DOC, we have seen their values shift in real-time. With their financial support, we expanded our program to 9 counties across our state and now serve over 100 individuals in independent apartments across the state at any given time. Now, the main resource for people exiting incarceration in our state is Housing First.

It is Pathways’ belief that a strong investment in people – both interpersonally and systemically – reduces their reliance on expensive social systems and supports a fuller community for all. Our ultimate hope is for massive change: communities without carceral institutions. A recent Vermont Digger article highlights some of the possibilities, many driven by the Department of Corrections itself. For now, through our ever-evolving relationship with the DOC, we are continuing to learn together and incrementally change the system from within. Through the power of human connection and mutual relationships between Pathways, the DOC, and the individuals we support, we are able to build genuine, dynamic relationships that are transformative for all of us. One step at a time.

Soteria Vermont: A Practical Guide To Peer Support in a Residential Setting

The following is excerpted from a chapter that appears in Humane Alternatives to the Psychiatric Model, edited by Eric Maisel and Chuck Ruby.

There is a long history and extensive literature justifying the isolation, objectification, and of course incarceration of people labeled “mentally ill.” What we need to understand is that when we build prisons we imprison ourselves, when we isolate others we isolate ourselves. If we want to free ourselves we must free each other. Moving from “doing to” to “being with” is about liberation and relationship. Soteria Vermont is an experiment in mutual liberation and an invitation to collective healing.
Peer support emerged from the natural camaraderie experienced among the institutionalized and those labeled as mentally ill. It is a movement to reclaim our experiences from powerful institutions that have worked to define and control our minds and bodies. Peer support advances the perspective that our lives and experiences are not illnesses to be cured but challenges to be met with creativity and courage, as well as opportunities for personal growth. Furthermore, we propose that intentional and compassionate communities of peers are most supportive for individuals in crisis.

Although the origin of peer support is rooted in the community of psychiatric survivors, Soteria Vermont has differentiated between “peer” as an identity and “peer support” as a practice. The insights and direction provided by those with lived experience and psychiatric survivors can inform all who provide care. All those who choose to adhere to the practice and values of peer support may work as a peer. We can all connect with one another through our shared human experience. Much of the human experience is universal, we all want to survive and even thrive in a challenging world. The desire to understand ourselves and others and to use this understanding to move toward empowerment and self-mastery is a shared human project. Everyone’s experience is valuable. As peers, we meet each other with respect and compassion. As peers, we ask one another, “What do your experiences mean to you?” As peers, we do not pretend to know what is best or right or possible for others. As peers, we work together to move forward with a deeper understanding.

The intentional relationship: New boundaries, new potential

Soteria Vermont is one of the first organizations to offer Intentional Peer Support as the primary support in a residential setting with an extended time frame of three to six months. At Soteria, there are no clinicians or clinical oversight. This has given us an opportunity to explore more fully the potential of these relationships as well as identify specific challenges that emerge.
As peer support practitioners, we are not therapists and we are not friends. We have defined a relationship that is mutual and genuine but maintained within specific professional boundaries. Staff engage residents as equals. Staff share from our personal experiences with the intention of offering narratives of wellness and resilience. Staff do not share personal contact information or social media. Staff do not spend time with residents outside of their scheduled work hours. Our goal is to have focused, short term relationships that have lasting impacts.

A clearly defined and limited relationship can become a reliable container for inquiry and exploration of difficult material. Relationships that are circumscribed in time and free of the obligations and complications of friendship or romance open a new space for sharing and exploration of self and other. It is critical that we are clear and explicit about what we are offering because we want people to take advantage of this opportunity and avoid drifting into a casual relationship or one of authority. Peer support places relationship, human connection, and community at the forefront of working with crises.
We build relationships through shared experience. We identify with each other’s experiences and we share experiences in real time together. It is important to be able to communicate who we are and why we are here, both on the organizational level and on the personal level. We are joining people in an intense and intimate moment in their lives. Mutuality can not be achieved without sharing about ourselves. We share about ourselves with these intentions:

  • To normalize difficult experiences and reduce feelings of isolation, guilt, and shame.
  • To model and embody resilience and transformation.
  • To share successful tools we have learned to use.
  • To break down the false dichotomy of “well” and “sick.” No one is completely one or the other and we don’t need to be perfect to have rich and rewarding lives and relationships.
  • To establish mutuality, connection, and trust.

