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School of Medicine
Dome - Whatever It Takes
Whatever It Takes
Date: March 2, 2010
Creative Alternatives empowers patients who have enduring mental illness.
Sheila Goldscheider was one of the first to spot a spark in Quentin Fisher.
There’s a groundedness about Quentin Fisher that’s disarming, a quiet certainty about where his life is going that would be uncommon even outside of a place set up for some of a city’s sickest patients.
The Baltimore man wouldn’t hesitate to say that he’s centered, in large part, from his connection with Creative Alternatives, a program that, for 14 years, has helped people with enduring mental illness, resolutely blanketing them with support until their lives improve.
The Hopkins program defies the usual approaches nationwide.
Fisher had been living with a foster family when his schizophrenia led to a five-year stay at Spring Grove state psychiatric hospital. He grew better under therapy and the constancy of medication; his illness was attended to. “But I didn’t have anything to hope for,” says Fisher. “They weren’t so interested in where my life was going. I wanted to work. And I wanted to do something.”
When he’d improved enough for discharge, a Creative Alternatives interviewer laid out the benefits of coming to their voluntary program, which now serves 175 “members” from Baltimore city. “Creative Alternatives is based on hope,” says program manager Sheila Goldscheider. As its name implies, the program offers a change from the constant cycle of hospital visits, returns to psychiatric institutions, and being on the street or in jail that often dogs those with persistent schizophrenia, bipolar disorder or unrelenting major depression.
“We’re the proverbial one-stop shopping,” Goldscheider, a registered nurse, explains. When Fisher first came to the program in 2006, for example, a personal service coordinator sat him down: What do you want to do with your life? Then she and other staff united as Team Fisher, working with the 42-year-old to lay paths to his goal: to live independently and have a job.
Creative Alternatives has a Hopkins psychiatrist and psychotherapist to keep Fisher and other members on an even keel medically. There’s substance abuse therapy. A housing coordinator aims for the best fit between living quarters and personal need. An entitlement coordinator helps members with social security, medical assistance and such. The community integration person engineers ways to let members grow roots, arranging shared dinners, for example, if they live close to each other. Other staff teach life skills: shopping, cooking, keeping house, sticking to a budget.
“We try to be ‘real world,’” Goldscheider says. “And we do whatever it takes.”
As for Fisher, his self-esteem shot up after he took and passed a community college course in real estate. Then the program’s employment staff helped him find and hold a job. Currently, some 17 percent of members work—good stats for that population.
Begun in 1993 as a demo project within Hopkins Community Psychiatry program at Bayview, the program was a response to a request from the state of Maryland for capitated services for the slip-through-the-cracks group. It hasn’t disappointed. “In addition to meeting our goals to turn peoples’ lives around,” Goldscheider adds, “we’ve saved the state money hand over fist.”
A required independent review each year gives Creative Alternatives highest marks. Success comes from the relationships built with members, Goldscheider says. “We often see if things are wrong before they can themselves. We become family.” Fisher says it best: “I’ve been helped every moment I’ve been here.”