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Celebrating 10 Years

Written by Director of Respite, Nicole B.

Wow!  10 Years of Respite care at Haywood Street Congregation.  1,388 people who—instead of having to recover from an acute medical need outside–were able to have a warm bed, smiling faces, good food, and support around their medical care.  I feel a little inadequate speaking about the last 10 years knowing that I have only been involved for the past 2.  Years of history and memories come before me–walking through the front door greeted by the pictures of the friends who had stayed before.  Stories from current co-workers who lives were forever changed by their stay at respite.  Memories shared of a friend who chose respite as the only place he wanted to be at the end of his life.  There is no doubt that this small space has impacted lives and holds such a dear place in the hearts of many.  And I think that because through all of the changes over the past 10 years one thing holds true and steady-our ever-persistent focus at Haywood Street on relationships.  

When I came into this role, I knew that I was coming into a beloved space that a lot of people loved and felt ownership over…why?  Because it had been such a special and important place in their own journey.  My hope was to honor all that respite was while also pushing the boundaries of what radical love and relationships with the marginalized of our community could and should look like.  I had this tugging at my heart that I just couldn’t ignore, and that was for the IV drug user and those with significant and persistent mental health issues.  

Respite had traditionally been a place where we focused on keeping those inside respite safe and protected from the often-nefarious things that can happen around the Haywood Street Campus.  But that protection, while right for so long, no longer fit our changing demographic.  As heart breaking as it is, the person who has significant and persistent mental illness and suffers from polysubstance use is now the majority not the minority.  I just felt everything within me saying we have to figure out how to serve them in respite—how to offer a place for healing and relationship for those who typically can’t get it anywhere else.   

While hard to move something in a new direction it felt like the stars aligned and our community was primed to make a bold move towards serving those in active substance use in respite.  Buncombe Counties Community Paramedics were up and running and had just started using an office space in the main Haywood Street building.  Respite had built a good relationship with them and were now receiving referrals directly from them.  They were also able to get friends started on medication assisted treatment for those with opioid addiction.  During this same time our peer support, Kim, started a harm reduction group at Haywood Street focused on those who weren’t ready to quit using, but wanted to reduce use or find safer ways to use.  We also had a nurse practitioner, Lucy, start volunteering significant time in respite which helps us provide medical care with those who struggled to get connected to traditional primary care.  All of this came together along with a grant from the National Institute of Medical Respite (NIMRC) to integrate behavioral health services into Respite care.  NIMRC realized that often those with significant behavioral health issues (such as IV drug users) are unable to access respite care and wanted to fund and offer support to respite providers interested in moving in this direction.  We were one of only 4 respite providers in the country to receive this grant.  Through this we were able to hire 1 full time peer support, 2 part time peer supports, and a full time licensed clinical social worker.  We have also received technical assistance from NIMRC and have calls with staff and other respite providers on how to implement policies to serve this population.  In this last year we have been able to serve 36 friends who needed medical respite care and were in active substance use.  We were able to do this because of the incredible supports we have been able to put in place.  Friends are not allowed to use drugs anywhere on the Haywood Street campus, but instead meet with our peer support and LCSW in order to make a harm reduction plan that is tailored to their medical respite needs–essentially figure out how can they meet their plan for healing from their acute medical need while figuring out how they can meet their needs around their substance use or mental health.  

But what I’ve realized through all of this is that what this all hinges on is–relationships.  Yes, we have so much support and qualified staff, but the same thread that made respite such an amazing healing place on day 1 is what makes it such an amazing and healing place at 10 years.  None of these services are done without relationships being the goal.  When they leave here, did they feel loved and cared for and feel connected to this community is all that truly matters.  And what I’ve learned is that building true lasting relationships with those in respite, is what is most healing for our friends…even more so than the medical care and the substance use and mental health support.  When I read through our exit surveys the comments aren’t about how well we scheduled appointments or got them connected to a primary care doctor.  But instead, about how they felt cared for by the staff and how they feel like they are part of a family.  And for the last 10 years that is what respite has been.  A place of healing and rest, yes, but most importantly a place to quote my friend Robert Stafford, “a place where you are not just friends, but family.”

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