Peer support asks us to form a very specific relationship. This relationship has professional boundaries that are closer than those found in most traditional clinically defined settings. There is a distinct and significant difference between the peer relationship that intentionally provides human connection and a more distanced clinical relationship defined by professional boundaries that can leave all engaged in them feeling isolated and disconnected.

This intimacy is not self-indulgent nor is it something that only psychiatric survivors have the capacity to offer. This intimacy and genuine human connection offers a direct mechanism of support to people in crisis. It is also evident that these relationships provide a value and quality to staff that supports their ability to do this demanding work in a sustainable way. Healthy, positive relationships are supportive to all engaged in them. There is in fact an element of self-care for the practitioner embedded in the peer relationship. We ask staff to engage in a passionate participation with a resident’s experience. We want to become a part of a resident’s experience and collaborators in it.

Four priorities of Peer Support

The four priorities of peer support at Soteria are:

1. Respectful, equal relationship. It is extremely important that we meet people with respect and acceptance. The respect of others directly supports self-respect and self-acceptance. We strive not to just “meet people where they are” but to join in their experience. We want to collaborate in a truly shared experience, which is the genesis of relationship and connection. Positive, authentic relationships are healing.

2. Defining and ensuring success. Success is getting what we need. Everyone needs to be accepted and valued in our relationships and community. We can do this for one another in a consistent and reliable manner. Our goal is to provide residents with interactions that support self-respect and self-esteem. This will mean providing encouragement and compassion as well as drawing clear boundaries and firm expectations. The goal of peer support is to move through difficult experiences toward joy, meaning, and transformation. An interaction or relationship is successful if it connects us to one of these. Adversity and powerful experiences offer us powerful opportunities for personal growth.

3. Normalization. Extreme states are within the “normal” range of human experience and do not make us weird or scary.

4. Personal empowerment. Exploring our experiences with the intention of fostering self-awareness and self-mastery. Engaging in important conversations about identity and narrative. Exploration of relationship to self and others. What patterns of behavior and thought are we perpetuating? What narratives are we maintaining? Where can we assert ourselves and replace damaging behaviors and damaging narratives with behavior and narratives that serve us?

“Being With” in the presence of suffering

It is difficult to be a witness to suffering. This difficulty is exacerbated by the fact that suffering may not always look the way we expect it to. People in crisis may appear to be in a place of arrogance or callousness to others. People in crisis may be dishonest with us. People in crisis may insult, offend, or even physically attack others. It is our job as peer support practitioners to see beyond the immediate situation and understand the context of difficult behavior as an expression of suffering.

It is also important to see beyond the suffering and recognize the whole person that resides in all of us. Whatever behavior is expressed in a crisis may be understood as a person’s reaction to and attempt to cope with an overwhelming experience. Being present with suffering without becoming overwhelmed by it or alternatively becoming callous to it is a difficult balance. Suffering is not alleviated by pity. We can have compassion for others without the condescension of pity. Suffering is a part of the human condition and can be dignified if those around us offer that dignity.

To learn more about Soteria Vermont, contact [email protected] or register for one of our upcoming training sessions:

Soteria: The Power of Human Connection, Wednesday, April 5th, 9am-12pm ET
Soteria: The Power of Human Connection , Wednesday, May 3rd, 1pm-4pm ET

Tolerating Discomfort: Pathways Vermont’s Relationship-First Practice

I have a pretty decent tolerance for discomfort in relationships. In my role as Director of Training & Advocacy at Pathways Vermont, I talk often with staff about the importance of tolerating and even embracing discomfort in relationships with service recipients. After all, discomfort is frequently a precursor to learning, growth, and transformation. And I’ve seen the harm that can be done when people in positions of power struggle to tolerate discomfort in relationships – I’ve seen discomfort become fear, seen that fear then lead to control. 

