In the reception area of the Ulster County Center for Well Being's Crisis Support Center, the lights are bright. The walls and upholstery are a mix of creamy white and pastel orange, and there's art on the wall. It sort of feels like a hotel lobby. That, according to site director Tanisha Castellanos, is intentional. "We are like the bed and breakfast of mental health," she says. "So we want every guest not to feel like a patient or client, or part of a system that's been broken."
That word - "guest" - is also intentional. Castellanos says People USA, a mental health organization that runs the crisis center on behalf of Ulster County, prides itself on helping people avoid the hospital. They actually have a counter on their website that keeps track of what they call "hospital stays diverted."
At the crisis center, people show up for all sorts of reasons, not all of them medical. Once they sit down in the pastel chairs, a staff member approaches and asks what brought them in. "You know, houselessness, homelessness, food insecurity, loss of job, employment, grief, and loss," Castellanos says. "Sometimes just support in general, feeling overwhelmed, feeling stressed with society, the state of the world, the state of their personal life."
If the person wants to take a shower, they can take one. If they need clothes or shoes, the crisis center has a closet full of them. There are guitars in almost every room, in case the person wants to strum a few chords and mellow out. There's a room with a yoga mat and noise-cancelling headphones, and tapestries on the wall. And for people with more serious needs, there's also rooms where a registered nurse can take vitals and recommend medical intervention.
But, Castellanos adds, a lot of people come in just to talk. "So we do believe in a therapeutic environment, a conducive environment that speaks to our guests, that makes them feel safe, that makes them feel invited. It should give you that feeling of, like, fresh air, you know? Like, 'wow, this is really different.' It's not the question of, 'what is going on with you?' It's, 'what happened to you to get you to this place?'"
In therapy sessions, Castellanos and her team use what's known as a peer-led modality, where therapists often discuss their own lived experiences. "We're able, of course with discretion and wisdom, to self-disclose what we ourselves have been through, or maybe a family member, or people we know and love and respect have been through."
Castellanos herself has done this. She told me a story about a session where she opened up about losing her father. She says the person she was talking to was grateful to have a conversation about a shared experience of real pain, instead of the same old platitudes about how it gets better over time, and grief being natural.
There are a lot of schools of thought when it comes to what works best in therapy. But many therapists subscribe to the belief that they should not disclose their personal lives to people they're working with. When I asked Castellanos about that, she acknowledged that People USA's approach is "non-traditional." But given the amount of people who've visited the crisis center since it opened in January - over 360 by her count - Castellanos says it's clear that traditional therapeutic methods are not addressing people's needs. "It hasn't really worked. It's been around forever, and if it worked, I think stats would look different, and data would look different, just to be brutally honest. So, I think what's important here is that, this being a crisis support center and having therapeutic modalities, it is not your common, 'I'm the therapist behind this desk and you are my client,' you know? It's a different approach altogether. It's a different mindset altogether."
Castellanos spends a lot of her time traveling around the county to meet with police officers. She gives presentations on the types of people who might benefit from People USA's interventions, and encourages officers to bring people here instead of the hospital. "The goal is so that they can use the proper resource for that person, where they can focus on the things that they're really designed to focus on, not so much the mental health. You know, the person that they keep maybe getting calls on, and it's like the same situation, and they're not really sure what to do. They bring them to the hospital, then they come home, and then a week later they're back at the same spot, right? House, or street area where that person might reside - and it's this cycle that no one really knows what to do with. The hope is that us stepping in and them being able to rely on us as a resource can break that cycle."
