In the middle of Manchester, Iowa, there’s a river. The Maquoketa River runs through the downtown district; next to the river there’s a gazebo. In the middle of the gazebo is a long table where people can enjoy the serene and peaceful surroundings, sit and talk and visit and, just occasionally, get a small piece of the support they need to build successful lives in the community with help from the staff at RHD Iowa.
“Our office,” said Care Coordinator Marty DeCamp, “is wherever our clients need us to be.”
With three Assertive Community Treatment (ACT) teams, RHD Iowa promotes recovery and independence for people with mental health challenges, helping people build life skills and self-confidence and removing as many barriers to independent living as possible. Across the state almost 200 people get community-based services and supports from RHD. DeCamp sits with Life Skills Specialist Aaron Cavalier and checks in with David, a client who lives in a nearby apartment and receives in- home services.
"I know they're beside me"
“I was in a bad situation and I began to feel isolated and hopeless. Then along comes RHD … I’m so grateful to be in this program. It’s better than winning the lottery. These people care. They hear me. It’s a journey, but I know they’re beside me. I don’t feel alone anymore. I don’t feel the isolation. I don’t feel like a freak. I just feel human. I’ve been humanized.” Philomena, a client at RHD CROSS ACT
“I’ve changed my life quite a bit with support from RHD,” said David. “They’re the best thing that’s happened to me in a long while.”
Cavalier arrives after having met with Mark, who wanted a walk along the water. Mark points out a particular spot that is his favorite and says: “Good fishing. I’ve caught some fish here.”
“I still have my ups and downs, but I’m doing good,” Mark said. “They’ve helped me a lot.”
From there Cavalier and DeCamp meet up with Calvin, who is walking his dog, Dino. Calvin, like most of the people RHD supports in Iowa, moved from costly long-term institutional settings to supported living in his own apartment.
“I’d be homeless without RHD,” Calvin said.
“The staff comes to see me three times a week; they’re available by phone, any time I need them,” said Jamie, an RHD Iowa client in Cedar Rapids. “Even after hours, they have on-call, so that’s very helpful. “They talk with me, through my decisions, they help me make better decisions than what I would normally make. The staff has been extremely important in my life. They’re always there, and they’re generally interested in my overall wellbeing and what happens to me.”
RHD Iowa ACT–Waterloo serves participants in a 30-mile service territory, while RHD Iowa ACT–Cedar Rapids serves a 60-mile radius of the Cedar Rapids office in the ECR MHDS region. RHD CROSS ACT serves the seven counties of the CROSS MHDS region.
Assertive Community Treatment (ACT) is an evidence-based, best- practice model of service provided through an interdisciplinary team to ensure a recovery-oriented system of care. ACT is available 24 hours a day, seven days per week, and is prepared to carry out a full range of treatment functions in the participants chosen community. The ACT team consists of the following members: master’s level mental health clinicians, registered nurse, substance abuse specialist, vocational specialist, psychiatrist/ARNP, peer support specialist, and a program assistant.
Team members work together with the individuals served to promote symptom stability and appropriate use of medication; restore personal, community living and social skills; promote and maintain physical health; establish access to housing, work and social opportunities; and help maintain the highest possible level of functioning in the community.
"My life is a lot better"
“Before I was with RHD, I was living on the streets, by myself, living out of a backpack. Ever since I got involved with RHD, they’ve been helping me with everything in my life, pretty much. Medication. Housing; I have my own place now. It’s amazing, to have someplace to go. No matter what, I get to go there — it’s my place. My life has changed considerably. My life’s a lot better since I came to RHD.” Cody, a client at RHD ACT in Waterloo
At RHD Iowa, 23 percent of participants have had psychiatric hospitalizations, compared with 40 percent in one large study of ACT participants. Nearly all (93 percent) have remained stably housed during their first year of engagement with the program, and 83 percent have had no arrests or other law enforcement involvement (compared with 67 percent in the large study of ACT participants).
“The people we support are the central and driving force of the services we deliver each day,” said Gina Hiler, RHD Midwest Regional Director, who oversees RHD programs in Iowa. “RHD wraps services and supports around people in a responsive and personally-developed way. We support each participant in building their life in their chosen community — a life defined by the participant and supported by each member of RHD’s staff.”
RHD ACT teams create support and treatment in a community setting, working to enable individuals with mental illness to live in their community to the fullest extent and to achieve recovery.
“We meet the clients where they are; we meet them in their homes, or wherever they feel comfortable,” said Sharice Bell, RHD Iowa Peer Specialist. “Everything is client-based. Whatever the client needs, whatever might help them on their road to recovery, that’s what we do.”
RHD is committed to using Certified Peer Specialists in its programs at all levels of leadership, and views peer support as a core component for success in human services. Certified Peer Specialists assist persons in recovery as they work to live as independently as possible. Peers in RHD programs demonstrate and model recovery through education, training as a CPS, and their own lived experiences.
“A lot of what I do is talk people through what’s going on in their lives, what kinds of instances they might be facing,” said Thomas Kullen, a Certified Mental Health Peer Support Specialist at RHD ACT in Waterloo. “Depression and isolation are best friends. To be stuck, isolated, definitely triggers depression — or whatever people’s mental illness might be. We make sure we’re there for people.”
Said Cody, a client who works most o en with Thomas: “I talk with Tom in ways I don’t talk with anybody else.”
Philomena was not only Sharice’s first client, she was among the first clients to walk in the door at RHD CROSS ACT.
“At the beginning, I was skeptical — like this is too good to be true,” she said. “They keep saying: We’re a team. I fall, and I get back up, and they’re there. It’s good knowing you can talk to people who speak your language. You can rely on the people here. They won’t let you down.”
"There's somebody who thinks I matter"
“Before I came to RHD, my life was pretty much a mess. I didn’t really do anything to take care of myself, I didn’t have anybody there to really care. At RHD, my staff helps motivate me to do better things in life. It always brings me joy when I see them. It makes me feel good to know there’s somebody who cares, who thinks that I matter. Without RHD, I wouldn’t be here.” Jamie, a client at RHD Iowa’s RIST program.