To illustrate the importance of tolerating discomfort, here’s a story about my relationship with a Pathways service recipient: 

When I was a service coordinator on one of our ACT teams, I supported a Housing First program participant who used self-harm, cutting in particular. One afternoon, we were on a hike (we often went for walks during our time together, Vermont weather permitting) and he told me he’d recently cut using an X-Acto knife. We talked about how he used self-harm as a strategy when his distress became overwhelming (in this case, his feelings about an anniversary related to a significant traumatic experience). He reflected that the cutting was a tool he used to make his distress feel more manageable. I validated his experience and conveyed my appreciation that he had a tool that worked for him. I spoke about my own history of getting tattoos during times of intense distress, how the process of being tattooed reminded me that pain and distress can be transformative.  

He noted that the wound from the cut was long and somewhat deep. My authentic response at that moment was concern that his wound may become infected if not cared for properly; I asked if I could share my concerns with him and he consented. He said that he did not want to have an infected wound. I asked if I could look at the wound with him (he was wearing long sleeves that day and his forearm, where he’d cut, was covered). He consented and lifted his sleeve to show me his wound which, as he’d described, was long and somewhat deep. Together we talked about options for wound care and bandaging. I also offered that, on our way back to his house, we could stop by the store for wound care supplies, though he said didn’t need that support. We continued our hike and conversation for another hour or so, during which we explored the meaning of the distress he was experiencing and talked about various other unrelated topics. 

I believe this experience highlights the values and importance of our relationship-first practice: I trusted him as the expert of his own experience. I acknowledged and validated that he used self-harm as a survival strategy. I shared some about my own experiences with navigating distress. With his consent, I voiced my own concerns about wound care and together we had a mutual conversation wherein I offered support that he declined. I did not try to problem solve nor change or control his experience. My approach was to show up authentically, center our relationship, and, above all, trust him as the expert of his own experience and trust his capacity to know and meet his own needs.

This experience changed my life. My connection with this service recipient changed my life. Together we practiced vulnerability and talked about some of our deepest pains. We talked about our needs, we made meaning together, we trusted each other, and we co-created a relationship that became a transformative space. This was all possible because we tolerated discomfort and focused on the relationship first.

The way I show up to my relationships at Pathways Vermont is deeply informed by my own personal healing and transformation. I haven’t always had a tolerance for discomfort within myself or in my relationships. Like many people, I grew up in a family impacted by various types of intergenerational trauma. My family’s experiences include domestic violence, alcoholism, fatphobia, sanism, and suicide. In addition to being impacted by these experiences, I also experienced homophobia, transphobia, and bullying. 

I believe my parents and grandparents endeavored to do their best with the relationship skills they were taught and yet the impacts of trauma manifested in various ways in my family’s relationships with me:  

I wasn’t taught how to make or negotiate boundaries, how to understand my experience – my emotions, my thoughts, my beliefs, my physical body – as separate and individual from the experiences of others. I wasn’t taught this because my parents and grandparents weren’t taught this. 

I wasn’t taught how to directly articulate my needs or expectations. My family learned to communicate their needs and expectations through passive aggression, by making demands, by indirectly expressing discomfort and disappointment without revealing the source, by suppressing their feelings until an inevitable explosion. 

I was taught to make myself responsible for the emotional wellbeing of others. If the adults around me experienced discomfort and stress, it was upon me to problem solve, to set aside my own needs and feelings to tend to theirs. If something I did upset a family member, I learned to fear the loss of connection unless I did everything I could to appease them. 

I was taught to intuit and anticipate the needs of others. I was taught from a young age to perceive subtle changes in tone of voice and mannerisms and adjust accordingly. I wasn’t taught to believe that the adults around me could directly articulate their feelings and needs to those around them. 

This all means that – in addition to being taught to feel responsible for the discomfort of others – I was taught to make others responsible for my own discomfort by seeking control, ascribing meaning to and labeling the experiences of others, denying the truth of others, and looking to others to change (instead of acknowledging that I might have some changing to do as well). It feels incredibly vulnerable to admit this publicly and yet I trust that I’m not alone in having learned some of these dynamics.

