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Serious Fun: Virtual Peer Support at CMHC

August 27, 2020
by Lucile Bruce and Clayton Simses, Communications Intern

Ed was having a “10” day.

“I went for a walk this morning and cooked my Cornish hens,” he reported. “I put sunflower seeds in the stuffing. I amazed myself!”

Ed’s “check-in” was part of Connecticut Mental Health Center’s Virtual Peer Support group, an open roundtable for clients held daily at 11am on secure, HIPAA-compliant Zoom. Virtual Peer Support was launched as a response to the COVID-19 pandemic by Rebecca Miller, PhD and her team of Peer Support Specialists at the Center. The group has been going strong since its March 30th debut. From computers, cell phones, and iPads, people in recovery log in to share an hour on-screen that, they say, is helping them cope during quarantine.

The group follows the same ritual every day. First, each participant offers a brief reflection on her or his current situation and rates their personal wellbeing on a 1-10 scale. The day we attended, people reported a number of “firsts.”

One woman would soon cook her first lasagna in years. Another had attended her first in-person doctor’s appointment since COVID began (it went well). Another had just talked to her sister in Florida—their first conversation in several years.

As they listened, group members chimed in with good wishes, relishing the tangible details of others’ lives and expressing unequivocal support.

The COVID-19 pandemic caused an abrupt change to clinical services at Connecticut Mental Health Center (CMHC), the public mental health center in New Haven serving over 4,000 clients with serious mental health challenges. Although the Center has not closed during the pandemic, it rapidly transformed services to meet the moment. Connecticut’s governor declared a state of emergency, and all in-person therapeutic groups and recreational activities were cancelled. Many staff members began to work remotely. CMHC’s bustling cafeteria, hallways, and meeting rooms fell into an eerie quiet.

The cancellations were OK with the clients attending Virtual Peer Support—they felt safer staying home. But some said they lost the community and routines that boost their mental health. Feelings of isolation and depression began to creep in.

For Ed, “It was like living in a cave.”

“It turned me upside down,” noted another Virtual Peer Support participant, who said that ordinarily, she likes to keep busy but found her schedule entirely disrupted. “I’ve been joining every day,” she said of the group. “It helps me keep my mind off things.”

Others said joining Virtual Peer Support provides just the right amount of human contact to fuel their natural introversion. “I talk to my family over the phone,” said one participant, describing her day. “I’m reading and doing lots of things. It’s not that bad, it just gets boring after a while.”

After checking in, the group turned to an open forum. They discussed the ins-and-outs of tele-mental health at CMHC (“It’s working out, but once in a while we have technical issues”). They shared information about the community: is the Wooster Square Farmer’s Market open? (Yes, with virus prevention strategies in place.) Do they still take food stamps? (Yes.)

Peer Support staff member Serena Spruill shared her twice-daily practice of self-affirmation. “You say positive statements and invoke positive things,” she explained, “and when you say them, they basically come true. ‘I am strong.’ ‘I am healthy.’ ‘I am courageous.’ Say the kinds of things you want in your life, and they actually come to pass.”

“It’s amazing to see how with video and even just audio, you can build a connection,” noted Rebecca Miller, PhD, CMHC’s director of peer support, Associate Professor of Psychiatry at Yale, and convener of the Virtual Peer Support Group. We talked with Dr. Miller outside the daily meeting to learn more about the “why” and “how” of Virtual Peer Support.

During non-pandemic times, peer support staff at CMHC lead groups on their own at the CMHC building, but Miller said she decided to co-facilitate this one with staff.

“I joined to support doing group facilitation and to move those skills online,” she explained. “In the beginning of the pandemic, everyone was so stressed out. I wanted to be there so people would feel more comfortable.” Also, she added, from a technical perspective, they needed to use her secure Zoom account.

Peer support—those with "lived experience" supporting others—is a key aspect of recovery-oriented care. Peers occupy a special place in the CMHC workforce. As people in recovery with lived experience of mental illness, they share their expertise with others. Their role is a growing trend in mental health services, although it has been part of the substance use community for decades. Knowing that "you are not alone" and that others have made it through provides a kind of hope that's important for people facing tough times, including a pandemic.

To foster the person-to-person connection, Miller said she prefers for participants to join Virtual Peer Support by camera if possible. Since the group started, they’ve learned a lot about “Zoom etiquette.” Working together, trial and error, they have figured out how to relate on-screen. Miller said the ideal number of people is 8-10; any more than that, and the conversation becomes more difficult to track.

“We keep to a structured frame,” she emphasized, “and that is helpful.”

During the open discussion part of the meeting, we asked people what the group meant to them.

“We have to learn that we can’t change the things we can’t change,” one noted, “but we can change other things. We can’t change COVID, but when we attend this group, we can change things.”

“We’re all going through the same thing,” another noted. “After one session, we feel a part of something. We’re not alone anymore.”

“There’s a lot of laughter in this group,” said peer support specialist Bob Forlano, “especially at my bad jokes, which I very much appreciate.”

Several said the group poem, created by speaking in turns, is always a highlight.

“We each say a line,” one member explained, “then listen, and sometimes laugh. It’s so funny sometimes!"

“Whatever it is, it always comes together,” said another of their poetry-making process. “It always works. No matter how stupid it is, no matter what—it always turns out to be perfect.”

On the spot, they made a poem:

Don’t belittle me.

Don’t be afraid.

As I look in the sky

I praise with joy.

Listening to the sound of the birds

Seeing deer

I’m seeing many more animals these days

And the chipmunks are my personal favorite

We have bunny rabbits too

Together we’re home.

It was getting toward 12 noon—almost time to close. “What’s one thing you’re going to do today that will bring you joy?” Miller asked, sticking with the frame.

The answers sounded like poetry, too: Read. Sit on my porch. Make myself something to eat. Play my guitar. Take care of my garden. See a friend. Go outside in the sun and pretend I’m at the beach. Peel sweet potatoes for my grandson.

Now it was time to say goodbye. Instead of melancholy farewells, Miller offered a musical send-off, the same she uses every time: Baha Men’s classic “Who Let the Dogs Out,” guaranteed to bring enormous smiles.

And with that, and everything that came before, Virtual Peer Support offered its daily online proof that sometimes, the best medicine is serious fun.

Submitted by Lucile Bruce on August 26, 2020