For Crisis Residential clients and employees, the holiday season can bring undesired problems, unexpected surprise
by Travis Atkinson
Imagine your favorite holiday memory. What makes it special? Is it belly-laugh hysterical? Or deep with meaning? Does it bring you back to a joyful time in your life? Does it tell the story of love or family connection?
Now imagine what it would take to change this memory into one that was less enjoyable. Think about if Uncle Steve wasn’t there. Imagine if you didn’t get exactly what you wanted for Christmas—perhaps a scooter instead of a bike. Or imagine if the holiday family reunion turned into a bickering session about politics and religion, causing angry family members to leave the party early. Or worse yet, imagine if Dad didn’t make it home in time for Christmas dinner.
All of these unfortunate scenarios pale in comparison to the reality faced by thousands of Americans every year: spending the holiday season away from home receiving mental health treatment. Yet while the circumstances may seem grim, the support offered is often the strongest during these trying times.
Emergency Mental Health Treatment: Crisis Residential Services
There is never a good time to be in crisis, and the holidays are no exception. In these times people experiencing crisis have to interrupt their daily lives and celebrations to care for their mental health. For people with depression, anxiety, or psychosis, they may qualify to receive treatment in a more homelike setting than a psychiatric hospital, known as a Crisis Residential home.
Crisis Residential homes provide critical mental health treatment in about 600 communities across the United States, providing a safe haven for mental health treatment where people can stay from a few days to a few weeks. Services are often provided in an inconspicuous home within a neighborhood, and clients have access to a psychiatrist, nurses, social workers, and direct support staff. Crisis Residential programs have a 40-year history of keeping people safe and satisfied while positively affecting their mental health symptoms. These programs often make extensive accommodations to ensure a person feels comfortable, respected, and valued.
Most Crisis Residential homes enjoy high levels of client satisfaction. People who are exposed to this treatment option often request it by name if they find themselves in crisis again. Others who have completed their treatment seek out ways to give back through volunteering or employment in a paraprofessional role.
Some Pain is Unavoidable
Even with these considerations, there are virtually no accommodations that can adequately prepare someone to spend the holidays in a residential treatment center. People receiving treatment for addiction or mental illness face these challenges on a regular basis, and some of them lack thoughtful and compassionate family members that include them in their holiday plans.
Even expanded visitation hours and other accommodations can’t completely compensate for being in a Crisis Residential home during the holiday season. Sometimes people are estranged from their family members and spending a holiday in a crisis home is another variation on a lonely existence. Other people are in a tenuous relationship with their family which may have contributed to the current state of crisis, and they are subsequently not welcomed as visitors for the duration of their treatment. Still others are separated by distance or transportation challenges and are not able to be with the ones they love.
Hope in Difficult Times
In response to the challenges faced by clients in treatment, many Crisis Residential providers exhibit compassion and thoughtfulness during this particularly difficult holiday season. Filling stockings, making special meals or food orders, and hosting potlucks are some of the ways the Crisis Residential homes share the seasonal love with the people they serve. Hats, gloves, and blankets are typical gifts provided to clients who reside in colder areas. Practical items like backpacks, journals, and fast food gift cards are also popular gifts.
Some providers see the value in carrying on traditions with clients or starting new ones. Susan Cromwell, Division Director of Residential Crisis for Mosaic Community Services in Baltimore, MD, believes these efforts are rewarding for clients and staff alike, like taking people to see holiday lights around the city.
Some Crisis Residential homes extend their generosity to former clients of the program, often referred to as “alumni”. At the Harris Center’s Crisis Residential Unit in Houston, TX, alumni are invited to join the clients and staff for a meal and spend the entire day with them. “On December 25th, we always begin with a huge breakfast of tamales, eggs, and breakfast deserts,” says Mende Snodgress, Assistant Deputy of the Comprehensive Psychiatric Emergency Program at The Harris Center. “Later in the day, we have a great barbeque overseen by alumni and staff. We hope to communicate to each of the residents and alumni that they are important members of this family of choice.” Mosaic Community Services in Baltimore, MD, also offers holiday opportunities to its alumni.