These learned relationship dynamics resulted in a lot of pain, disappointment, and resentment for me. I wanted so badly to feel connected to myself and experience connection with others, though so frequently I felt disconnected from myself and experienced disconnect within my relationships. Sometimes I felt helpless, hopeless, trapped, and unable to change, to imagine doing anything differently. 

Through my work, relationships, and therapy, I learned that feeling stuck in unsustainable patterns is quite common among folks who’ve experienced trauma. I came to understand these learned dynamics – of feeling responsible for the discomfort of others while simultaneously making others responsible for my own discomfort – as a trauma response. As a child I felt responsible for the needs of others while my own needs frequently went unacknowledged and unmet. I developed into an adult who interpreted any and all discomfort as a threat to connection, safety, and my wellbeing. So I began to make resolving discomfort the focus of many of my relationships, which makes a lot of sense: connection, safety, and wellbeing are important and I was doing what I thought I needed to do to feel secure in myself and my relationships – though, truth be told, I never really gained that security through those dynamics. 

For quite some time, I struggled to move beyond the aforementioned dynamics because I’d internalized a belief that I wouldn’t be able to do anything about it (another trauma response, natch). I didn’t know how to focus on the relationship first and trust that encountering discomfort is part of the process of being in relationships with others. Though I’ve realized over the last decade or so (I’m currently 36) that a learned relationship dynamic can actually be unlearned – people can, in fact, learn how to do something different. Which brings me to our Relationship-First Practice at Pathways Vermont.

I want to keep thinking about discomfort and power: 

What I know from my work in social services is that when people are in positions of power – a service provider for example, it can be easy to slip into unsustainable relationship dynamics, to experience discomfort with someone else’s emotions, beliefs, choices, or boundaries and make solving that discomfort the focus of the relationship. 

Here’s an example: when a person says they’re considering suicide and a service provider responds by immediately involving crisis/emergency services or saying something like “you have to tell me you’re not going to kill yourself before we part ways today,” that service provider is essentially communicating, “I’m uncomfortable with your pain and I need you to change.” This may not be the intended message and yet impact matters more than intention: a person has conveyed deep pain and the response has been an attempt to shift the pain and/or control the outcome. What’s lost here is the actual relationship between service provider and service recipient, the human in human services. 

So what do we do with all of this? How do we move through discomfort and focus on the relationship first? 

I think there’s some key components to increasing one’s tolerance for discomfort:

Center humanity and strength. Trust that each person is their own expert and able to navigate their experiences and distress. Learning how to ask for what you need and negotiate getting your needs met is an ongoing journey for many of us. Be patient with yourself and others. Believe that I, you, we can do hard things. We all do hard things every single day. 

Be authentic. Talk about your needs. Directly articulate your feelings. Be vulnerable and share your understanding of yourself, of your discomfort, of the relationship, of the world. 

Collaborate. Co-create a relationship that works for each of you. Share power and decision-making. Negotiate boundaries. 

Be humble. Honor autonomy and choice. Relieve yourself of believing that you have to have all the answers. 

Foster curiosity and hope. Be willing to investigate your own discomfort and the narratives you’ve learned to tell yourself. See relationships as spaces to explore meaning-making and transformation. 

I’ve had many opportunities to sit with my own discomfort in my relationships at Pathways, with my partners, with family, with friends, and with community members. The opportunities truly never cease (to live is to feel discomfort, I think) and yet my understanding of discomfort has drastically changed. My partner and I often talk about discomfort as information. When we’re experiencing discomfort – concern, conflict, disconnect, disagreement, misunderstanding – we see that as a challenging though instructive moment, an opportunity to check in with ourselves about the meaning we’re making and hone in on what each of us needs in the moment, an opportunity to learn, to grow, to transform. 

I’m a work in progress and I probably always will be. Maybe you feel similarly. Let’s embrace discomfort together and, relationship by relationship, maybe we can change the world. 

