AT FRIENDLY HARBOR, PEER MENTORS ARE KEY TO MENTAL HEALTH

Friendly Harbor is not a treatment facility — “We’re very clear about that,” says Bowers — but rather a gathering place that promotes long-term healing through community events and bottom-up peer mentorship. It’s staffed and run by “consumers,” a word used to describe people living with mental illness.

“The term for somebody with a mental illness has been an object of controversy for a long time,” says Bowers. “As for myself, just call me crazy.”

Joe Bowers found a safe haven at Friendly Harbor, photo by: Jake Holschuh

Joe Bowers was raised by his grandparents in upstate New York, near the Catskills. He seemed a pretty typical boy who loved baseball, football, and track and field: “a total jock,” as he puts it.

So his grandparents were surprised when a middle-school teacher called to say that the boy’s grades had slipped, and he’d become withdrawn. The teacher recommended that he see a psychologist, and “I just hoped my classmates didn’t find out I was seeing a shrink,” Bowers recalls.

Despite the prevalence of mental illness, that stigma Bowers felt in the early ‘60s is still present today. One in five Americans — over 40 million people — has a mental health condition. While the most common mental illnesses are depression and anxiety, one in seventeen Americans suffers from a more serious disease: schizophrenia, bipolar disorder or extreme paranoia.

For four years, from 1961 to 1964, Bowers had weekly therapy sessions with a psychologist. “He did his best to help me out,” Bowers recalls. “I was already at the point where I couldn’t have avoided what came next without medication.”

What came next was his grandfather died, and the grief he felt triggered “an episode,” Bowers says. “I got very psychotic and delusional.”

Those delusions led him to his grandmother’s bedroom door with a loaded gun. There, for a split-second, he lost confidence in his delusion. “When you’re psychotic, sometimes you have these short moments of lucidity,” Bowers explains. “I released the shotgun, and I told my grandmother that I was trying to kill her.”

Bowers and his grandmother walked downstairs and called his uncle, who drove Bowers to the now defunct Middletown State Homeopathic Hospital, a mental institution where he would spend the next two and a half months. Doctors there determined that Bowers suffered from paranoid schizophrenia, but nobody told him that diagnosis. In fact, it would be fifteen years before he learned what condition he might have…and even then, the diagnosis was wrong.

At Middletown, he recalls, “My treatment consisted of therapy sessions with a psychiatrist, but those were infrequent. They weren’t big on medication. I was treated with electric shocks.”

He received fifteen shock treatments during his first stint at the hospital, and “I became lucid after a while,” Bowers says. He was released from the hospital in May and graduated high school the following year with his class.

Bowers had been prescribed Thorazine, but only took it sporadically because he didn’t like how the medication impacted his physical performance. “I’d been hoping for an athletic scholarship to college,” he explains.

Bowers didn’t get that scholarship, but he did get into Sullivan County Community College. Everything was going fine until his third year, when Bowers had his second psychotic episode, this one involving a czar and the fall of Russia. Over the next two decades, Bowers fantasized he was King Solomon, Leonardo da Vinci, William Shakespeare and James Bond, among many other historic and fictional figures. During these episodes, he was arrested for crimes such as trespassing and arson. From New York to Arizona to Wyoming, he bounced between solitary confinement in jail cells and state mental hospitals, where he was medicated with Thorazine and Stelazine. At one point, he learned he’d been diagnosed as a paranoid schizophrenic.

In spite of all this, Bowers somehow managed to complete a bachelor’s degree in fisheries science at the University of Arizona, and then continue to hold down jobs, initially as a hotshot wildland firefighter before taking a position as a lab technician with a Wyoming power company.

Sometimes it seemed like his wife, Molly, was the only thing keeping Bowers together. “She’s the most important part of my support system,” he says, noting that he even started taking his medication as prescribed because it was easier than arguing with his wife.

The medication wasn’t working in 1986, when Bowers started contemplated killing Molly during a bad episode that led him to sign himself into Holy Cross Hospital in Salt Lake City. Bowers was prescribed Haldol at Holy Cross. He’s been taking the antipsychotic since then, and has been “mostly symptom free,” he says.

Back in Wyoming, therapists emphasized the importance of ongoing counseling, and one doctor gave Molly signs to watch for, such as pacing, that would alert her it was time to tweak the dosage of his medication. “A lot of people with mental illness lack awareness,” Bowers says. “Over time, I came to trust Molly if she would say, ‘You’re acting strangely.’”

Bowers retired from his job in 2013, and he and Molly were eager to move to Colorado. Their two sons were living in Denver at the time, but they preferred the small-town charm — and the lower cost of living — in Pueblo.