Holidays have presented opportunities for community partnerships between many Crisis Residential homes and churches, grocery stores, and generous donors. Brian Ormsby, Director of Operations at Spring Creek Recovery Center in Sapulpa, OK, described how they have developed a partnership with a local grocery store who provides a special meal for Christmas, and a local church provides a meal for Thanksgiving.
Some agencies create a budget for holiday gifts and meals for clients, while others simply don’t have the means. In these cases, staff at Crisis Residential homes, like the ones at The Harris Center, contribute money from their own paychecks to ensure the holiday is special for clients.
Many Crisis homes offer special support groups during the holidays to focus on grief, depression, and coping skills during particularly difficult times for clients.
At Pivot Crisis Residential Unit in Grand Rapids, MI, staff created an interactive art project called “25 Days of Self-Care”, where, each day, staff and clients create an ornament with a self-care idea attached to it so anyone in the home can engage in healthy behaviors.
Michael Usino, Director at New Perspectives Crisis Services in Pennsylvania, believes that integrating holiday traditions into the Crisis home experience is important for the client experience. “At Hope House and New Perspectives Crisis Services we make every effort to make the holiday—and in particular Christmas Eve and Christmas Day—as ‘normalized’ as possible.” Michael said the house is decorated and clients are welcome to decorate their rooms as well. A Christmas day dinner is provided with collaboration between staff and clients, and families are invited to attend.
The team at Productive Alternatives Crisis Stabilization Unit in Fergus Falls, MN, takes a decidedly different approach. “Since this is a high trauma-triggering season for our clients we keep things quiet and have more neutral seasonal decorations. This can be a highly sensitive time for our people so we don’t place a lot of emphasis on holidays as much as day-to-day and what they can control,” says Beth Nelson, Site Treatment Director at Productive Alternatives. Beth has adopted this approach in part because of her own father’s struggle with bipolar disorder and how the holidays adversely affected him compared to their family and friends.
Productive Alternatives’ approach raises an important consideration: the importance of understanding a client’s emotional relationship to certain holidays and their preferences to celebrate with others or spend time alone or with a supportive staff member. Many clients are open to making new holiday memories despite their condition, and the lengths that Crisis staff go to celebrate the holidays and honor their clients provides a welcome contrast to unfavorable memories of holidays past.
Caring for the Caregivers
Most employers provide a holiday party and gifts for all staff, and some Crisis Residential homes host their own staff parties. Staff are paid overtime for working the holiday (between one and a half and two times their normal pay rate). At Community Research Foundation’s Vista Balboa Crisis Residential home in San Diego, CA, holiday schedules are posted months ahead of time so staff can coordinate coverage with one another. At Continuum Connecticut’s Crisis New Haven home, any holiday time off request is approved, and other supervisory staff fill in the scheduling gaps.
In a season where caring for your clients and your own family’s needs can easily fill the time, one Crisis Residential home’s employees extend their hearts beyond their Crisis home. At the Corinth Crisis Stabilization Unit in Corinth, MS, Helen Rider, Director of the Corinth CSU, says, “We have a nursing home and Animal Shelter Angel Tree and the nursing home gifts are delivered by a staff member on Christmas morning.” She said that staff often playfully argue with one another to determine who will deliver these gifts.
At Robert Brown Crisis Residential Unit in Holland, MI, staff make the most of the holiday celebration by hosting a spirit week where they are encouraged to dress up in festive holiday gear in the week leading up to Christmas. Staff made a full breakfast for clients and each other, including a special Grinch hot cocoa blend (pictured here).
Some supervisors engage their staff with a holiday door decorating contest, where clients judge the doors and award prizes.
Time Marches On
The holidays have the potential to bring out the best in all of us, even in times of darkness or unwanted struggle. The next time you find yourself enjoying a pleasant, relaxing holiday with the people you care about, remember what a gift it is to be in that place, and consider all the features that make it wonderful. Don’t forget the people spending their holidays in less fortunate circumstances, and think how you could bring hope and beauty to their struggle.