You Could’ve Just Worn Your Converse

In February of this year I celebrated 10 years of working at Pathways, and in June I took on a new role as the Assistant Director of the organization.  These two milestones have gotten me thinking about why I work at Pathways – and what about the work is so enduring.

It was a warm day in late summer of 2011 and I was speed walking down a midtown Manhattan street.  I was sweaty from that hot breeze that whips through the subway. I was anxious.  I was meeting a woman named Hilary Melton, who at the time I knew little more about than her inviting blurb on a bare bones “Pathways to Housing Vermont” website.

I was dressed in a black suit, the same suit I’d worn to my father’s funeral the year before.  I was wearing beat-up green Converse sneakers – my favorites – and arrived early to the lobby.  I sat down and quickly pulled off my comfortable sneakers, switching to a pair of heels I’d purchased for that same funeral.  I took a few breaths and prepared to interview for a role at Pathways.

In the interview, I shared with Hilary all the reasons why I thought I’d be a great fit to lead her new Housing First team in Vermont.  I shared about my commitment to ending homelessness, my disillusionment working within the NYC shelter system, and my Master’s thesis on the commodification and dehumanization of the issue.  I performed the best version of “I’ve got it together” my 23 year old self could manage.  I was the neatest, cleanest, most professional version of myself I could be. 

Luckily, Hilary hired me anyway.

A few months into working at Pathways, I was getting a crash course in learning how different this organization would be.  Housing First was about housing, sure, but more than that it was about listening to each other – and honoring each other for who we are and what we want.  It was hard work, messy work – and it required constant self-reflection.  Who am I? Why am I showing up this way? 

I was doing my best to trod through these questions – at Pathways, in therapy, and in my relationships.  It’d been just over a year since my dad had died by suicide.  My whole family was grieving in that complicated way that families do – made all the more complicated by the circumstances of his death.  To others, we were calling it an “accident.”  In reality, it was anything but that.  The grief and the secret – and the shame that comes with secrets – were all tied up together for me.  On top of that, I was working through my own complicated relationship with the medical model, psychiatric labels, and medications.  I was grappling with how I fit into this world – simultaneously resisting “sick” labels while also taking comfort in them.

At Pathways, people were talking about their experiences.  All of us were.  Participants were sharing their stories, agency leadership were speaking out about some of the same struggles.  In spaces we shared, people were coming up to me, saying “thank you for saying that – I’ve never shared this but…”  I started to see pieces of myself in those stories, and it made it a little easier to bear my own. 

Hilary and I and others at the organization were trying to figure out how to support each other to be in relationships in this unique way.  A new organization came to Vermont to offer a training called Intentional Peer Support. Hilary and I attended – it was the closest thing we’d found to what we were talking about. We decided to train everybody at Pathways. 

Around that time, Hilary reflected to me on her experience interviewing me for Pathways.  She was an “always-early” person herself, so she’d watched me come into the lobby and change my shoes.  She said offhandedly,  “you know, you could’ve just worn your Converse.”

You could’ve just worn your Converse.  That was a lightbulb moment for me.  It was an invitation: to show up as your whole self, however messy and tattered that might be. To bring the big-picture of who you are becoming, and show up authentically, humbly, and full of hope.   Somehow, it felt like a revolution.

On a hot summer night in 2013, I got a phone call. There was a fire at one of our apartment buildings.  My mind immediately went to one of the tenants: a client of ours, who I’ll call Mark.  Mark had been referred to us by the local designated agency, where they weren’t sure how to continue to support him.  They’d supported him in lots of temporary settings – in group homes, in  motels, in shelters – the story was always the same.  Mark, they said, could not maintain his living space.  His spaces would quickly become cluttered with trash, cigarettes, dirt and grime – and he’d be asked to leave as the conditions became unsafe.  He inhabited spaces, it seemed, as though he had simultaneously been there forever, and as though he didn’t live there at all.

We gave it a try anyway.  We talked with Mark about what would be expected of him as a tenant, we found him an apartment, and he moved in.

At first, it was more of the same.  Early visits were spent on hands and knees, scrubbing endlessly.  Every visit we made a habit of first taking out the trash.  We talked a lot about what it meant to have this space, his space, and what it would take to keep it.  It was hard to know if it was working.