Andrew Romanoff now heads Mental Health Colorado, photo by: Jake Holschuh

Despite consistently ranking among the nation’s physically healthiest states, Colorado comes in 43rd nationally in behavioral wellness, indicating a high prevalence of mental illness and low access to care, according to a 2017 report issued by Mental Health America. Of the Coloradans polled, 11.8 percent reported poor mental health, up from 9.9 percent in 2015.

It costs money to treat mental illness, but not treating it can be far more expensive. Funding for mental health services in Colorado comes from a combination of state and federal funds, including Medicaid. The state’s budget to care for patients without insurance was $40.7 million in 2017. But in 2010, behavioral health cost Colorado at least $887 million, according to a report issued by the Colorado Health Foundation.

The criminal justice system often picks up the slack. Colorado’s state prison system and county jails spent $93 million on mental health services in 2010.

One of Friendly Harbor’s eleven board members has a daughter with mental illness. “We were told by professionals that in order for our daughter to get the help she needed, she’d have to commit a felony so she could be placed in a hospital for the criminally insane,” the boardmember says.

“Using our criminal justice system as a warehouse for people with mental illness is probably the most expensive decision we can make — and the least therapeutic,” adds Andrew Romanoff, president and CEO of Mental Health Colorado and former four-term state representative and two-term Speaker of the House. His group is holding a gubernatorial debate focusing on the issue of mental illness on March 23.

Mental health professionals know more about mental health care today than they did when Bowers was receiving electric shock therapy more that fifty years ago. They know, for example, that early intervention has been very beneficial for people with mental illnesses.

“When people come in early for treatment, 80 percent will get better — and those who don’t ‘get better’ usually still benefit from the treatment,” says Dr. Carl Clark, president and CEO of the Mental Health Center of Denver.

And yet, Romanoff notes, “about half a million people in Colorado are not getting the mental health care they need.”

Stigma is one obstacle. Nearly 40 percent of Coloradans polled for the 2017 Colorado Health Institute’s Health Access Survey said they were uncomfortable talking about their problems or concerned that somebody would find out. “But the single biggest barrier is cost,” says Romanoff.

Under the Mental Health Parity and Addiction Equity Act of 2008, which was amended by the Affordable Care Act to include individual health-insurance coverage, many insurance plans require equal benefits for mental and physical health care. These laws often go unenforced, though, and mental health professionals in Colorado are reimbursed at a rate that is 40 percent lower than that of some other providers. That helps explain why 35 percent of Coloradans polled in 2017 said they had trouble booking mental health appointments.

“For people with private insurance who have behavioral health coverage, only two out of every five who need treatment actually receive it,” Clark says. “People will look at their provider list, start calling providers, and oftentimes they’ll get an answering machine that says the provider is not currently taking new patients.”

Frustrated, many people simply give up.

Elissa Ball, a boardmember of Friendly Harbor, came up with the idea for the Courage and Hope art show, photo by: Jake Holschuh

During an early stint at a state mental hospital, Bowers remembers telling an orderly that when he got better, he wanted to get a degree so that he could work with people with mental illness. “The orderly told me that wasn’t possible with my history,” Bowers says.

But in 2017, Bowers proved naysayers wrong by completing a sixty-hour training program with Peer Coach Academy, a Denver-based nonprofit specializing in peer recovery training. The academy provides small-group training sessions at First Presbyterian Church of Pueblo for Friendly Harbor’s peer specialists, covering topics ranging from motivational interviewing to ethics and professional boundaries. Bowers has also received training through the National Association for the Mentally Ill, and is now well equipped to serve as a Friendly Harbor volunteer peer specialist.

Bowers has also written an ebook, Life Under a Cloud: The Story of a Schizophrenic, with which he hopes to dispel some of the fear and ignorance — and to make a point. “People with mental illness are sometimes treated with discrimination and prejudice,” he observes. “I felt like the system was all wrong, when somebody who is sick ends up spending half their life in jail or a hospital.”

On the days when he volunteers at Friendly Harbor, Bowers usually heads out around 5 p.m., but some nights he’ll stick around for one of the organization’s events or classes, such as the Wednesday night “Creative Arts” club.

Weekly support groups are augmented by recurring monthly activities, including movie night, poetry night and game night, as well as “Haircut Day,” when members can come in for free cuts. Gatherings are usually lighthearted and fun, and family members are encouraged to participate, especially in bi-monthly family support-group sessions.

For long-term mental health care, “a supportive community is key,” says Romanoff. “Most mental health disorders are chronic conditions, and a lot of folks will need support for the rest of their lives.”