A few months in, something shifted.  I visited with Mark and he met me at the door, welcoming me in – different than his usual holler to enter from the other room.  The floor was swept.  He’d placed some trinkets out on a dresser.  It wasn’t perfect – it was still messy, but it was authentic. It was home.

Back to the Friday night phone call, there was a fire. I didn’t know what else to do – so two of my coworkers and I drove to Mark’s.  I don’t know if you’ve ever seen a building actively burning to the ground.  It is the kind of thing that sticks with you. The smell, the smoke in the back of your throat, the heat even from a distance.

Everyone was safe.  But the building wasn’t salvageable.  For a while, Mark and I stood there, watching the fire.  Reality sunk in that he wasn’t going back home.

I took him to get some food and basic supplies before dropping him at the hotel the Red Cross had arranged.  I didn’t know what to say.  I didn’t know what I was doing. I felt such grief for Mark.

As we walked back to the car with his groceries, he stopped in the parking lot.  He turned and looked at me – and so earnestly, really caring to hear my answer, he asked “How are you doing?”

– 

Flash forward to February 2020. It was the day after a major snowstorm and a few feet of snow covered the ground. I was 34 weeks pregnant and as I pulled into the parking garage by our office the parking attendant joked if I’ll make it to term.  I climbed the steps to our office and sat down at my desk.  My water broke. 

9 hours and an emergency C section later, a group of doctors were telling me my daughter in the NICU didn’t look as they’d expect.  Her vitals were OK but she wasn’t waking like the other babies.  It could be a million things.  She was visited by specialists, there were many tests. Eventually, genetics came and we had our answer in a rare genetic disorder.  

The weeks began to go by and we were still in the NICU.  My whole world was in the NICU, and several times a day I’d climb the 10 flights of stairs to get to her.  I was too scared to take the elevator. To touch anyone. To breathe.  It was now March 2020.  My world was in the NICU, but the world outside the NICU was getting scarier and scarier.  A virus was getting people very sick.  I didn’t know what I was doing. 

I thought about my Converses – and remembered Mark.

In between my visits to the NICU, I found myself trying to put in some time with Pathways. Trying to figure out how to support my coworkers who are all out there supporting everyone else.

We started to offer co-reflection every day.  Co-reflection is a space we give each other to connect and think about what we’re doing in our relationships.  A group of us met virtually, since the world had locked down and we couldn’t be together.

A lot of the time, we didn’t know what to say.  The landscape was changing every day. We knew one thing.  We made it a point to ask each other, earnestly, really caring about the answer – “How are you doing?”

So what about the work is so enduring? Why am I still here?

Recently, a coworker was sharing with me about the impact working at Pathways had on them.  They said, in effect, it has been a space to heal, transform, and to be accepted just as they are. 

Yea. I felt that. The relationships I’ve had at Pathways have given me those same opportunities – and I have tried through my relationships at Pathways to afford others the same.  

I have dedicated so much of my life to trying to understand the concept of home – what it is, and why we fail to give it to each other.  But isn’t it just that? A space for healing, transformation, and unconditional love.

There’s another thing – there’s work to be done and at Pathways I am surrounded by people who care to do it. 

I wish I could say it was getting easier – but really, the issues just keep expanding. 10 years ago we were talking about mental health stigma, the value of peer support, community based alternatives to institutions. 

Today we’re…truthfully, still talking about all of that. But we’re also talking about safe consumption sites, Pathways developing property into housing, using psychedelics to process trauma. 

The questions keep getting harder. The landscape is constantly changing.  Sometimes the whole house burns down in front of you. But in conversations at Pathways, I never hear someone shy away from a problem.  It’s never “that’s too hard,” or “that’s not what we do.”  We are forever attempting to rise to the next challenge. 

And of course we are – because it has never been about the particular problem. It has always been about each other. Our commitment to one another, and to the community we want to be in together. 

So, over a decade later, and for the foreseeable future – I’ll be here at Pathways.  I’d love for you to join me.  If you’d like, wear your Converse.