“This type of support is scarce,” adds Michael George, Friendly Harbor’s volunteer executive director, a consumer who is in recovery from alcohol and drug addiction. George learned about Friendly Harbor during his tenure at Colorado Mental Health Institute Pueblo, a 449-bed inpatient hospital where he worked as a licensed clinical social worker until retiring in 2014. (CMHIP is one of two state mental hospitals in Colorado; the other is Colorado Mental Health Institute Fort Logan, in southwest Denver.) The peer-specialist program made Friendly Harbor particularly appealing to George.

A peer specialist is a person with “lived experience,” boardmember Ball says. “They have experienced mental illness or substance-abuse problems and are in recovery.” In addition to going through training, peer specialists must pass a written exam. Last October, Friendly Harbor received a $15,000 grant from Casey Family Programs, covering the cost of training and the exam. “We’re currently training three more peer specialists,” Ball notes.

Friendly Harbor is open six days a week, Monday through Saturday, and one of its five peer specialists is always on site during operating hours, from 11 a.m. to 5 p.m. In addition to manning the front desk at the center, peer specialists provide members with resources and lead daily support groups. Some groups are labeled by diagnostic set — there’s an anxiety and depression meet-up on Mondays, for example — but most are geared more generally toward mental wellness. “People can come to any group anytime to talk,” Ball notes. “We are not a treatment center, but we are beneficial to treatment.”

Bottom-up peer-leadership programs, such as Friendly Harbor’s Mentor2Success, have also been shown to be effective for people with mental illness. “A lot of research shows that involving peer specialists improves the outcome beyond what other specialists can do for people with mental illness,” says Ball. Demonstrated benefits of peer mentorship include symptom improvement, increased enjoyment of life, and decreased hospitalization and emergency-room visits.

“A peer specialist has that extra ability to empathize with what it is like to think crazy thoughts, and they can sympathize about the side effects of medication,” she continues. “Peer mentorship works because people with mental illness get hope from seeing somebody like them functioning at a high level.”

While a robust peer-mentorship program might be Friendly Harbor’s hallmark, one of the most extraordinary aspects of the organization is its leadership. Friendly Harbor doesn’t just serve consumers; it’s managed by them, too. “People with a lived experience of being in recovery from mental illness or substance abuse have a unique contribution to make,” George says. Under its bylaws, at least half of Friendly Harbor’s boardmembers must be consumers.

Friendly Harbor activities include art, photo by: Jake Holschuh

Friendly Harbor currently has about 300 active members. “We get 5,000 visits a year, mostly from local and regional members,” George says. “Important work happens here.”

Even so, Friendly Harbor is still “a nonprofit that’s limping along, trying to stay funded with grants and individual donors,” says Jill Wodiuk, the board secretary. The organization’s only paid employees are peer specialists; otherwise, it depends on the work of volunteers.

While the organization has morphed over the years, it has always worked to promote mental wellness by providing a spirit of connection among consumers, family members, advocates and organizations such as the Pueblo Chieftain, Colorado Mental Health Institute Pueblo, the Jackson Foundation, Mental Health America and Health Solutions. Now it’s in the process of formulating one-year and five-year visions. By 2019, Ball says, she’d like to increase Friendly Harbor’s annual operating budget from $60,000 to $120,000 in order to hire a three-quarter-time CEO and add more staff peer specialists. Such growth would allow the nonprofit to broaden its membership base and engage in outreach with more mental health organizations and private practitioners.

“We want to have longer hours, including Sunday,” Ball adds, noting that another goal is to provide off-site services to organizations such as churches. And within five years, Friendly Harbor would like to buy a van to take members on outings. The anticipated moves are modest, but critical.

“Nonprofits have a tendency to shrivel up and die,”Wodiuk says, “but this is too important for that.”

The Courage and Hope art show opens March 14, photo by: Jake Holschuh

Dealing with mental illness requires courage and hope. The people at Friendly Harbor show that every day, and now they’re putting it on display with an art exhibition, Courage and Hope, that opens with a reception March 14 at the Sangre de Cristo Arts Center in Pueblo. The exhibit includes over sixty pieces in mediums ranging from painting and sculpture to music and artistic narratives created by people with mental illness and substance-use disorders.

“We advertised to our mental health community, and we also have a few local artists who learned about the exhibition and wanted to participate,” says Ball, who came up with the idea for Courage and Hope.

Bowers has three blogs in the exhibit. One, “A Rose by Any Other Name,” discusses “the proper terms for referring to people with mental illness,” he says.

But don’t worry, he adds. You can still just call him crazy.

Article originally appeared in Westword.